慢性精神分裂症患者胰岛素抵抗水平与血浆超敏C反应蛋白的关系

The relationship between insulin resistance and plasma hs-CRP in patients with chronic schizophrenia

目的探讨慢性精神分裂症患者胰岛素抵抗及与血浆超敏反应蛋白(hypersensitive reactive protein,hs-CRP)之间的关系。方法2018年5~12月纳入247例慢性精神分裂症住院患者(患者组)与166例正常对照(对照组),收集一般社会人口学以及临床资料,检测空腹血糖、hs-CRP、C肽、胰岛素指标,计算胰岛素抵抗指数(HOMA-IR)。用Mann-Whitney U检验比较患者组与对照组胰岛素抵抗水平,用Spearman相关分析患者胰岛素抵抗与hs-CRP的关系。结果(1)患者组C肽[2.53(2.06,3.23)ng/ml]、胰岛素[(7.68(4.66,11.97))μIU/ml]、HOMA-IR[1.75(1.09,3.07)]均明显高于对照组[C肽:2.24(1.89,2.87)ng/ml,胰岛素:7.02(4.31,9.59)μIU/ml,HOMA-IR:1.57(0.97,2.22)](P<0.05);(2)高hs-CRP组患者的HOMA-IR[1.91(1.21,3.74)]高于低hs-CRP组[1.70(1.02,2.72)](P<0.05);(3)相关分析发现患者组的HOMA-IR与血浆hs-CRP水平呈正相关(r=0.139,P<0.05);(4)相关变量经对数转换后,多因素线性回归分析显示HOMA-IR与hs-CRP水平、体重指数存在线性相关。结论慢性精神分裂症患者hs-CRP水平对胰岛素抵抗有正向预测作用,监测精神分裂症患者的hs-CRP有利于评估胰岛素抵抗相关代谢风险状况。

Objective To explore the relationship between insulin resistance and plasma hypersensitive reactive protein (hs-CRP) in patients with chronic schizophrenia. Methods A total of 247 inpatients with chronic schizophrenia (patient group) and 166 cases of normal individuals(control group) were enrolled.Their general demographic and clinical data were collected, fasting blood glucose, hs-CRP, c-peptide and insulin indexes were tested, and insulin resistance index (HOMA-IR) was calculated.The insulin resistance level of the patients group and the control group was compared by Mann-Whitney U test, and the relationship between insulin-resistance and hs-CRP in patients group was analyzed using Spearman correlation analysis. Results (1)The levels of C-peptide (2.53(2.06, 3.23)ng/ml vs 2.24(1.89, 2.87)ng/ml), insulin (7.68(4.66, 11.97)μIU/ml vs 7.02(4.31, 9.59)μIU/ml) and HOMA-IR (1.75(1.09, 3.07) vs 1.57(0.97, 2.22)) in the patient group were significantly higher than those in the control group(all P<0.05).(2) The levels of HOMA-IR( 1.91(1.21, 3.74) vs 1.70(1.02, 2.72)) in patients with high hs-CRP(≥3 mg/L) was higher than those in the patients with low hs-CRP(<3 mg/L)(P<0.05).(3)Spearman correlation analysis showed that HOMA-IR was positively correlated with plasma hs-CRP level in the patient group (r=0.139, P<0.05).(4)After logarithmic transformation of related variables, multivariate linear regression analysis showed that HOMA-IR was linearly correlated with hs-CRP level and boy weight index. Conclusion The hs-CRP level in chronic schizophrenia has a positive predictive effect on insulin resistance.Detection of hs-CRP level in schizophrenic patients is helpful to assess metabolic risk of insulin.