McLaughlin Tracey, Abbasi Fahim, Lamendola Cindy, Liang Lynn, Reaven Gerald, Schaaf Patricia, Reaven Peter
Stanford University School of Medicine, Stanford, Calif, USA.
Circulation. 2002 Dec 3;106(23):2908-12. doi: 10.1161/01.cir.0000041046.32962.86.
Plasma C-reactive protein (CRP) concentrations are increased in obese and/or hyperinsulinemic individuals. The goal of this study was to determine if the relation between insulin resistance and CRP was independent of obesity.
Plasma CRP concentrations were measured before and after 3 months of calorie restriction in 38 healthy, obese women. Steady-state plasma glucose (SSPG) concentration during a 180-minute infusion of octreotide, glucose, and insulin was used to stratify participants into insulin-resistant (IR, n=20) or insulin-sensitive (n=18) groups, similar in terms of mean age (46+/-2 versus 44+/-2 years), body mass index (32.0+/-0.4 versus 31.4+/-0.3 kg/m2), and waist circumference (96+/-2 versus 95+/-2 cm). Mean CRP (0.39+/-0.08 versus 0.12+/-0.03 mg/dL, P=0.003) concentrations were higher in the IR group, as were day-long plasma glucose and insulin responses (P<0.001). There was a significant correlation at baseline between CRP and day-long plasma integrated insulin response (r=0.47, P=0.001) but not between CRP and body mass index (r=0.14) or waist circumference (r=0.10). Weight loss was similar in the two groups (8.7+/-0.9 versus 8.4+/-0.8 kg) but was associated with significant (P<0.001) decreases in SSPG and CRP concentrations in the IR group only. Regression analysis showed that SSPG and day-long plasma insulin response were the only significant predictors of CRP concentration.
CRP concentrations are elevated predominantly in obese individuals who are also insulin resistant and fall in parallel with weight loss-associated improvements in insulin resistance. The relation between CRP concentrations and insulin resistance is independent of obesity.
肥胖和/或高胰岛素血症个体的血浆C反应蛋白（CRP）浓度会升高。本研究的目的是确定胰岛素抵抗与CRP之间的关系是否独立于肥胖。
对38名健康肥胖女性在进行3个月热量限制前后测量血浆CRP浓度。在180分钟输注奥曲肽、葡萄糖和胰岛素期间的稳态血浆葡萄糖（SSPG）浓度用于将参与者分为胰岛素抵抗（IR，n = 20）或胰岛素敏感（n = 18）组，两组在平均年龄（46±2岁对44±2岁）、体重指数（32.0±0.4对31.4±0.3kg/m²）和腰围（96±2对95±2cm）方面相似。IR组的平均CRP浓度（0.39±0.08对0.12±0.03mg/dL，P = 0.003）更高，全天血浆葡萄糖和胰岛素反应也是如此（P < 0.001）。基线时CRP与全天血浆综合胰岛素反应之间存在显著相关性（r = 0.47，P = 0.001），但CRP与体重指数（r = 0.14）或腰围（r = 0.10）之间无相关性。两组体重减轻相似（8.7±0.9对8.4±0.8kg），但仅IR组体重减轻与SSPG和CRP浓度显著降低（P < 0.001）相关。回归分析表明，SSPG和全天血浆胰岛素反应是CRP浓度的唯一显著预测因素。
CRP浓度主要在同时存在胰岛素抵抗的肥胖个体中升高，并随着与体重减轻相关的胰岛素抵抗改善而平行下降。CRP浓度与胰岛素抵抗之间的关系独立于肥胖。
