Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Provincial Research Data Services, Alberta Health Service, Edmonton, Alberta, Canada.
Can J Diabetes. 2023 Jul;47(5):428-434. doi: 10.1016/j.jcjd.2023.03.006. Epub 2023 Mar 28.
Insulin resistance (IR) leads to type 2 diabetes mellitus. Multiple IR causes have been identified, including inflammation. This study determines the association between IR and the inflammatory marker C-reactive protein (CRP) in a healthy Canadian population and examines potential differences by sex and age.
Participants were adults with no self-reported history of diabetes, a glycated hemoglobin (A1C) of <6.5%, and a fasting blood glucose of <7 mmol/L, and who had participated in the Canadian Health Measures Survey, cycles 1 to 4 (2007-2015). IR was calculated using the Homeostasis Model of Insulin Resistance (HOMA-IR) assessment. The crude geometric mean HOMA-IR was calculated using a one-way analysis of variance. The association between CRP levels and HOMA-IR was examined using multivariate linear regression.
A total of 4,024 eligible nondiabetic adults (1,994 [49.5%] men and 2,030 [50.4%] women) were identified. Eighty percent of the subjects were Caucasian. Among all subjects, 36% had a CRP of ≥2 mg/L. The crude geometric mean HOMA-IR was 1.33 in men and 1.24 in women. Participants with a CRP of <0.7 mg/L had a crude geometric mean HOMA-IR of 1.15 (1.13 to 1.16), compared with 1.41 (1.39 to 1.43) for those with a CRP of ≥2 mg/L. After adjusting for sex, age, race, high-density lipoprotein cholesterol, triglycerides, body mass index, smoking, and diastolic blood pressure, the HOMA-IR-CRP association remained significant. A positive trend for CRP values in men with increasing values of HOMA-IR was observed. However, this trend was not consistent with the increase in women's CRP levels.
Elevated CPR levels are independently associated with IR in men. Prospective cohort studies can confirm the causal relationship between high CRP levels and IR and identify the underlying mechanisms.
胰岛素抵抗（IR）可导致 2 型糖尿病。已确定多种 IR 病因，包括炎症。本研究在加拿大健康人群中确定了 IR 与炎症标志物 C 反应蛋白（CRP）之间的关联，并检查了性别和年龄差异的潜在影响。
参与者为无糖尿病自述史、糖化血红蛋白（A1C）<6.5%、空腹血糖<7mmol/L 且参加过加拿大健康测量调查（2007-2015 年）1-4 周期的成年人。采用稳态模型评估法（HOMA-IR）评估胰岛素抵抗。采用单向方差分析计算未经校正的 HOMA-IR 几何均数。采用多元线性回归分析 CRP 水平与 HOMA-IR 之间的关系。
共确定了 4024 名合格的非糖尿病成年人（1994 名男性[49.5%]和 2030 名女性[50.4%]）。80%的受试者为白种人。在所有受试者中，36%的 CRP 水平≥2mg/L。男性的未经校正 HOMA-IR 几何均数为 1.33，女性为 1.24。CRP<0.7mg/L 的参与者未经校正 HOMA-IR 几何均数为 1.15（1.13-1.16），而 CRP≥2mg/L 的参与者为 1.41（1.39-1.43）。在校正性别、年龄、种族、高密度脂蛋白胆固醇、甘油三酯、体重指数、吸烟和舒张压后，HOMA-IR 与 CRP 的关联仍然显著。在男性中，随着 HOMA-IR 值的增加，CRP 值呈正相关趋势。然而，这种趋势与女性 CRP 水平的增加并不一致。
升高的 CRP 水平与男性的 IR 独立相关。前瞻性队列研究可以证实高 CRP 水平与 IR 之间的因果关系，并确定潜在的机制。
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