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Abstract：
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 (n = 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 (p < 0.001). Moreover, there was a significant positive association between the prevalence of SLD, MetS and albuminuria and hsCRP (p < 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.
摘要：
我们进行了这个单中心，回顾性,队列研究检查胰岛素抵抗（IR）和高敏C反应蛋白（hsCRP）是否与2型糖尿病（T2DM）患者的代谢异常有关。在总共3758名T2DM患者（n=3758）中，我们分析了医疗记录，从而评估了他们的基线特征，如年龄，性别,T2DM的持续时间，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），餐后血浆葡萄糖（PPG），胰岛素抵抗的稳态模型评估（HOMA-IR），β细胞功能的稳态模型评估（HOMA-β），天冬氨酸转氨酶（AST），丙氨酸氨基转移酶（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），白蛋白尿,内膜中层厚度（IMT）和hsCRP。根据胰岛素耐量试验（KITT）的K指数或hsCRP的三分法对患者进行分层。因此，它们被分为最低的(≥2.37)，KITT的中间（1.54-2.36）和最高三分位数（0-1.53）和最低（0.00-0.49），hsCRP的中间(0.50-1.21)和最高(≥1.22)。此外，KITT和hsCRP与代谢异常的关联，如脂肪变性肝病（SLD），代谢综合征（MetS），白蛋白尿,糖尿病视网膜病变和颈动脉粥样硬化，也进行了分析。SLD患病率之间存在显著正相关,MetS,蛋白尿和糖尿病性视网膜病变和KITT(p<0.001)。此外，SLD的患病率之间存在显着正相关，MetS与白蛋白尿和hsCRP(p<0.001)。总之,我们的结果表明,临床医师在2型糖尿病患者的治疗中应考虑IR和hsCRP与代谢异常的关系.然而,进一步大规模，prospective,多中心研究证实了我们的结果.
