2型糖尿病合并代谢综合征患者血清C反应蛋白与尿微量白蛋白改变及与相关血管病变的研究

Change of serum C-reactive protein and urine microalbumin in patients with type 2 diabetes mellitus complicated by metabolic syndrome and its relation with angiopathy

  • 摘要: 目的 探讨血清C反应蛋白(CRP)与尿微量白蛋白在糖尿病合并代谢综合征(MS)不同亚型患者中的改变及与相关大血管病变的关系。方法 选择132例2型糖尿病患者,将其分为MS组和无MS组,MS组分为4个亚组。血清CRP采用ELISA法测定,尿蛋白/肌酐(Alb/Cr)采用DCA2000测定。结果 MS组血清CRP和尿Alb/Cr显著高于正常对照组和2型糖尿病组(P<0.05)。血清CRP和尿Alb/Cr随着代谢组分的增加而升高,各亚组间差异有统计学意义(P<0.01)。MS组大血管病变显著高于无MS组(39.4%vs28.3%P<0.05),且随着代谢组分数目的增多而增加(分别为12.5%、35.1%、47.2%、51.2%,P<0.05)。血清CRP与尿Alb/Cr和MS组分聚集程度之间正相关(相关系数分别为r=0.217,P=0.05;r=0.220,P=0.012)Spearman相关分析显示CRP与尿Alb/Cr(r=0.211,P=0.042)、BMI(r=0.215,P=0.033)、LDL-C(r=0.212,P=0.037)、HbA1c(r=0.333,P=0.001) 呈显著正相关关系。结论 检测糖尿病患者 CRP 和尿 Alb/Cr 可能有助于早期发现 MS 及血管病变高危人群。

     

    Abstract: Objective To study the change of serum C-reactive protein(CRP) and urine microalbumin(Alb/Cr) levels in patients with type 2 diabetic mellitus complicated by metabolic syndrome(MS) and to evaluate its related macrovasculopathy. Methods One hundred and thirty-two patients with type 2 diabetes mellitus were divided into MS group and non-MS group.MS group was divided into 4 subgroups.Serum CRP and urine Alb/Cr levels were measured by enzymatic linked immunosorbent assay(ELISA) and with DCA2000,respectively. Results The serum CRP and urine Alb/Cr levels were significantly higher in patients with diabetic mellitus complicated by MS than in those not complicated by MS and normal controlsCRP:2.49(1.14-8.78),1.57(0.18-4.00),0.37(0.171.18)mg/L,P<0.01;Alb/Cr:28.0(10.00-118),8.5(5.0-14),4.10(2.02-5.71)mg/g,P<0.01.The serum CRP and urine Alb/Cr levels increased gradually with the increased clustering of MS components.The incidence of macrovasculopathy in patients complicated by MS was obviously higher(39.4%)than in those not complicated by MS(28.3%)(P<0.05).The incidence of macrovasculopathy in the 4 subgroups was 12.5%,35.1%,47.2%,and 51.2%,respectively.The CRP concentration was positively correlated with urine Alb/Cr and accumulated MS components(r=0.217,P=0.05;r=0.220,P=0.012).Spearman correlation analysis showed that the CRP level was positively correlated with urine Alb/Cr(r=0.211,P=0.042),BMI(r=0.215,P=0.033),LDL-C(r=0.212,P=0.037) and HbA1c(r=0.333,P=0.001). Conclusion Measurement of CRP and urine Alb/Cr levels in patients with type 2 diabetes mellitus complicated by MS contributes to the early discovery of MS and in those at a high risk of developing related vasculopathy.

     

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