Chuengsamarn Somlak, Rattanamongkolgul Suthee, Sittithumcharee Gunya, Jirawatnotai Siwanon
Division of Endocrinology and Metabolism, Faculty of Medicine, HRH Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University, Nakornnayok, Thailand.
Department of Preventive and Social Medicine, Faculty of Medicine, HRH Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University, Nakornnayok, Thailand.
Diabetes Metab Syndr. 2017 Apr-Jun;11(2):103-108. doi: 10.1016/j.dsx.2016.08.012. Epub 2016 Aug 22.
To determine an association between hs-CRP and metabolic control/diabetic chronic vascular complications (DCVCCxs) in the patients with type 2 diabetes (DM). In addition, the possibility of using hs-CRP levels to predict risk of DCVCCxs will also be validated.
This cohort study randomly enrolled 608 patients with DM during the 2007-2008 study period. We also recorded basic laboratory findings at baseline and at one year, to include fasting plasma glucose, HbA1c, triglyceride, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and hs-CRP.
Logistic regressions of odds ratios between hs-CRP and DCVCCxs (coronary arterial disease, cerebrovascular disease, diabetic nephropathy, diabetic retinopathy, and diabetic peripheral neuropathy) showed significant correlations, except for cerebrovascular disease, as follows 0.2 (0.11-0.38), 0.09 (0.01-0.77), 0.06 (0.02-0.16), 0.31 (0.12-0.82), and 0.17 (0.07-0.43), respectively. Linear regression for changes in hs-CRP were significantly correlated with HbA1c (r=0.38), fasting plasma glucose (r=0.40), triglyceride (r=0.20), low-density lipoprotein cholesterol (r=0.12), and high-density lipoprotein cholesterol (r=-0.12). No correlation was found for total cholesterol (r=0.06). Based on receiver operating characteristic (ROC) analysis, the cut-off points for hs-CRP levels for prediction of DCVCCxs were 2.89, 2.25, 2.10, 2.25, and 2.82mg/L, for coronary arterial disease, cerebrovascular disease, diabetic nephropathy, diabetic retinopathy, and diabetic peripheral neuropathy, respectively.
Our data showed that DCVCCxs were associated with hs-CRP in patients with DM. The cut-off point for hs-CRP can be used to predict association with DCVCCxs. Well-controlled metabolic components in diabetic patients, especially HbA1c, fasting plasma glucose, and triglyceride may reduce the level of hs-CRP.
确定2型糖尿病（DM）患者中高敏C反应蛋白（hs-CRP）与代谢控制/糖尿病慢性血管并发症（DCVCCxs）之间的关联。此外，还将验证使用hs-CRP水平预测DCVCCxs风险的可能性。
这项队列研究在2007年至2008年研究期间随机招募了608例DM患者。我们还记录了基线和一年时的基本实验室检查结果，包括空腹血糖、糖化血红蛋白（HbA1c）、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和hs-CRP。
hs-CRP与DCVCCxs（冠状动脉疾病、脑血管疾病、糖尿病肾病、糖尿病视网膜病变和糖尿病周围神经病变）之间的比值比的逻辑回归显示出显著相关性，但脑血管疾病除外，分别为0.2（0.11 - 0.38）、0.09（0.01 - 0.77）、0.06（0.02 - 0.16）、0.31（0.12 - 0.82）和0.17（0.07 - 0.43）。hs-CRP变化的线性回归与HbA1c（r = 0.38）、空腹血糖（r = 0.40）、甘油三酯（r = 0.20）、低密度脂蛋白胆固醇（r = 0.12）和高密度脂蛋白胆固醇（r = -0.12）显著相关。总胆固醇未发现相关性（r = 0.06）。基于受试者工作特征（ROC）分析，预测DCVCCxs的hs-CRP水平的截断点分别为冠状动脉疾病2.89mg/L、脑血管疾病2.25mg/L、糖尿病肾病2.10mg/L、糖尿病视网膜病变2.25mg/L和糖尿病周围神经病变2.82mg/L。
我们的数据表明，DM患者的DCVCCxs与hs-CRP相关。hs-CRP的截断点可用于预测与DCVCCxs的关联。糖尿病患者良好控制的代谢成分，尤其是HbA1c、空腹血糖和甘油三酯，可能会降低hs-CRP水平。
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