血清高敏C反应蛋白水平与五年累积糖尿病发病风险的关系  

Association between high sensitivity C-reactive protein levels in serum and the 5-year- accumulative-risk of diabetes

作　　者：刘海行[1] 赵冬[1] 王薇[1] 秦兰萍[1] 刘军[1] 孙佳艺[1] 王淼[1] 李岩[1] 齐玥[1] 刘静[1] 

机构地区：[1]首都医科大学附属北京安贞医院北京市心肺血管疾病研究所,北京100029

出　　处：《中华流行病学杂志》2011年第1期1-4,共4页Chinese Journal of Epidemiology

基　　金：北京市自然科学基金（7082019）;北京市卫生系统高层次卫生技术人才培养计划（2009-3-46）;省部共建教育部心血管重塑相关疾病重点实验室（110267）

摘　　要：目的 研究高敏C反应蛋白（hs-CRP）与5年糖尿病发病风险的关系.方法 研究对象来源于＂中国多省市心血管病前瞻性队列研究＂中的北京大学社区队列.2002年对该队列45～74岁1541人进行心血管病危险因素调查和hs-CRP水平测定,2007年进行危险因素复查,对两次资料完整且基线无糖尿病和感染性疾病的1045人进行分析.结果 研究人群5年间糖尿病的年龄标化累积发病率为8.8%,男性为9.8%,女性为8.2%.基线hs-CRP水平四分层后显示：男女两性糖尿病的累积发病率均有随hs-CRP水平升高而逐渐增加的趋势（P＜0.01）.调整基线年龄、高血压、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯、血糖、吸烟和腹部肥胖后,男女两性中hs-CRP≥3mg/L者发生糖尿病危险分别是hs-CRP＜1 mg/L者的3.30倍（95%CI：1.25～8.73）和2.58倍（95%CI：1.06～6.29）.男女两性基线hs-CRP水平判定糖尿病是否发病的ROC曲线下面积分别为0.619（95%CI：0.536～0.701）和0.667（95%CI：0.585～0.749）.结论 基线hs-CRP水平是糖尿病发病的独立预测因素,提示慢性炎症在糖尿病发生的病理过程中发挥重要作用.Objective To analyze the association between hs-CRP（high-sensitivity C-reactive protein） levels in serum and the 5-year-accumulative-risk of diabetes in a general population.Methods Participants were from the cohort of Peking University residential community in the Chinese Multi- provincial Cohort Study（CMCS）. Two surveys on cardiovascular risk factors and the measurements of serum hs-CRP levels were conducted in 2002 and 2007, respectively. Individuals with incomplete information and those having infectious diseases at baseline were excluded. A total of 1045 participants aged 45 to 74 years and free of diabetes at baseline were included in this analysis.Results The age-standardized 5-year accumulative incidence rate of diabetes was 8.8% （male：9.8%, female： 8.2% ） and increased significantly with the level of hs-CRP in both women and men （P〈0.01）. After adjustment for age, hypertension, low-density liproprotein cholesterol, and high-density liproprotein cholesterol, triglycerides, fasting glucose, smoking status and central obesity,people with hs-CRP≥3 mg/L had a 3.30 times higher risk of developing diabetes in men and 2.58 times for women when compared to those with hs-CRP〈1 mg/L. The areas under the receiver operating characteristic curves of baseline hs-CRP level in predicting the incidence of diabetes were 0.619（95%CI：0.536-0.701 ） in men and 0.667（95%CI：0.585-0.749） in women. Conclusion Serum hs-CRP levels could predict the incidence of diabetes, indicating that inflammation might have great importance in the onset of diabetes.

关 键 词：糖尿病 高敏C反应蛋白 前瞻性研究 

分 类 号：R541.4[医药卫生—心血管疾病]