胃转流术后2型糖尿病与C反应蛋白的关系  

Relationship between type 2 diabetes after gastric bypass and C-reactive protein levels

作　　者：刘岩[1] 叶飞[1] 谭娟[1] 刘升平[1] 朱利勇[1] 李鹏洲[1] 张大伟[1] 朱晒红[1] 

机构地区：[1]中南大学湘雅三医院普外科,湖南长沙410013

出　　处：《中国内镜杂志》2012年第6期593-596,共4页China Journal of Endoscopy

摘　　要：目的研究胃转流术(RYGB)后2型糖尿病(T2DM)患者C反应蛋白(CRP)水平变化及与术后体重指数(BMI)下降的关系。方法选择29例进行RYGB手术治疗的T2DM患者。检测术前1周、术后3个月、术后6个月的血清CRP、空腹血糖(FPG)、餐后血糖(PPG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-c)、高密度脂蛋白(HDL-c)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINs)及BMI等水平变化,比较并进行各指标之间的相关分析。结果 T2DM组的血糖(FPG、PPG)、血脂(TC、TG、LDL-c)各项水平、FINs、HbA1c、CRP、BMI水平均显著高于对照组(P<0.05)。术后各项指标均得到改善。T2DM组术后3～6个月FFA,HOMA-IR呈进行性下降,均显著低于术前(P<0.05)。CRP与BMI、FINs相关性分析显示,术后6个月时仅FINs与CRP水平差异有显著性(r=0.63,P<0.05)。结论 RYGB术后,T2DM患者血清CRP、BMI、血糖水平均呈下降趋势,但是CRP下降情况与胰岛素水平显著性相关,无BMI无关。RYGB手术可能有助于T2DM患者减少心脑血管的发病风险。[ Objective ] The aim of the present study was to investigate whether CRP is altered and whether there was any correlation between reduced body mass index （BMI） and decreased CRP level in type2 diabetes mellitus patients after gastric bypass surgery. [ Methods ] In total, 29 T2DM individuals were studied prior to 3 and 6 months following Roux-en-Y gastric bypass （RYGB） surgery. Serum concentrations of CRP, glucose, lipid, HbA1C, insulin levels and BMI were obtained. They were compared among the groups and their correlation was analyzed. [ Results ] Prior to surgery, markers of CRP, glucose, lipid, insulin levels and BMI were elevated compared to the reference range of healthy normal subjects （P 〈0.01）. Postoperatively, all the marker levels were improved in patients. At 3 months and 6 months post surgery, CRP, glucose, lipid, insulin levels and BMI were significantly reduced （P 〈0.01）. At 6 months post surgery, CRP correlated with insulin levels （r=0.63, P 〈0.01） but not BMI. [Conclusions] There were significant reductions in CRP, glucose, lipid, HbAlc, insulin levels and BMI after gastric bypass surgery. The relation between CRP concentrations and insulin lever is independent of BMI.RYGB might be decreased their cardiovascular risk by the marked reduction in C-reactive protein.

关 键 词：胃转流术 C反应蛋白 2型糖尿病 

分 类 号：R656.61[医药卫生—外科学] R587.1[医药卫生—临床医学]