Li Xiao-Ying, Xu Min, Wang Ji-Guang, Wang Xin-Jun, Huang Yun, Cheng Qi, Huang Hong-Er, Li Rui, Xiang Jie, Tan Jiao-Rong, Dai Meng, Ning Guang
Shanghai Clinical Center for Endocrine and Metabolic Diseases, Division of Endocrinology and Metabolism, E-Institutes of Shanghai Universities, Shanghai, China.
Clin Endocrinol (Oxf). 2009 May;70(5):691-7. doi: 10.1111/j.1365-2265.2008.03371.x. Epub 2008 Aug 7.
Serum C-reactive protein (CRP) and microalbuminuria are predictors of cardiovascular disease. The association of these factors of cardiovascular risk with fasting and 2-h postload plasma glucose in a group of Chinese subjects was investigated.
This was a cross-sectional cohort study.
In 1776 subjects randomly selected from the permanent residents of a community in the city of Shanghai, China, a simplified 75-g oral glucose tolerance test (fasting and 2-h postload blood sampling only) was performed, and serum CRP concentrations and urinary albumin : creatinine ratio were measured.
Serum CRP concentration significantly increased from 1.62 mg/l in normoglycaemic subjects to 2.63 mg/l in subjects with impaired glucose regulation, and to 3.09 mg/l in newly diagnosed diabetic patients (P < 0.0001). The corresponding prevalence of microalbuminuria also increased from 4.3% to 6.6% and to 11.4% (P < 0.0001). Both before and after adjustment for confounders, fasting and 2-h postload plasma glucose levels were significantly associated with serum CRP concentration and the risk of microalbuminuria (P < 0.003). However, the association for CRP tended to be more prominent with 2-h postload plasma glucose than with fasting plasma glucose. Indeed, with adjustments applied, for 1 SD change in fasting and 2-h postload plasma glucose concentration, serum CRP concentration increased by 14% and 18% (between the two regression coefficients, P = 0.01), respectively. With similar adjustments, for 1 SD change in fasting and 2-h postload plasma glucose concentration, the odds of microalbuminuria increased by 28% and 32% (P = 0.28 for the difference between 28% and 32%), respectively.
Our finding suggests that in Chinese plasma glucose, especially 2-h postload, is associated with biological markers of cardiovascular disease, such as serum CRP concentration and microalbuminuria.
血清C反应蛋白（CRP）和微量白蛋白尿是心血管疾病的预测指标。本研究调查了一组中国受试者中这些心血管风险因素与空腹及负荷后2小时血浆葡萄糖之间的关联。
这是一项横断面队列研究。
在中国上海市某社区常住人口中随机选取1776名受试者，进行简化的75克口服葡萄糖耐量试验（仅采集空腹及负荷后2小时血样），并检测血清CRP浓度和尿白蛋白：肌酐比值。
血清CRP浓度从血糖正常受试者的1.62毫克/升显著升高至糖调节受损受试者的2.63毫克/升，新诊断糖尿病患者的3.09毫克/升（P<0.0001）。微量白蛋白尿的相应患病率也从4.3%增至6.6%，再增至11.4%（P<0.0001）。在对混杂因素进行调整前后，空腹及负荷后2小时血浆葡萄糖水平均与血清CRP浓度及微量白蛋白尿风险显著相关（P<0.003）。然而，CRP与负荷后2小时血浆葡萄糖的关联往往比与空腹血浆葡萄糖更为显著。实际上，经调整后，空腹及负荷后2小时血浆葡萄糖浓度每变化1个标准差，血清CRP浓度分别升高14%和18%（两个回归系数之间，P=0.01）。进行类似调整后，空腹及负荷后2小时血浆葡萄糖浓度每变化1个标准差，微量白蛋白尿的比值分别增加28%和32%（28%与32%之间的差异，P=0.28）。
我们的研究结果表明，在中国人群中，血浆葡萄糖，尤其是负荷后2小时血浆葡萄糖，与心血管疾病的生物学标志物如血清CRP浓度和微量白蛋白尿相关。
