高敏C反应蛋白与代谢综合征患者颈动脉粥样硬化的关系

目的探讨高敏C反应蛋白(hs-CRP)与代谢综合征(MS)及其颈动脉粥样硬化的关系。方法88例研究对象MS诊断标准分为MS组44例、亚MS组23例以及对照组21例。应用酶联免疫吸附法检测血清hs-CRP水平,多普勒超声测定受试者颈总动脉(CCA)内膜-中层厚度(IMT),并观察颈动脉斑块的有无。结果(1)与对照组比较,MS组血清hs-CRP水平显著升高(P<0.01)。随着MS代谢组分的增多,血清hs-CRP水平逐渐升高;(2)与对照组及MS亚组比较,MS组CCA-IMT明显增厚(P<0.05);(3)血清hs-CRP与体质量指数、腰臀比以及稳态模型胰岛素抵抗指数呈显著正相关,与高密度脂蛋白胆固醇(HDL-C)呈显著负相关(P<0.05);(4)颈动脉IMT增厚组(IMT≥0.9mm)血清hs-CRP水平显著高于颈动脉IMT正常组(IMT<0.9mm)(P<0.05),有颈动脉粥样斑块组hs-CRP水平明显高于无斑块组(P<0.05)。(5)hs-CRP是IMT的独立影响因素(P<0.05)。结论血清hs-CRP水平与MS代谢组分及其数量密切相关,血清hs-CRP水平增高是MS发病的危险因素。血清CRP水平升高可能参与了MS患者颈动脉粥样硬化的进程。

Study on the relationship between high-sensitivity C-reactive protein and carotid atherosclerosis in the patients with metabolic syndrome

Objective To explore the relationship between high-sensitivity C-reactive protein （hs-CRP） and carotid atherosclerosis in the patients with metabolic syndrome （MS）. Methods According to the standard of MS from Chinese Diabetes Society in 2004,88 patients were enrolled and divided into three groups, as follow：MS group with three to four components （ n = 44）, inferior MS group with one to two components （ n = 23 ） and control group （ n = 21 ）. The level of serum hs-CRP was detected by the enzyme linked immunosorbent assay （ ELISA）. Carotid intimamedia thickness （IMT） and carotid atherosclerotic plagues were assessed by the color Doppler ultrasound. Results （ 1 ） Serum hs-CRP level was significantly higher in MS group, compared with that in control group （ P 〈 0. O1 ）. Increasing MS components leaded to higher level of serum hs-CRP. （2） The patients in MS group had thicker IMT than those in the other two groups （ P 〈 0.05 ）. （3） Correlation analysis indicated that sermn hs-CRP level was positively correlated with BMI, WHR and HOMA-IR, and negatively correlated with high density lipoprotein cholesterol （ P 〈 0.05）. （4） The level of serum hs-CRP was significantly higher in patients with thicker carotid IMT （IMT≥ 0.9 mm） ,compared with those with normal carotid IMT （IMT 〈 0.9 mm） （P 〈 0.05 ）. The patients with carotid plagues had higher serum bs-CRP level than those without carotid plagues （P 〈 0.05 ）. （5） Multiple linear regression analysis showed that the level of serum hs-CRP had significant influence on the carotid IMT （ P 〈 O. 05 ）. Conclusions Serum hs-CRP level is closely correlated to the components and quantity of MS. The elevated hs-CRP level may be one of bio-markers of MS. High level of serum CRP could involve in the progress of carotid atherosclerosis.