2型糖尿病患者颈动脉内膜中层厚度与血清超敏C-反应蛋白及胰岛素抵抗危险因素的关系

Relationship of Carotid Intima-media Thickness with Serum High Sensitive C-reactive Protein and Insulin Resistance Risk Factors in Type 2 Diabetes Mellitus

目的观察2型糖尿病(T2DM)患者颈动脉内膜中层厚度(IMT)与血清超敏C-反应蛋白(hs-CRP)及胰岛素抵抗相关危险因素的关系。方法92例2型糖尿病患者根据是否伴有大血管病变分为两组,A组48例伴大血管病变,B组44例无大血管病变,分别测定两组患者的平均颈动脉IMT、hs-CRP、胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)及血脂,并进行比较,分析平均颈动脉IMT与hs-CRP及胰岛素抵抗危险因素的相关性。结果两组患者平均颈动脉IMT、hs-CRP、TC、LDL-C、HDL-C、HOMA-IR及BMI的均值间差别均有显著性意义(均P<0·05)。两组患者颈动脉IMT与hs-CRP、TC、LDL-C、HOMA-IR及BMI均相关,IMT与hs-CRP独立相关;另外,A组患者平均颈动脉IMT与HbA1c相关。结论T2DM患者的hs-CRP、血脂、血糖水平、HOMA-IR、BMI在动脉粥样硬化发生中有不同程度的作用。

Objective To evaluate the relationship of carotid intima - media thickness （IMT） with risk factors of insulin resistance and serum hs - CRP level in type 2 diabetic subjects. Methods Carotid IMT by ultrosonography and serum hs - CRP level were measured for 92 patients of type 2 diabetes （ group A of 48 subjects with atherosclerosis, group B of 44 subjects without atherosclerosis）, their BMI, HbA1c, plasma lipids and insulin resistance index （ HOMA - IR） were also measured and analyzed. Results In group A mean carotid IMT and hs - CRP level HOMA - IR, BMI, TC, LDL - C were higher than group B, HDL - C was lower than group B. Carotid IMT was correlated with hs - CRP, TC, LDL - C, HOMA - IR, BMI; IMT was also related with HbA1c in Group A. There was statistical significance in the above data analysis. Conclusion The carotid IMT in T2DM is associated with serum hs -CRP and insulin resistance risk factors, which contribute to atherosclerosis at different degrees.