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目的评价不同糖代谢状态人群血浆可溶性CD36(sCD36)水平的差异,分析sCD36与炎性反应、血糖、血脂等指标的相关性。方法 2011年3月—2012年1月选取上海市浦东新区川沙、合庆及机场镇3个社区的居民234例,根据75 g葡萄糖耐量试验分为正常糖耐量组(NGT组,n=121),糖调节异常组(IGR组,n=69)及初发糖尿病组(NDM组,n=44)。比较3组受试者的体质指数(BMI)、腰臀比(WHR)、空腹血糖(FPG)及口服葡萄糖后2 h血糖(2 hPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、sCD36、超敏C反应蛋白(hs-CRP)。结果 IGR组与NDM组高血压病史发生率高于NGT组,BMI、WHR、收缩压(SBP)、舒张压(DBP)高于NGT组(P<0.05)。3组sCD36、hs-CRP、HOMA-IR、HbA1c、FPG、2 hPG、血肌酐(Scr)、TG、LDL-C逐渐升高(P<0.05),HDL-C逐渐降低(P<0.05)。血浆sCD36与WHR、FPG、2 hPG、HbA1c、hs-CRP及log10(TG)呈正相关(r=0.230、0.273、0.267、0.178、0.254、0.142,P<0.05),与性别呈负相关(男=1,女=2)(r=-0.213,P<0.05)。多元回归分析显示,FPG(标准化偏回归系数=0.204,P=0.002)、男性(标准化偏回归系数=-0.175,P=0.007)和hs-CRP(标准化偏回归系数=0.156,P=0.017)是sCD36升高的独立影响因素。结论不同糖代谢状态人群血浆sCD36水平存在显著差异,其水平与炎性反应及糖尿病的发生密切相关。
Objective To evaluate the difference of plasma soluble CD36 (sCD36) levels in different glycometabolism population and to analyze the correlation between sCD36 and inflammatory response, blood glucose, blood lipid and other indexes. Methods From March 2011 to January 2012, 234 residents of Chuansha, Heqing and Airport Town of Pudong New District in Shanghai were selected and divided into three groups according to their 75 g glucose tolerance test: normal glucose tolerance group (n = 121 ), Abnormal glucose regulation group (IGR group, n = 69) and primary diabetes group (NDM group, n = 44). The body mass index (BMI), WHR, FPG, 2 hPG, FINS and HOMA-IR of the three groups were compared. HbA1c, TC, TG, HDL-C, LDL-C, sCD36, high-sensitivity C-reactive protein (hs-CRP). Results The incidence of hypertension in IGR group and NDM group was higher than that in NGT group. The BMI, WHR, SBP and DBP were higher than those in NGT group (P <0.05). The levels of sCD36, hs-CRP, HOMA-IR, HbA1c, FPG, 2 hPG, Scr, TG and LDL-C in the 3 groups were increased gradually and HDL-C was gradually decreased (P <0.05). Plasma sCD36 was positively correlated with WHR, FPG, 2 hPG, HbA1c, hs-CRP and log10 (r = 0.230,0.273,0.267,0.178,0.254,0.142, P < 1, female = 2) (r = -0.213, P <0.05). Multivariate regression analysis showed that FPG (standardized partial regression coefficient = 0.204, P = 0.002) and male (standardized partial regression coefficient = -0.175, P = 0.007) and hs-CRP (standardized partial regression coefficient = 0.156, P = 0.017) The independent influential factors of sCD36 elevation. Conclusion There are significant differences in plasma sCD36 levels among different glucose metabolism status groups. The level of sCD36 is closely related to inflammatory reaction and diabetes mellitus.