1型糖尿病患者超敏C反应蛋白与微量白蛋白尿发展的关系

摘要

目的 评估年轻的1型糖尿病患者中超敏C反应蛋白(hsCRP)与微量白蛋白尿进展之间的关系.方法 选取49例微量白蛋白尿期的1型糖尿病患者及49例年龄、性别、病程与之相匹配的正常白蛋白尿期的1型糖尿病患者.观察两组糖化血红蛋白(HbA1 c)和hsCRP水平以及hsCRP与年龄、病程和体质量指数(BMI)的相关性.结果 微量白蛋白尿期的1型糖尿病惠者的HbA1c和hsCRP的水平明显高于正常白蛋白尿期的Ⅰ型糖尿病患者,分别为HbA1 c(11.86±1.95)％vs(10.26±1.03)％,hsCRP(1.7±0.5)mg/L vs(1.2±0.4)mg/L(均P＜0.01).hsCRP与年龄、病程、BMI及HbA1 c呈显著正相关(P＜0.05或＜0.01),而与胰岛素的应用量无相关.多元线性回归分析显示年龄、病程和BMI是hsCRP的独立危险因素.结论 在年轻的1型糖尿病患者中随着微量白蛋白尿的出现,hsCRP的水平有明显增加,这是炎症状态的一种反应.显示了微量白蛋白尿与亚临床炎症及内皮功能损伤有关.%Objective To perform a longitudinal evaluation of high-sensitivity C-reactive protein (hsCRP) in young patients with type 1 diabetes mellitus(TlDM) in relation to the development of microalbuminuria. Methods hsCRP was measured from 49 T1DM patients with microalbuminuria and 49 normoalbuminuric T1DM patients matched for age, sex, and duration of diabetes mellitus. HbA1C and hsCRP in two groups were detected, correlation between hsCRP, age, duration of diabetes mellitus and BMI were observed. Results After the onset of microalbuminuria,HbA1C and hsCRP levels were significantly higher in T1DM patients with microalbuminuria when compared with normoalbuminuric,HbA1c HbA1c (11. 86± 1. 95)% vs (10. 26± 1. 03)% ,hsCRP(l. 7±0. 5) mg/L, (1.2±0.4) mg/L(all P <0.01). hsCRP was significantly related to age, duration of diabetes mellitus, BMI and HbA1c ( P <0. 05 or <0. 01), whereas there was a borderline relationship with insulin dose. Conclusion In this population of young T1DM patients, there was a significant increase in hsCRP levels after the onset of microalbuminuria, which likely reflects a general state of inflammation. Microalbuminuria is associated with the state of subclinical inflammation and endothelial dysfunction.