Abdella N A, Mojiminiyi O A, Moussa M A, Zaki M, Al Mohammedi H, Al Ozairi E S S, Al Jebely S
Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait.
Diabet Med. 2005 Mar;22(3):278-85. doi: 10.1111/j.1464-5491.2004.01405.x.
The aim of this study was to evaluate the relationship of obesity, leptin, insulin resistance and C-reactive protein (CRP) with coronary heart disease (CHD) risk factors in patients with Type 2 diabetes mellitus (DM) with CHD compared with those with Type 2 DM without CHD.
Leptin, CRP (high sensitivity assay), fasting plasma insulin, glucose, HbA(1c) and full lipid profile were determined in 58 Type 2 diabetic patients with CHD and 87 Type 2 DM patients without CHD.
were compared between those with and without CHD. Univariate correlation as well as logistic regression analyses were used to relate these markers with traditional CHD risk factors.
Leptin showed significant correlations with BMI (r = 0.59; P < or = 0.0001), waist circumference (r = 0.45; P < 0.0001), CRP (r = 0.36; P < 0.0001), and fasting insulin (r = 0.53; P < 0.0001) as well as with systolic (r = 0.23; P = 0.007) and diastolic (r = 0.23; P = 0.007) blood pressure. However, when those with and without CHD were compared only age (P < 0.0001), duration of diabetes (P < 0.001) and degree of microalbuminuria (P = 0.02) were significantly higher in patients with CHD. Leptin (P = 0.49), CRP (P = 0.19) and lipid parameters were not significantly different between the two groups.
Our study confirms a relationship between leptin and CRP with CHD risk factors. The lack of significant difference when patients with and without CHD are compared may be due to the potential confounding effects of treatment with aspirin and statins.
本研究旨在评估肥胖、瘦素、胰岛素抵抗及C反应蛋白（CRP）与2型糖尿病（DM）合并冠心病（CHD）患者冠心病危险因素之间的关系，并与无冠心病的2型糖尿病患者进行比较。
对58例2型糖尿病合并冠心病患者和87例无冠心病的2型糖尿病患者测定瘦素、CRP（高敏检测法）、空腹血浆胰岛素、血糖、糖化血红蛋白（HbA1c）及全套血脂谱。
对有冠心病和无冠心病患者的结果进行比较。采用单变量相关性分析以及逻辑回归分析将这些标志物与传统冠心病危险因素相关联。
瘦素与体重指数（r = 0.59；P≤0.0001）、腰围（r = 0.45；P < 0.0001）、CRP（r = 0.36；P < 0.0001）、空腹胰岛素（r = 0.53；P < 0.0001）以及收缩压（r = 0.23；P = 0.007）和舒张压（r = 0.23；P = 0.007）均呈显著相关性。然而，在比较有冠心病和无冠心病患者时，仅冠心病患者的年龄（P < 0.0001）、糖尿病病程（P < 0.001）和微量白蛋白尿程度（P = 0.02）显著更高。两组之间瘦素（P = 0.49）、CRP（P = 0.19）和血脂参数无显著差异。
我们的研究证实了瘦素和CRP与冠心病危险因素之间的关系。比较有冠心病和无冠心病患者时缺乏显著差异可能是由于阿司匹林和他汀类药物治疗的潜在混杂效应。
