糖耐量减低人群血清C反应蛋白、白介素6、肿瘤坏死因子α及瘦素水平变化及其相关因素研究

Changes of Serum Levels of CRP,IL- 6,TNF- α and Leptin in Crowd with Impaired Glucose Tolerance and Its Related Factors

目的探讨糖耐量减轻人群血清C反应蛋白(CRP)、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)及瘦素水平变化及其相关因素。方法 2005年6月在四川省南充市顺庆区医学街社区募集符合条件的健康志愿者82例,其中糖耐量减低者27例(糖耐量减低组)、糖耐量正常者55例(正常对照组)。常规测量所有志愿者血压、体质量、身高、腰围、臀围,计算体质指数(BMI)、腰臀比,抽取空腹静脉血检测其空腹血糖、餐后2 h血糖、血脂、空腹胰岛素、C肽、CRP、IL-6、TNF-α及瘦素,采用稳态模型计算胰岛素抵抗指数(HOMA-IR)。结果糖耐量减低组志愿者年龄、BMI、收缩压、腰臀比、空腹血糖、餐后2 h血糖、TC、TG、LDL-C、空腹胰岛素、C肽、HOMA-IR、CRP及瘦素均高于正常对照组(P<0.05);两组志愿者性别、舒张压、HDL-C、IL-6及TNF-α比较,差异无统计学意义(P>0.05)。Pearson相关分析结果显示,糖耐量减低人群血清瘦素水平与血清TC水平(r=0.561,P=0.003)、HOMA-IR(r=0.435,P=0.016)呈正相关,血清CRP水平与HOMA-IR(r=0.578,P=0.002)呈正相关,血清IL-6、TNF-α水平与其他指标间无直线相关性(P>0.05)。多元线性回归分析结果显示,以瘦素为因变量时,TC和HOMA-IR进入回归方程;以CRP为因变量时,HOMA-IR进入回归方程。结论糖耐量减低人群血清CRP、瘦素水平升高,并与胰岛素抵抗有关。

Objective To investigate the serum levels of CRP , IL-6, TNF-αand leptin in crowd with impaired glucose tolerance （IGT） and its related factors.Methods In June 2005, 82 healthy volunteers were enrolled and divided into IGT group （n=27） and normal glucose tolerance （NGT） group （n=55） .Blood pressure, weight, height, waistline and hipline were measured, and BMI, WHR calculated; FBG, 2 h -BG, blood liquid, FINS, C -peptide, CRP, IL -6, TNF-αand leptin detected, and HOMA-IR calculated.Results Age, BMI, SBP, WHR, FBG, 2 h -BG, TC, TG, LDL-C, FINS, C-peptide, HOMA-IR, CRP and leptin of IGT group were higher than those of NGT group （P〈0.05）. There was no significant differences of gender SDP , HDL-C, IL-6 and TNF-αbetween the two groups （P〉0.05）.Pear-son correlation analysis showed that, serum leptin level was positively correlated with serum TC level （r=0.561, P=0.003） and HOMA-IR （r=0.435, P=0.016）, and serum CRP level was positively correlated with HOMA-IR （r=0.578, P=0.002）, no correlations was found between serum IL -6, TNF-αlevels and other index.Multiple linear regression analysis showed that , when take leptin as dependent variable , TC and HOMA-IR entered the regression equation; when take CRP as dependent variable , HOMA-IR entered the regression equation .Conclusion Serum levels of leptin and CRP are higher in crowd with IGT, and are correlated with insulin resistance .