脂蛋白（a）、超敏C 反应蛋白表达水平 与胰岛素抵抗的相关性研究

Correlation between expression of lipoprotein(a) and high-sensitivity C-reactive protein and insulin resistance in diabetic patients

摘要:

目的 探讨脂蛋白（a）LP（a）、超敏C 反应蛋白（hs-CRP）表达水平与胰岛素抵抗的相关性。 方法 选取2016 年10 月—2017 年12 月遵义市第一人民医院收治的2 型糖尿病（T2DM）患者60 例作为观察组。 选择同期该院健康体检者60 例作为对照组，比较各组LP（a）、hs-CRP 等指标。结果 观察组hs-CRP、胰 岛素抵抗指数（HOMA-IR）及空腹血糖（FBG）均高于对照组（P <0.05），而LP（a）、高密度脂蛋白、胆固 醇（HDL-C）低于对照组（P <0.05）。hs-CRP 与HOMA-IR、低密度脂蛋白（LDL-C）及FBG 呈正相关 （P <0.05），与HDL-C 呈负相关（P <0.05）；LP（a）与HOMA-IR、LDL-C 及FBG 呈负相关（P <0.05），与 HDL-C 呈正相关（P <0.05）。经多因素Logistic 回归分析，hs-CRP、LDL-C、LP（a）及FBG 是微血管并发 症的危险因素（P <0.05），HDL-C 是微血管并发症的保护因素（P <0.05）。结论 LP（a）和hs-CRP 表达水 平与胰岛素抵抗和微血管并发症有密切关系，对胰岛素抵抗及微血管并发症的发生、发展及预后有预测价值。

Abstract:

Objective To investigate the correlation between the expression levels of lipoprotein(a) [LP(a)] and high-sensitivity C-reactive protein (hs-CRP) and insulin resistance in diabetic patients. Methods Totally 60 patients with type 2 diabetes in our hospital were selected as the observation group; the other 60 cases of healthy persons were selected as control group. The levels of LP(a), hs-CRP and other indexes in each group were compared. Results The hs-CRP, HOMA-IR and FBG in observation group were significantly higher than those in control group (P < 0.05), but LP(a) and HDL-C were significantly lower than those in control group (P < 0.05); hs-CRP was positively correlated with HOMA-IR, low density lipoprotein (LDL-C) and fasting blood sugar (FBG) (P < 0.05), but negatively correlated with high density lipoprotein (HDL-C) (P < 0.05); LP(a) was negatively correlated with HOMA-IR, LDL-C and FBG (P < 0.05), but positively correlated with HDL-C (P < 0.05). Multivariate logistic regression analysis showed that hs-CRP, LDL-C, LP(a) and FBG were independent risk factors for microvascular complications (P < 0.05), and HDL-C was the protective factor (P < 0.05). Conclusions The expression levels of high-sensitivity C- reactive protein and a- lipoprotein are closely related to insulin resistance and microvascular complications in diabetic patients, and have predictive value for the occurrence, development and prognosis of diabetic insulin resistance and microvascular complications.