2型糖尿病患者血超敏C反应蛋白和微血管并发症的关系

目的分析2型糖尿病患者各种微血管并发症和血超敏C反应蛋白(hsCRP)的关系。方法以2003年5月至2006年6月北京协和医院内分泌科321例2型糖尿病住院患者为研究对象。根据尿白蛋白排泄率(UAER)分为无肾病组(UAER<20μg/min)213例,早期肾病组(20μg/min≤UAER<200μg/min)62例和临床肾病组(UAER≥200μg/min)46例;根据眼底镜检查分为无糖尿病视网膜病变组238例、有糖尿病视网膜病变组83例;根据肌电图检查分为无糖尿病神经病变组255例和有糖尿病神经病变组66例。观察3种并发症中各组hsCRP的变化。结果只有糖尿病肾病和血hsCRP相关,hsCRP随尿白蛋白的增加而升高。Pearson相关分析显示,hsCRP与UAER(r=0.448,P=0.002)、三酰甘油(r=0.385,P=0.008)及体重指数(r=0.261,P=0.004)呈正相关。逐步线性回归表明,UAER、三酰甘油、体重指数是影响hsCRP的主要因素。结论hsCRP与糖尿病肾病相关,其水平与糖尿病肾病的程度具有一致性。

Relationship of serum high sensitivity C-reactive protein with microvascular complications in type 2 diabetes

Objective To evaluate whether high sensitivity C-reactive protein is associated with microvascular complications in patients with type 2 diabetes mellitus.Methods A total of 321 patients with type 2 diabetes mellitus were recruited.According to the results of 8 h urine albumin excretion rate,ophthalmoscope examination and nerve conduction velocity test,nephropathy,retinopathy and neuropathy were defined respectively.To evaluate differences of the serum hsCRP levels of those with and without nephropathy,retinopathy and neuropathy.Results Only diabetic nephropathy correlated with the serum hsCRP level.With increment of urine albumin excretion rate,hsCRP level was increased.Pearson correlation analysis indicated that hsCRP correlated positively with urine albumin excretion rate(r=0.448,P=0.002),triglyceride(r=0.385,P=0.008),and body mass index(r=0.261,P=0.004).Stepwise linear regression showed that hsCRP and UAER,TG and BMI existed linear correlation.Conclusion hsCRP is associated with diabetic nephropathy and its level is correlated with the degree of diabetic nephropathy.