单纯性肥胖成人血清高敏C反应蛋白、血脂水平与胰岛素抵抗的相关性研究

Relationship between insulin resistance and serum high sensitivity C-reactive protein,blood lipids level in adult with simple obesity

目的探讨单纯性肥胖成人血清高敏C反应蛋白(hs-CRP)、血脂水平与胰岛素抵抗(IR)的关系。方法选择单纯性肥胖成人99例[按体质量指数(BMI)分为i度肥胖组46例,ii度肥胖组38例,iii度肥胖组15例],单纯性超重成人56例及健康成人80例。测定所有入选对象的身高、体质量、腰围、臀围、空腹血糖(FBG)、空腹胰岛素(FIN)、血脂、hs-CRP水平,并计算胰岛素抵抗指数(HOMA-IR)、BMI及腰臀比(WHR)。结果 hs-CRP、HOMA-IR、FBG、FIN、TG、TC、LDL-C、脂肪肝发生率随着BMI的升高呈逐渐升高趋势,HDL-C则呈现逐渐降低趋势。血清hs-CRP与BMI、WHR、FIN、HOMA-IR、TG呈显著正相关(P<0.05～P<0.01),与HDL-C呈显著负相关(P<0.01),多元逐步回归分析提示,BMI、HOMA-IR、HDL-C是影响hs-CRP的独立危险因素。结论单纯性肥胖成人存在IR,炎性因子hs-CRP的过量表达参与并加重单纯性肥胖成人IR、血脂紊乱的发生和发展。

Objective To explore the relationship between insulin resistance（IR） and serum high sensitivity C-reactive protein（hs-CRP）,blood lipids level in adults with simple obesity.Methods Ninety nine adults with simple obesity were divided into 3 groups according to body mass index（BMI）,including forty six cases in i degree obesity group,thirty eight cases in ii degree obesity group and fifteen in iii degree obesity group,and fifty six adults with simple overweight and eighty healthy adults were also enrolled.All selected cases were measured for height,body weight,waistline,hip circumference,fasting blood glucose（FBG）,fasting insulin（FIN）,blood lipids and hs-CRP.IR index（HOMA-IR）,BMI and waist-hip-ratio（WHR） were calculated.Results When BMI increased,levels of hs-CRP,HOMA-IR,FBG,FIN,triglyceride（TG）,cholesterol（TC）,low density lipoprotein-cholesterol（LDL-C） and incidence of fatty liver were gradually increased.However,high density lipoprotein-cholesterol（HDL-C） was gradually degraded.Hs-CRP was significantly positively correlated with BMI,WHR,FIN,HOMA-IR and TG（P〈0.05 or P〈0.01）,and significantly negatively correlated with HDL-C（P〈0.01）.Multiple stepwise regression analysis indicated that BMI,HOMA-IR and HDL-C were independent risk factors influencing hs-CRP.Conclusion The overexpression of inflammatory factor hs-CRP might participate and aggravate the occurrence and development of IR and lipid disorders in adults with simple obesity.