血清高敏C反应蛋白与代谢综合征关系的横断面研究

Relation between serum high sensitivity C-reactive protein and metabolic syndrome

目的分析高敏C反应蛋白(hs-CRP)与代谢综合征(MS)的关系。方法选择北京社区居民1680例,MS根据修订的美国国家胆固醇教育计划成人治疗指南3定义。MS患者655例,无MS患者1025例。采用多因素logistic回归分析MS发病危险,应用ROC曲线评价hs-CRP诊断MS的价值。结果校正性别、年龄后,MS患者hs-CRP明显高于非MS患者(P<0.01)。随着MS成分由0增加至4～5个,hs-CRP逐渐升高为1.89、2.01、2.23、2.49和2.56mg/L(线性趋势P=0.002)。MS 5个组分表现为腹型肥胖、高TG血症和低HDL-C者,hs-CRP相对较高。校正年龄、性别、肌酐、估算肾小球滤过率、LDL-C、血尿酸、吸烟、饮酒、运动等因素后,与hs-CRPⅠ比较,hs-CRPⅡ、Ⅲ、Ⅳ的MS发生风险分别为(OR=1.378,95%CI:1.012～1.876,P<0.05;OR=1.875,95%CI:1.382～2.545,P<0.01;OR=2.318,95%CI:1.594～2.904,P<0.01)。应用ROC诊断MS的hs-CRP最佳截断点为2.15mg/L,敏感性和特异性分别为62.9%和51.3%。ROC曲线下面积为0.585(95%CI:0.557～0.613)。结论高hs-CRP可能是MS发生的相关因素,hs-CRP对MS有一定的诊断价值。

Objective To study the relation between serum high sensitivity C-reactive protein （hs-CRP） and metabolic syndrome（MS）. Methods A total of 1680 residents（655 MS patients and 1025 non-MS patients） in a Beijing community were enrolled in this study. MS was defined according to the updated NCEP-ATP Ⅲ criteria. Risk of MS was analyzed by multivariate logistic regression analysis. The value of hs-CRP in diagnosis of MS was assessed according to the receiver operating characteristic（ROC） curve. Results The hs-CRP level was significantly higher in MS patients than in non-MS patients after adjustment of their gender and age（P^0.01）. The hs-CRP level was relatively higher in those with abdominal obesity, hypertriglyceridemia and low HDL-C. Multiple logistic regression analysis revealed that the risk of MS in those with hs-CRP Ⅱ ,Ⅲ and Ⅳ was 1. 378（95%CI：1. 012-1. 876,P〈0.05） ,1. 875（95%CI.1. 382-2. 545,P〈0.01） ,2. 318 （95% CI. 1. 594 - 2. 904, P〈0. 01）, respectively, after adjustment of age, gender, creatinine, eGFR, LDL-C, uric acid, smoke, drink and exercise. The optimal hs-CRP cutoff point for the diagnosis of MS according to the ROC curve was 2.15mg/L with a sensitivity of 62.9% and a specificity of 51.3%. The area under the ROC curve was 0. 585（95%CI：0. 557-0. 613）. Conclusion hs-CRP level is a factor for MS and is of certain value for the diagnosis of MS.