Jeong Yuchul, Lee Beom Jun, Hur Wonjai, Lee Minjoon, Han Se-Hyeon
Department of Internal Medicine, Chungna Good Hospital, Incheon 22738, Republic of Korea.
St. Mary's Best ENT Clinic, Seoul 08849, Republic of Korea.
Metabolites. 2024 Jun 30;14(7):371. doi: 10.3390/metabo14070371.
We conducted this single-center, retrospective, cohort study to examine whether insulin resistance (IR) and high-sensitivity C-reactive protein (hsCRP) have a relationship with metabolic abnormalities in patients with type 2 diabetes mellitus (T2DM). In a total of 3758 patients ( = 3758) with T2DM, we analyzed medical records and thereby evaluated their baseline characteristics such as age, sex, duration of T2DM, systolic blood pressure (SBP), diastolic blood pressure (DBP), waist circumference, body mass index (BMI), visceral fat thickness (VFT), fasting plasma insulin levels, C-peptide levels, glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), homeostatic model assessment of insulin resistance (HOMA-IR), homeostatic model assessment of β-cell function (HOMA-β), aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), albuminuria, intima-media thickness (IMT) and hsCRP. The patients were stratified according to the tertile of the K index of the insulin tolerance test (KITT) or hsCRP. Thus, they were divided into the lowest (≥2.37), middle (1.54-2.36) and highest tertile (0-1.53) of KITT and the lowest (0.00-0.49), middle (0.50-1.21) and highest tertile (≥1.22) of hsCRP. Moreover, associations of KITT and hsCRP with metabolic abnormalities, such as steatotic liver disease (SLD), metabolic syndrome (MetS), albuminuria, diabetic retinopathy and carotid atherosclerosis, were also analyzed. There was a significant positive correlation between the prevalence of SLD, MetS, albuminuria and diabetic retinopathy and KITT ( < 0.001). Moreover, there was a significant positive association between the prevalence of SLD, MetS and albuminuria and hsCRP ( < 0.001). In conclusion, our results indicate that clinicians should consider the relationships of IR and hsCRP with metabolic abnormalities in the management of patients with T2DM. However, further large-scale, prospective, multi-center studies are warranted to confirm our results.
我们开展了这项单中心、回顾性队列研究，以检验胰岛素抵抗（IR）和高敏C反应蛋白（hsCRP）与2型糖尿病（T2DM）患者代谢异常是否存在关联。在总共3758例T2DM患者（n = 3758）中，我们分析了病历记录，从而评估他们的基线特征，如年龄、性别、T2DM病程、收缩压（SBP）、舒张压（DBP）、腰围、体重指数（BMI）、内脏脂肪厚度（VFT）、空腹血浆胰岛素水平、C肽水平、糖化血红蛋白（HbA1c）、空腹血糖（FPG）、餐后血糖（PPG）、胰岛素抵抗稳态模型评估（HOMA-IR）、β细胞功能稳态模型评估（HOMA-β）、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、蛋白尿、内膜中层厚度（IMT）和hsCRP。患者根据胰岛素耐量试验K指数（KITT）或hsCRP的三分位数进行分层。因此，他们被分为KITT的最低三分位数（≥2.37）、中间三分位数（1.54 - 2.36）和最高三分位数（0 - 1.53），以及hsCRP的最低三分位数（0.00 - 0.49）、中间三分位数（0.50 - 1.21）和最高三分位数（≥1.22）。此外，还分析了KITT和hsCRP与代谢异常的关联，如脂肪性肝病（SLD）、代谢综合征（MetS）、蛋白尿、糖尿病视网膜病变和颈动脉粥样硬化。SLD、MetS、蛋白尿和糖尿病视网膜病变的患病率与KITT之间存在显著正相关（P < 0.001）。此外，SLD、MetS和蛋白尿的患病率与hsCRP之间存在显著正相关（P < 0.001）。总之，我们的结果表明，临床医生在管理T2DM患者时应考虑IR和hsCRP与代谢异常的关系。然而，需要进一步开展大规模、前瞻性、多中心研究来证实我们的结果。
