上海市某社区居民糖代谢异常与血清C-反应蛋白的相关性

Cross-Sectional Study on Association of Serum C-Reactive Protein Levels with Abnormal Glucose Metabolism in Residents of a Community in Shanghai

[目的]了解上海市浦东新区某社区居民的糖代谢异常状况，探讨糖代谢异常与血清C-反应蛋白（CRP）的关系。[方法]2009年采取二阶段随机抽样方法，在某社区抽取1317名居住满5年及以上的35—74岁社区居民进行横断面调查，包括问卷调查、体格检查和生化指标检测。数据的单因素分析采用Kruskal-Wallis H非参数检验和卡方检验；多因素分析采用多项logistic模型。[结果]该社区居民糖尿病患病率为12．45％，糖调节受损患病率为12．68％；糖尿病患病率随着年龄的增高而增高（趋势χ^2=48．53，P〈0．001）。调整年龄、高血压、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、三酰甘油后，女性居民中CRP≥3mg／L者糖尿病和糖调节受损患病风险分别是CRP〈1mg／L者的2．510倍（95％CI：1．263—4．987）和4．335倍（95％CI：2．299—8．172）；进一步调整体质指数（BMI）后，CRP≥3mg／L者糖尿病和糖调节受损患病风险分别是CRP〈1mg／L者的1．972倍（95％CI：0．972—4．000）和3．929倍（95％CI：2．055～7．510）。男性居民中糖代谢异常与不同CRP水平的关联性无统计学意义。[结论]该社区居民中糖代谢异常与不同CRP水平的关联仅存在于女性社区居民中；调整BMI后糖调节受损与不同CRP水平的关联性减弱，而与糖尿病间的关联性无统计学意义。

[ Objective ] To evaluate abnormal glucose metabolism among residents of a community in Pudong New Area in Shanghai, and to study its association with serum C-reactive protein （CRP） levels. [ Methods ] By two-stage cluster randomized sampling, 1 317 community residents aged 35 to 74 years who had lived for at least five years in Gaoqiao Town were selected in 2009. A structured questionnaire was used for interview, and physical examination and biochemical assays were also conducted. Non-parametric Kruskal-Wallis H test, chi-square test, and muhinomial logistic model were employed for statistical analysis. [ Results ] The prevalence of diabetes among the selected residents was 12.45%, which was increased with age, and the prevalence of impaired glucose regulation was 12.68%. After adjusted for age, hypertension, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides, the odds ratios for diabetes and impaired glucose regulation in the female residents with CRP ≥ 3mg/L were 2.510 （95%CI： 1.263-4.987） and 4.335 （95%CI： 2.299-8.172）, respectively, with CRP〈1 mg/L in the female residents as reference. After further adjusted for body mass index （BMI）, the odds ratios were 1.972 （95%CI： 0.972-4.000） and 3.929 （95%CI： 2.055-7.510）, respectively, for diabetes and impaired glucose regulation. But the similar association between CRP levels and glycemic status was not found statistically significant in the male residents. [ Conclusion ] The association between different CRP levels and impaired glucose regulation only exist in the selected female residents. After adjusting BMI, the association of different CRP levels with impaired glucose regulation is attenuated, and its association with diabetes is no statistically significant.