2型糖尿病及代谢综合征患者血清超敏C反应蛋白水平与胰岛素抵抗的关系

The serum level of high sensitive C-reactive protein and the risistance of insulin in patients with metablolic syndrome and type 2 diabetes mellitus

目的:探讨2型糖尿病(T2DM)及代谢综合征(MS)患者超敏C反应蛋白(hs-CRP)与机体胰岛素敏感度、胰岛素分泌功能的关系。方法:选择2004年1月至2007年8月清远市人民医院内分泌科病房及门诊T2DM患者280例,其中合并MS156例(T2DM并MS组),未合并MS124例(T2DM非MS组),中老年健康体检者(对照组)40例,比较其血清hs-CRP、血脂、糖化血红蛋白、空腹血糖、空腹胰岛素等水平并进行各指标之间的相关分析,并计算稳态模型胰岛素抵抗指数(HOMA-IR)和胰岛素分泌指数,以反映胰岛素敏感度和胰岛细胞功能。结果:T2DM并MS组患者血清hs-CRP水平和HOMA-IR明显高于T2DM非MS组及对照组(P<0.01)。线性相关分析显示,T2DM患者hs-CRP水平与体重指数、收缩压、舒张压、低密度脂蛋白胆固醇、HOMA-IR均呈正相关(P<0.05或P<0.01)。结论:hs-CRP水平与T2DM胰岛素抵抗及MS密切相关,对于T2DM及MS除控制血糖、血脂、体重指数外,降低炎症反应应成为综合治疗的重要部分。

Objective To explore the relationship between sensitive C-reactive protein （hs-CRP） and insulin sensitivity and insulin secretion function in patients with type 2 diabetes mellitus （T2DM） and patients with type 2 diabetes and metablolic syndrome（MS）. Methods 280 patients with T2DM were divided to two groups, 156 with MS and 124 without MS. 40 healthy persons were in normal control group. Serum levels of hs-CRP, lipid, HbA1C, limosis blood sugar and insulin level, body mass index and blood pressure were compared among the groups and their correlation were analysed. HOMA-IR and HOMA-IS was calculated. Results The serum level of hs-CRP and HOMA-IR were significantly higher in T2DM with MS group than without MS group and normal control group （P 〈 0.01 ）. The correlation anlalysis showed that the level of hs-CRP was positively correlated with body mass index, systolic blood pressure, dialasitic blood pressure, LDL-C, HOMA-IR （P 〈 0.05 or P 〈 0.01 ）. Conclusion hs-CRP is closely related with insulin resistance and metablolic syndrome in T2DM and MS.