糖耐量减低人群血清C反应蛋白、白介素6、肿瘤坏死因子α及瘦素水平变化及其相关因素研究

摘要

目的：探讨糖耐量减轻人群血清C反应蛋白（CRP）、白介素6（IL－6）、肿瘤坏死因子α（TNF－α）及瘦素水平变化及其相关因素。方法2005年6月在四川省南充市顺庆区医学街社区募集符合条件的健康志愿者82例，其中糖耐量减低者27例（糖耐量减低组）、糖耐量正常者55例（正常对照组）。常规测量所有志愿者血压、体质量、身高、腰围、臀围，计算体质指数（ BMI）、腰臀比，抽取空腹静脉血检测其空腹血糖、餐后2 h血糖、血脂、空腹胰岛素、 C肽、 CRP、 IL－6、 TNF－α及瘦素，采用稳态模型计算胰岛素抵抗指数（ HOMA－IR）。结果糖耐量减低组志愿者年龄、 BMI、收缩压、腰臀比、空腹血糖、餐后2 h 血糖、 TC、 TG、 LDL －C、空腹胰岛素、 C 肽、HOMA－IR、 CRP及瘦素均高于正常对照组（ P＜0.05）；两组志愿者性别、舒张压、 HDL－C、 IL－6及TNF－α比较，差异无统计学意义（P＞0.05）。 Pearson相关分析结果显示，糖耐量减低人群血清瘦素水平与血清TC水平（r＝0.561， P＝0.003）、 HOMA－IR （ r＝0.435， P＝0.016）呈正相关，血清CRP水平与HOMA－IR （ r＝0.578， P＝0.002）呈正相关，血清IL－6、 TNF－α水平与其他指标间无直线相关性（P＞0.05）。多元线性回归分析结果显示，以瘦素为因变量时， TC和HOMA－IR进入回归方程；以CRP为因变量时， HOMA－IR进入回归方程。结论糖耐量减低人群血清CRP、瘦素水平升高，并与胰岛素抵抗有关。%Objective To investigate the serum levels of CRP , IL-6, TNF-αand leptin in crowd with impaired glucose tolerance (IGT) and its related factors.Methods In June 2005, 82 healthy volunteers were enrolled and divided into IGT group (n=27) and normal glucose tolerance (NGT) group (n=55) .Blood pressure, weight, height, waistline and hipline were measured, and BMI, WHR calculated; FBG, 2 h -BG, blood liquid, FINS, C -peptide, CRP, IL -6, TNF-αand leptin detected, and HOMA-IR calculated.Results Age, BMI, SBP, WHR, FBG, 2 h -BG, TC, TG, LDL-C, FINS, C-peptide, HOMA-IR, CRP and leptin of IGT group were higher than those of NGT group (P<0.05). There was no significant differences of gender SDP , HDL-C, IL-6 and TNF-αbetween the two groups (P>0.05).Pear-son correlation analysis showed that, serum leptin level was positively correlated with serum TC level (r=0.561, P=0.003) and HOMA-IR (r=0.435, P=0.016), and serum CRP level was positively correlated with HOMA-IR (r=0.578, P=0.002), no correlations was found between serum IL -6, TNF-αlevels and other index.Multiple linear regression analysis showed that , when take leptin as dependent variable , TC and HOMA-IR entered the regression equation; when take CRP as dependent variable , HOMA-IR entered the regression equation .Conclusion Serum levels of leptin and CRP are higher in crowd with IGT, and are correlated with insulin resistance .