Heald Adrian H, Anderson Simon G, Ivison Fiona, Laing Ian, Gibson J Martin, Cruickshank Kennedy
Department of Diabetes and Endocrinology, University of Manchester, Salford Royal Hospitals University Trust, Hope Hospital, Stott Lane, Salford, Greater Manchester M6 8HD, UK.
Atherosclerosis. 2003 Sep;170(1):79-86. doi: 10.1016/s0021-9150(03)00235-1.
Inflammatory processes, marked in part by the acute phase reactant C-reactive protein (CRP) and insulin resistance are implicated in atherogenesis. Low insulin-like growth factor-I (IGF-I) and IGF binding protein-1 (IGFBP-1) concentrations are closely associated with insulin resistance. We examined CRP in ethnic groups with differing risk for cardiovascular disease and type 2 diabetes and its relationship with insulin sensitivity (Homeostasis model assessment (HOMA)-S) and the IGF system. European (n=155), Pakistani (n=108) and African-Caribbean (African Caribbean) (n=177) origin participants were randomly sampled from population registers. All underwent basic anthropometry, glucose tolerance testing and measurement of insulin sensitivity, CRP and other metabolic variables. CRP was significantly lower in African Caribbean men and women than in other ethnic groups. Across all groups CRP correlated negatively with (HOMA-S) (rho=-0.29, P<0.001). Regression analysis which included ethnicity and body mass index (BMI) showed that low HOMA-S (beta=-0.17, P<0.001) and low IGFBP-1 (beta=-0.14, P<0.001) were independently and inversely associated with CRP, but the effect was modified by obesity. In obese subjects insulin sensitivity was not associated with CRP. However, for the whole population, a 2.7 mg/l increase in CRP was associated with a 50% (95% confidence interval (CI) 10-210%) greater risk of WHO defined metabolic syndrome, independent of IGF-I (odds ratio (OR) 0.46 (95% CI 0.22-0.96)), IGFBP-1 (OR 0.58 (0.44-0.76)), female sex (OR 0.43 (0.22-0.84)), NEFA (OR 1.06 (1.03-1.09)) and Pakistani ethnicity. High CRP (as a measure of chronic subclinical inflammation), low IGF-I and low IGFBP-1 are independently associated with the presence of the metabolic syndrome and with insulin resistance. In obese subjects insulin sensitivity is not associated with changes in CRP whilst in non-obese subjects CRP independently contributes to variation in HOMA-S.
炎症过程在动脉粥样硬化的发生中起作用，部分表现为急性期反应物C反应蛋白（CRP）和胰岛素抵抗。低胰岛素样生长因子-I（IGF-I）和IGF结合蛋白-1（IGFBP-1）浓度与胰岛素抵抗密切相关。我们研究了心血管疾病和2型糖尿病风险不同的种族群体中的CRP及其与胰岛素敏感性（稳态模型评估（HOMA）-S）和IGF系统的关系。从人口登记册中随机抽取了欧洲裔（n = 155）、巴基斯坦裔（n = 108）和非洲加勒比裔（n = 177）的参与者。所有人都进行了基本人体测量、葡萄糖耐量测试以及胰岛素敏感性、CRP和其他代谢变量的测量。非洲加勒比裔男性和女性的CRP显著低于其他种族群体。在所有群体中，CRP与（HOMA-S）呈负相关（rho = -0.29，P < 0.001）。纳入种族和体重指数（BMI）的回归分析表明，低HOMA-S（β = -0.17，P < 0.001）和低IGFBP-1（β = -0.14，P < 0.001）与CRP独立且呈负相关，但肥胖会改变这种影响。在肥胖受试者中，胰岛素敏感性与CRP无关。然而，对于整个人群，CRP每增加2.7mg/l，与世界卫生组织定义的代谢综合征风险增加50%（95%置信区间（CI）10 - 210%）相关，独立于IGF-I（比值比（OR）0.46（95%CI 0.22 - 0.96））、IGFBP-1（OR 0.58（0.44 - 0.76））、女性性别（OR 0.43（0.22 - 0.84））、非酯化脂肪酸（NEFA）（OR 1.06（1.03 - 1.09））和巴基斯坦种族。高CRP（作为慢性亚临床炎症的指标）、低IGF-I和低IGFBP-1与代谢综合征的存在和胰岛素抵抗独立相关。在肥胖受试者中，胰岛素敏感性与CRP变化无关，而在非肥胖受试者中，CRP独立导致HOMA-S的变化。
