ApoB/ApoA1比值和hs-CRP与胰岛素抵抗的相关性研究

Comparison of the associations of ApoB/ApoA1 ratio and high-sensitive C-reactive protein with insulin resistance

目的：比较载脂蛋白B（Apolipoprotein B,ApoB）/载脂蛋白A1（Apolipoprotein A1,ApoA1）比值（ApoB/ApoA1比值）和超敏C反应蛋白（High sensitive C-reactive protein,hs-CRP）与胰岛素抵抗（Insulin resistance,IR）的相关性。方法：纳入426例非糖尿病个体,测定体重、身高、血压、腰围、空腹血浆葡萄糖（Fasting plasma glucose,FPG）、血清胰岛素（Fasting insulin,Fins）、血脂和hs-CRP等,计算IR指数（HOMA-IR）,并以HOMA-IR上四分位为切点分为IR组与非IR组。结果：IR人群ApoB/ApoA1比值和hs-CRP较非IR人群有显著差异（P〈0.01）。校正性别、年龄和腰围后,线性回归分析发现ApoB/ApoA1比值仍是HOMA-IR的主要影响因素[B（95%CI）：0.27（0.06~0.48）,P=0.013];而hs-CRP与HOMA-IR的关系无统计学意义。控制性别、年龄后,高ApoB/ApoA1比值人群发生IR的危险较低ApoB/ApoA1比值人群增加2.17倍[OR（95%CI）：2.17（1.33~3.54）,P=0.002],而高hs-CRP人群发生IR的危险较低hs-CRP人群增加1.78倍[OR（95%CI）：1.78（1.09-2.92）,P=0.021]。结论：在非糖尿病人群中,与hs-CRP相比,ApoB/ApoA1比值是更好的IR预测指标。

Objective：To compare the associations of Apolipoprotein B/Apolipoprotein A1 ratio（ApoB/ApoA1 ratio） and high sensitive C-reactive protein（hs-CRP） with insulin resistance（IR）.Methods：426 non-diabetes Chinese were recruited.Weight,height,blood pressure,waist circumference,fasting plasma glucose（FPG）,fasting serum insulin（Fins）,blood lipids and hs-CRP were measured.HOMA index（HOMA-IR） was calculated.IR was defined as the upper quartile of HOMA-IR.Results：ApoB/ApoA1 ratio and hs-CRP were significantly higher in subjects with IR compared with subjects without（P0.01）.After adjustment for age,gender and waist circumference,line regression analysis found that ApoB/ApoA1 ratio was still the main influence factor of HOMA-IR [B（95%CI）：0.27（0.06-0.48）,P=0.013];However,the partial regression coefficient of hs-CRP and HOMA-IR was no longer statistically significant.Compared to the subjects with low ApoB/ApoA1 ratio,those with high ApoB/ApoA1 ratio were 2.17 [OR（95%CI）：2.17（1.33-3.54）,P=0.002] times more likely to be with IR;and Compared to the subjects with low hs-CRP,those with high hs-CRP were [OR（95%CI）：1.78（1.09-2.92）,P=0.021] times more likely to be with IR.Conclusion：compared with hs-CRP,ApoB/ApoA1 ratio might be a better marker of IR in non-diabetic Chinese population.