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目的观察不同糖代谢人群补体C3、超敏C反应蛋白(high-sensitive C-reactive protein,hs-CRP)水平变化及其与胰岛素抵抗指数(HOMA index,HOMA2-IR)之间的相关性。方法选择重庆医科大学附属第一医院内分泌科2008年1月至2010年12月就诊的168例患者,其中2型糖尿病(T2DM)患者54例[男性36例,女性18例,年龄(57.7±12.0)岁]、糖耐量异常(IGT)者54例[男性34例,女性20例,年龄(58.5±9.3)岁]、糖耐量正常(NGT组)60例[男性40例,女性20例,年龄(57.2±6.5)岁],分别测定体质量、身高、血压、腰围、空腹血浆葡萄糖(FPG)、糖负荷后2 h血糖(2 hPG)、血清胰岛素(Fins)、血脂、C3及hs-CRP等,比较各组HOMA2-IR。结果 T2DM组、IGT组血清C3和hs-CRP均显著高于年龄、BMI匹配的NGT组(P<0.01)。在T2DM、IGT、NGT组,C3均与HOMA2-IR正相关(r=0.27,0.49,0.33,P<0.05),而hs-CRP仅在NGT组、IGT组与HOMA2-IR呈显著正相关(r=0.22、0.28,P<0.05)。在校正年龄、性别后C3仍是HOMA2-IR的主要影响因素(P<0.05)。结论不同糖代谢状态人群中,随着糖代谢紊乱的加重血清C3和hs-CRP水平均逐渐升高,C3与HOMA2-IR的相关性均较hs-CRP更为密切。
Objective To observe the changes of complement C3 and high-sensitive C-reactive protein (hs-CRP) in patients with different glycometabolism and its relationship with HOMA index (HOMA2-IR). Methods A total of 168 patients were selected from Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University from January 2008 to December 2010, including 54 patients with type 2 diabetes (T2DM) [36 males and 18 females, with an age of 57.7 ± 12.0 ) Were included in the study. There were 54 patients with impaired glucose tolerance (IGT) [34 males and 20 females (58.5 ± 9.3) years old] and 60 patients with normal glucose tolerance (NGT group [40 males and 20 females, (57.2 ± 6.5) years old]. The body weight, height, blood pressure, waist circumference, fasting plasma glucose (FPG), 2 h blood sugar (2 hPG), serum insulin (Fins), serum lipids, C3 and hs-CRP Etc., compare HOMA2-IR of each group. Results Serum C3 and hs-CRP in T2DM group and IGT group were significantly higher than those in NGT group (P <0.01). In T2DM, IGT, NGT and C3 were all positively correlated with HOMA2-IR (r = 0.27,0.49,0.33, P <0.05), while hs-CRP was positively correlated only with NGT and IGT r = 0.22, 0.28, P <0.05). After adjusting for age and gender, C3 remained the major factor of HOMA2-IR (P <0.05). CONCLUSIONS: In patients with different glycometabolism status, serum C3 and hs-CRP levels gradually increase with the aggravation of glucose metabolism. The correlation between C3 and HOMA2-IR is more significant than that of hs-CRP.