C-肽释放试验与hs-CRP在2型糖尿病中的应用

C-Peptide Release Test and The hs-CRP Application in Type 2 Diabetes Mellitus

目的探讨C-肽释放试验与高敏C反应蛋白(hs-CRP)联合检测对2型糖尿病患者β细胞功能受损的应用价值。方法采用随机抽样法选取35例正常自愿受试者作为对照组,185例符合临床诊断标准的2型糖尿病患者进行对比观察其C-肽释放试验与hs-CRP的变化,并依据2型糖尿病患者的身体质量指数、空腹血糖水平、糖化血红蛋白含量的不同分为低危组(87例)、中危组(51例)、高危组(47例),经数据处理后,比较分析其危险度水平。结果患者组全组hs-CRP水平明显高于对照组水平,空腹血糖、糖化血红蛋白与hs-CRP呈明显正相关,而空腹血糖、糖化血红蛋与C-肽释放试验呈明显负相关。整合上述指标将β细胞受损状况分为低危、中危和高危水平。低危患者组hs-CRP均数为(1.20±0.26)mg/L[95%置信区间0.9～1.55mg/L];中危患者组(3.30±0.97)mg/L[95%置信区间2.1～4.5 mg/L]:高危患者组(5.7±1.46)mg/L[95%置信区间4.5～6.8 mg/L],与对照组(0.64±0.13)mg/L[95%置信区间0.43～0.75 mg/L]相比差异有统计学意义(P<0.05)。结论高敏C反应蛋白结合C-肽释放试验,可有效判定2型糖尿病的危险度水平,前者可反映2型糖尿病的亚临床、慢性、全身性的低度炎症水平,后者可直接反映胰岛β细胞的分泌状态。

Objective The research is to explore the application value on type 2 diabetes mellitus suferers whose β cells are dysfunctional through the joint medical testing of both C-peptide release and hs-CRP. Methods The C-peptide release test and hs-CRP were compared in 185 patients with type 2 diabetes who met the criteria of clinical diagnosis, and 35 normal volunteers were selected by random sampling as control group. According to the body mass index, fasting blood sugar level, and glycated hemoglobin content of patients with type 2 diabetes, they were divided into low-risk groups （87 cases）, medium-risk groups （51 cases）, and high-risk groups （47 cases）. After data processing, its risk level was analyzed. Results The hs-CRP level of the whole group was significantly higher than that of the control group, fasting blood sugar and glycosylated hemoglobin were positively correlated with hs-CRP, while fasting blood sugar and glycosylated hemoglobin were significantly negatively correlated with C-peptide release test. Combining the above indicators, the damage status of beta cells was divided into low risk,middle risk and high risk level. The hs-CRP average of low-risk patients was （1.20 ± 0.26） mg/L[ 95 % confdence interval 0.9-1.55 mg / L]; Middle-risk patients was （3.30 ± 0.97） mg / L[ 95 % confdence interval 2.1-4.5 mg/L]; High-risk patients was （5.70 ± 1.46） mg/L[ 95 % confidence interval 4.5-6.8 mg / L] , with control group （0.64 ± 0.13）mg/L[ 95 % confdence interval 0.43-0.75 mg / L] The difference was statistically significant （P 〈 0.05）. Conclusion The high-sensitivity C-reactive protein binding C-peptide release test can efectively determine the risk level of type 2 diabetes. The former can refect the sub-clinical, chronic, systemic low infammation level of type 2 diabetes, andthe latter can directly refect the secretion status of islet beta cells.