2型糖尿病患者血清超灵敏C反应蛋白水平的检测

摘要/Abstract

摘要： 目的探讨2型糖尿病患者血清超灵敏C反应蛋白(hs-CRP)水平与机体胰岛素敏感性的关系。方法运用高灵敏酶联免疫吸附法检测68例2型糖尿病患者和20名健康对照者的血清hs-CRP水平,同时检测血糖、血清胰岛素、糖基化血红蛋白(HbAlc)、尿白蛋白排泌率和血脂,并计算稳态模型胰岛素抵抗指数(HOMA-IR指数)和胰岛B细胞分泌指数(HOMA-IS)以分别反映机体的胰岛素敏感性和胰岛素分泌功能。结果 2型糖尿病患者的血清hs-CRP水平显著高于对照(P<0.01),HOMA-IR指数和HOM-IS指数均低于正常对照(P<0.01)。进一步将患者按HbAlc分为血糖控制良好组(n=42)和血糖控制欠佳组(n=23)后发现,控制欠佳组的血清hs-CRP水平显著高于控制良好组(P<0.05)。线性相关分析显示,糖尿病患者的血清hs-CRP水平均与HbAlc、空腹血糖、体质量指数、舒张压和HOMA-IS指数呈显著正相关。结论 2型糖尿病患者血清hs-CRP水平高于正常人,而且与糖尿病的发生、发展有密切的关系。

Abstract: Objective To investigate the relationship between serum level of highly sensitive C-reactive protein (hs-CRP) and insulin sensitivity in type 2 diabetic patients. Methods Serum hs-CRP level was determined by highly sensitive enzyme-linked immunosorbent assay (ELISA) in 65 patients with type 2 diabetes and 25 normal controls. Plasma glucose, serum insulin, glycosylated hemoglobin (HbA1c), urinary albumin excretion rate (UAER), plasma lipids and lipoprotein were also measured. Moreover, homeostasis model analysis (HOMA) of insulin resistance index (HOMA-IR) and islet secretion index (HOMA-IS) were calculated to estimate the insulin sensitivity and islet function. Results In the patients with type 2 diabetes, serum hs-CRP was increased, HOMA-IR index and HOMA-IS index were decreased as compared with the normal control subjects (P<0.01). Moreover, serum hs-CRP was significantly higher in poorly controlled diabetic patients (n=23) with HbA1c≥7% than that in well controlled diabetic patients (n=42) with HbA1c<7%. Liner regression analysis in diabetic patients showed that serum hs-CRP was negatively correlated with HOMA-IS index but positively correlated with fasting plasma glucose, body mass index, HbA1c and diastolic blood pressure, respectively. Conclusion Serum HS-CRP level is higher in the patients with type 2 diabetes than in normal subjects, and plays an role in the development and progression of type 2 diabetes mellitus.

中图分类号:

R587.1

李晨钟, 薛耀明, 高方, 汪敏. 2型糖尿病患者血清超灵敏C反应蛋白水平的检测[J]. 南方医科大学学报, 2004, 24(07): 791-793.

LI Chen-zhong, XUE Yao-ming, GAO Fang, WANG Min. Determination of serum highly sensitive C-reactive protein in patients with type 2 diabetes[J]. Journal of Southern Medical University, 2004, 24(07): 791-793.

参考文献

[1] Barzilay JI, Abraham L, Heckbert SR, et al. The relation of markers of inflammation to the development of glucose disorders in the elderly: the cardiovascular health study [J]. Diabetes, 2001, 50 (10):2384-9.
[2] Pradhan AD, Manson JE, Rifai N, et al. C-reactive protein. interleukin 6, and risk of developing type 2 diabetes mellitus [J]. JAMA,2001, 18, 286(3): 327-34.
[3] Forouhi NG, Satter N, McKeigue PM. Relation of C-reactive protein to body distribution and feature of the metabolic syndrome in Europeans and South Asians[J]. Int J Obes Relat Metab Disord, 2001, 25(9): 1327-31.
[4] Moro E, Gallina P, Pais G, et al. Hypertriglyceridemia is associated with increased insulin resistance in subjects with normal glucose tolerance: evaluation in a large cohort of subjects assessed with 1999World Health Organization criteria for the classification of diabetes[J]. Metabolism, 2003, 52(5): 616-9.
[5] Haffner SM, Mykkanen L, Festa A, et al. Insulin-resistant prediabetic subjects have more atherogenic risk factors than insulin-sensitive prediabetic subjects[J]. Circulation, 2000, 101: 975-80.
[6] Kelly CC, Lyall H, Petrie JR, et al. Low grade chronic inflammation in women with polycystic ovarian syndrome [J]. J Clin Endocrinol Metab, 2001, 86(6): 2453-5.
[7] Pannacciuilli N, Cantatore FP, Minenna A, et al. C-reactive protein is independent associated with total body fat, center fat, and insulin resistance in adult women[J]. Int J Obes Relat Metab Disord, 2001, 25(10): 1416-20.
[8] Festa A, D’Agostino R, Howard G, et al. Chronic sub-clinical inflammation as part of the insulin-resistance syndrome: the insulin resistance atherosclerosis study (IRAS)[J]. Circulation, 2000,102(1): 42-7.
[9] Rodriguez-Moran M; Guerrero-Romero F. Increased levels of C-reactive protein in non-controlled type Ⅱ diabetic subjects [J]. J Diabetes Complications, 1999, 13(4): 211-5.

[1]	吕伟明；雷尚通；张强；张赟建；王深明；石汉平；. 精氨酸对糖尿病的作用观察[J]. 南方医科大学学报, 2006, 26(10): 1434-.
[2]	陈世伟；张立实；张红敏；冯晓凡；. 大豆异黄酮对胰岛素抵抗大鼠低度炎症因子水平的影响[J]. 南方医科大学学报, 2006, 26(10): 1484-1486.
[3]	郭津含；唐红；. 脉冲多普勒组织成像技术评价2型糖尿病患者的左室舒张功能[J]. 南方医科大学学报, 2006, 26(10): 1515-1517.
[4]	贾贺堂；张素华；纪立农；韩学尧；. 北京市100个早发糖尿病家系MODY1基因突变的筛查[J]. 南方医科大学学报, 2006, 26(09): 1301-1303.
[5]	钱孝贤；陈燕铭；吴伟康；刘勇；周彬；刘金来；陈璘；. 伊贝沙坦对糖尿病大鼠心脏一氧化氮系统的影响[J]. 南方医科大学学报, 2006, 26(09): 1359-1362.
[6]	张定康；俞守义；耿仁文；秦建增；谭筱江；. 国内应用胰岛素泵治疗2型糖尿病疗效循证研究[J]. 南方医科大学学报, 2006, 26(08): 1211-1212.
[7]	关美萍, 沈洁, 李晨钟, 谢翠华, 薛耀明. 经皮左锁骨下动脉导管药盒系统置入术+药物灌注治疗糖尿病足1例报道[J]. 南方医科大学学报, 2005, 25(11): 1417-1417.
[8]	王玲, 黄新胜, 周颖玲, 陈纪言, 林曙光. 血管紧张素转换酶抑制剂和血管紧张素受体拮抗剂改善2型糖尿病合并动脉粥样硬化患者血管内皮功能近期疗效的对比研究[J]. 南方医科大学学报, 2005, 25(08): 967-971.
[9]	方咏红, 张继平, 周少雄, 郑菊芬, 余永卫, 晏世刚, 范文奎, 陈月崧. 2型糖尿病合并肾病患者血清内皮素含量的临床分析[J]. 南方医科大学学报, 2005, 25(08): 1007-1008,1011.
[10]	王玲, 周颖玲, 林曙光. 高敏C反应蛋白水平的变化与ACEI/D基因多态性的相关性分析[J]. 南方医科大学学报, 2005, 25(06): 691-695.
[11]	方咏红, 张继平, 周少雄, 郑菊芬, 余永卫, 晏世刚, 范文奎, 陈月崧. 2型糖尿病患者血清血管性血友病因子、血小板活化因子水平与糖尿病肾病的关系[J]. 南方医科大学学报, 2005, 25(06): 729-731.
[12]	陈雪梅, 邵虹, 邱晓敏, 李蜀光, 张耿新, 潘鉴枝. 佛山市老年人体重指数与糖尿病的关系[J]. 南方医科大学学报, 2005, 25(02): 216-217,222.
[13]	关美萍, 李晨钟, 薛耀明, 沈洁, 高方, 罗祥容. 2型糖尿病合并高血压病患者尿微量白蛋白患病率研究[J]. 南方医科大学学报, 2005, 25(02): 234-235.
[14]	李永勤¹, 王胜军¹, 高方², 邓亲恺¹. 糖尿病自主神经病变的皮肤流电响应检测分析[J]. 南方医科大学学报, 2004, 24(10): 1140-1142,1146.
[15]	陈刚, 林丽香, 庄维特, 姚瑾, 黄惠彬, 梁继兴, 张芳林, 温俊平, 李连涛, 林苗, 林庆明. 卡托普利对糖尿病性心肌病大鼠心肌组织能量代谢和炎症反应的影响[J]. 南方医科大学学报, 2004, 24(07): 827-828,831.