Prospective study of C-reactive protein in relation to the development of diabetes and metabolic syndrome in the Mexico City Diabetes Study
Prospective study of C-reactive protein in relation to the development of diabetes and metabolic syndrome in the Mexico City Diabetes Study
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DOI：
10.2337/diacare.25.11.2016
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发表时间：
2002-11-01
期刊：
影响因子：
16.2
通讯作者：
Haffner, SM
中科院分区：
文献类型：
--
作者：
Han, TS;Sattar, N;Haffner, SM
目的 - 最近的证据表明，C反应蛋白（CRP）可以预测高加索人群中糖尿病的发展。我们评估了CRP作为糖尿病和代谢综合征发展的可能危险因素，这是对墨西哥城糖尿病研究的515名男性和729名妇女研究的6年研究。研究和方法 - 研究和方法 - 基线CRP，肥胖性索引，抗胰岛素抵抗性， （稳态模型评估[HOMA-IR]）用于预测定义为包括以下两种或多种的代谢综合征的发展： 1）血脂血症（男性中的甘油三酸酯大于或等于2.26 mmol/l或HDL胆固醇小于或等于或等于男性的0.91 mmol/l，女性小于或等于1.17 mmol/l;高血压药物）；或3）糖尿病（1999年世界卫生组织标准）。基线 - CRP与女性的所有代谢指数显着相关（p <0.001），但男性的相关性较小。 6年后，男性中有14.2％和16.0％的女性发展了代谢综合征。与三位一体1相比，最高三位一体的CRP女性的相对风险增加了4.0（95％CI 2.0-7.9）和糖尿病的相对风险增加了5.5（2.2-13.5）；调整BMI或HOMA-IR后，这些风险变化很小。接收器操作特征（ROC）曲线下的综合征发展的面积为0.684，与BMI合并后，CRP，CRP，BMI和HOMA-IR.CONCLUSIONS的复杂模型时增加到0.706，至0.710 - CRP不是男性代谢综合征发展的重要预测指标。我们的数据强烈支持这样的观念，即炎症在女性的糖尿病和代谢性疾病的发病机理中很重要。
OBJECTIVE - Recent evidence suggests that C-reactive protein (CRP) may predict development of diabetes in Caucasian populations. We evaluated CRP as a possible risk factor of the development of diabetes and metabolic syndrome in a 6-year study of 515 men and 729 women from the Mexico City Diabetes Study.RESEARCH DESIGN AND METHODS - Baseline CRP, indexes of adiposity, and insulin resistance (homeostasis model assessment [HOMA-IR]) were used to predict development of the metabolic syndrome defined as including two or more of the following: 1) dyslipidemia (triglyceride greater than or equal to2.26 mmol/l or HDL cholesterol less than or equal to0.91 mmol/l in men and less than or equal to1.17 mmol/l in women; 140/90 mmHg or on hypertensive medication); or 3) diabetes (1999 World Health Organization criteria).RESULTS - At baseline, CRP correlated significantly (P < 0.001) with all metabolic indexes in women, but less so in men. After 6 years, 14.2% of men and 16.0% of women developed the metabolic syndrome. Compared with tertile 1, women with CRP in the highest tertile had an increased relative risk of developing the metabolic syndrome by 4.0 (95% CI 2.0-7.9) and diabetes by 5.5 (2.2-13.5); these risks changed minimally after adjusting for BMI or HOMA-IR. The area under receiver-operating characteristic (ROC) curve for the prediction of the development of the syndrome was 0.684 for CRP, increasing to 0.706 when combined with BMI and to 0.710 for a complex model of CRP, BMI, and HOMA-IR.CONCLUSIONS - CRP was not a significant predictor of the development of the metabolic syndrome in men. Our data strongly support the notion that inflammation is important in the pathogenesis of diabetes and metabolic disorders in women.