不同糖耐量水平者血清C反应蛋白水平及阿卡波糖干预的影响  

Serum C-reactive protein levels in subjects with varying glucose tolerances and effect of acarbose intervention

作　　者：王先令[1] 陆菊明[1] 潘长玉[1] 

机构地区：[1]解放军总医院内分泌科,北京100853

出　　处：《中华内分泌代谢杂志》2003年第4期254-256,共3页Chinese Journal of Endocrinology and Metabolism

基　　金：军队十五重点课题 (0 1Z0 33)

摘　　要：目的　比较不同糖耐量水平者血清C反应蛋白 (CRP)水平 ;观察糖耐量低减 (IGT )患者应用阿卡波糖降糖治疗后血CRP水平的变化。方法　 15 4例受试者 ,行口服 75 g葡萄糖耐量试验 (OGTT)确诊糖耐量正常 (NGT) 44例 ,IGT 89例 ,新诊断的 2型糖尿病 ( 2型DM ) 2 1例 ,其中 60例IGT患者进行为期 16周的随机、双盲、安慰剂对照、阿卡波糖 ( 15 0mg/d)干预治疗试验。血清CRP采用免疫散射比浊法测定。结果　 ( 1)NGT、IGT、新诊断的 2型DM者中 ,血清CRP水平逐渐升高〔中位数 (四分位距 )〕 ,分别为 4.60 ( 4 .10～ 5 .2 5 )、5 .2 5 ( 4 .5 0～ 6.0 0 )和 5 .70 ( 5 .2 0～ 7.5 0 )mg/L(F =15 7.0 0 ,P <0 .0 0 1)。血清CRP水平与OGTT 2h血糖 (r =0 .3 6,P <0 .0 0 1)、HbA1C(r =0 .2 7,P <0 .0 5 )、总胆固醇 (TC ,r =0 .17,P<0 .0 5 )、甘油三酯 (TG ,r =0 .2 7,P <0 .0 1)呈正相关。 ( 2 )在IGT患者 ,应用阿卡波糖治疗 16周后 ,血清CRP水平从 5 .3 5 ( 4 .40～ 6.60 )mg/L下降到 4.90 ( 4 .40～ 5 .5 0 )mg/L(P <0 .0 5 ) ,对照组从 5 .2 5 ( 4 .60～ 5 .80 )mg/L下降到 5 .0 5 ( 4 .60～ 6.0 0 )mg/L(P >0 .0 5 )。 结论　 ( 1)随着糖耐量受损的加重 ,血清CRP水平逐渐升高 ;( 2 )血清CRP水平与OGTT 2h血糖。Objective To investigate the difference of serum C-reactive protein (CRP) concentrations in subjects with various glucose tolerances and the change of serum CRP concentrations in cases of impaired glucose tolerance (IGT) treated with acarbose. Methods A total of 154 subjects participated in the study and according to oral 75 g glucose tolerance test (OGTT), among them there were 44 subjects with normal glucose tolerance (NGT), 89 cases with IGT and 21 cases with type 2 diabetes (DM). Sixty IGT subjects were recruited into randomized, double-blind, placebo-controlled study. The IGT subjects received either 150 mg acarbose daily or placebo for 16 weeks. The serum CRP concentration was detected with immunoscattering assay. Results (1) The serumCRPconcentration〔median(25%, 75%)〕 was 4.60(4.10-5.25)mg/L in NGT subjects, 5.25(4.50-6.00)mg/L in IGT subjects, 5.70(5.20-7.50)mg/L in type 2 DM patients (F=157.00, P<0.001). The serum CRP concentration waspositivelycorrelatedwithOGTT 2h blood glucose (r=0.36,P<0.001), HbA 1C (r=0.27,P<0.05), total cholesterol (TC) (r=0.17,P<0.05),triglyceride (TG) (r=0.27,P<0.01). (2) The serum CRP concentration in IGT subjectstreatedwithacarbosefor 16 weeks was decreased from 5.35(4.40-6.60)mg/L to 4.90(4.40-5.50)mg/L (P<0.05),whilethechangein placebo group was from 5.25(4.60-5.80)mg/L to 5.05(4.60-6.00)mg/L (P>0.05). Conclusion (1) The serum CRP concentration is gradually increased with the worsening of glucose tolerence; (2) The serum CRP concentration is positively correlated with OGTT 2 h blood glucose, HbA 1C , TC, TG; (3) The serum CRP concentration is decreased in IGT subjects treated with acarbose following the improvement of hyperglycemia.

关 键 词：C反应蛋白 糖耐量低减 非胰岛素依赖型糖尿病 急相反应 

分 类 号：R587.1[医药卫生—内分泌]