型糖尿病血清超敏C 反应蛋白与胰岛素抵抗的关系

　　【摘要】 探讨血清CRP与胰岛素抵抗之间的相关性及其临床意义。方法 Ⅱ型糖尿病患者122例，测定其血清超敏CRP、空腹血糖(FPG)、空腹胰岛素(FINS)、甘油三酯(TG)、胆固醇(TCH)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)、糖化血红蛋白(HbA1c)等生化指标。并测定每个病人的血压(收缩压SBP，舒张压DBP)，体重指数(BMI)。计算胰岛素抵抗(IR)和胰岛素敏感指数(ISI)。结果 高CRP组SBP、DBP、TG、BMI均显著高于正常CRP组(P<0.05)，而高CRP组的HDL-C则显著低于正常CRP组(P<0.01)。血清超敏C-反应蛋白与各项指标之间的相关性分析表明，糖尿病病人血清hs-CRP与DBP、BMI、FPG、FINS、TG、UA、IR均存在显著正相关(P<0.05或P<0.01)，hs-CRP与HDL-C、ISI之间则存在显著负相关(P<0.05)。结论 糖尿病病人血清超敏CRP与胰岛素抵抗之间存在较好的相关性，CRP在糖尿病发生及发展中起一定的作用，超敏CRP可作为Ⅱ型糖尿病的一个早期协助诊断指标。

　　【关键词】 Ⅱ型糖尿病 超敏C-反应蛋白 胰岛素抵抗

　　The Relationship between Serum Hs-CRP, Insulin Resistance in Type II Diabetes. YE Xiong-wei, YU Xiao-mei, XIE Hai-bao, et al. Clinical Laboratory of Zhejiang Hospital, Zhejiang 310013, China

　　[Abstract] Objective To analyse the correlation between serum high-sensitivity C-reactive protein (hs-CRP) and insulin resistance in type II diabetes, and discuss whether elevated serum hs-CRP level is associated with development of type II diabetes. Methods In 122 patients with type II diabetes, serum hs-CRP, FPG, FINS, TG, TC, HDL-C, LDL-C, UA, HbA1c, blood pressure and BMI were measured. Homeostasis model assessment (HOMA) and improved insulin sensitivity index (ISI) were applied to assess the status of insulin resistance (IR). Results It was found that SBP, DBP, BMI, TG were significantly higher in elevated hs-CRP group than in normal hs-CRP group (P<0.01). Serum hs-CRP was positive correlated with DBP, BMI, FPG, FINS, TG, UA, IR in type II diabetes (P<0.05), but was negative correlated with HDL-C and ISI (P<0.05). Conclusions There was positive correlation between Serum hs-CRP and insulin resistance in type II diabetes. Elevated Serum hs-CRP predicted the development of type II diabetes.

　　[Key words] Type II diabetes; High-sensitivity C-reactive protein; Insulin resistance

　　C-反应蛋白作为一个敏感的炎症指标，近年来已受到重视。有研究表明，长期反复的慢性炎症是动脉粥样硬化形成和进展的一个重要组成部分，是引发心血管疾病的独立危险因素[1];测定低浓度的C-反应蛋白(超敏感CRP

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