血清C反应蛋白/催产素对代谢综合征的预测及诊断价值

摘要

目的 探讨血清C反应蛋白(CRP)/催产素(OXT)对代谢综合征(MS)发病的风险预测及诊断价值.方法 选取非代谢综合征(non-MS)患者81例(non-MS组)和MS患者87例(MS组),收集体质量、身高、腰围、臂围等数据,测血压.均行口服葡萄糖耐量试验(O GTr),采用化学发光法测定血清CRP,ELISA法测定血清OXT,同时测定糖化血红蛋白(HbA1c)、空腹血糖(FPG)、75 g葡萄糖耐量试验(OGTT)2 h血糖(2 h PG)、空腹胰岛素(FIns)、OGTT 2 h胰岛素(2 h Ins)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),计算胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能(HOMA-β),比较两组间各指标的差异,分析各指标间的相关性.Logistic回归分析血清CRP、OXT、CRP/OXT预测MS发生的价值,绘制ROS曲线,评估三者对MS的诊断价值.结果 与non-MS组比较,MS组血清CRP水平高,OXT水平低,CRP/OXT高(P均＜0.01).相关分析显示,血清CRP/OXT分别与体质量指数、腰围、收缩压、HbA1c、FPG、2hPG、FIns、2 h Ins、TG、HOMA-IR、CRP呈正相关(P均＜0.05),与HDL-C、HOMA-β、OXT呈负相关(P均＜0.01).Logistic回归分析提示CRT、CRT/OXT对MS的发生有预测价值(P均＜0.05).ROC曲线分析提示,CRP/OXT诊断MS的曲线下面积为0.768(0.697,0.830),优于单用CRP[0.744(0.671,0.808)]、OXT[0.670(0.593,0.740)].结论 血清CRP/OXT对MS发生具有较好的预测及诊断价值,优于单独使用CRP、OXT.%Objective To investigate the predictive and diagnostic value of the ratio of serum C-reactive protein (CRP) to oxytocin (CRP/OXT ratio) for the metabolic syndrome (MS).Methods | A total of 168 subjects were divided into non-MS group (n =81) and MS group (n =87),respectively.Oral glucose tolerance test (OGTT) was performed for all subjects.Serum levels of CRP were measured by chemiluminescence method.Fasting serum OXT level was determined by enzyme linked immunosorbent assay (ELISA).The biochemical parameters of two groups such as glycosylated hemoglobin A1c (HbA1c),fasting plasma glucose (FPG),OGTT 2-hour glucose (2 h PG),fasting insulin (FIns),OGTT 2-hour insulin (2 h Ins),total cholesterol (TC),triacylglycerol (TG),high-density lipoprotein cholesterol (HDL-C),and lowdensity lipoprotein cholesterol (LDL-C) were detected and compared,and the correlation of those parameters were analyzed.Logistic regression was used to analyze the value of serum CRP,OTX,CRP/OXT in the prediction of MS,and we drew the receiver operating characteristic (ROC) curve,and evaluated the diagnostic value of these three parameters for MS.Results Serum CRP and CRP/OXT ratio of the MS group were significantly higher than those of the non-MS group,but OXT was lower than that of the non-MS group (all P ＜ 0.01).Serum CRP/OXT ratio was positively correlated with body mass index (BMI),waist circumference (WC),systolic blood pressure (SBP),HbA1c,FPG,2 h PG,FIns,2 h Ins,TG,homeostasis model insulin resistance index (HOMA-IR),and CRP (all P ＜0.05),but was negatively correlated with HDL-C,HOMA-β and OXT (all P ＜0.001).Logistic regression analysis showed that the serum CRP,OTX,and CRP/OXT had certain predictive value for MS (all P ＜ 0.05).The ROS curve analysis for MS was significantly greater than that of CRP [0.744 (0.671,0.808)] orOXT [0.670 (0.593,0.740)] alone (P＜0.05).Conclusion Serum CRP/OXT has better predictive and diagnostic value for MS,superior to CRP or OXT alone.