血清中高敏感度C-反應蛋白與糖尿病患罹患心血管疾病之相關性

(1)

血清中高敏感度C-反應蛋白（High sensitivity

C-reactive protein）與糖尿病患者罹患心血管

疾病之相關性

李永成、何孟純、楊淑惠

台北醫學大學保健營養學系

本研究的目的是在探討高敏感性C-反應蛋白（High-sensitivity C-reactive protein, hs-CRP）是否可以作為罹患

心血管疾病的早期指標。

研究進行時間在2007年7月至2008年2月，地點在台北醫學大

學附設醫院新陳代謝科門診進行收案。研究經人體試驗委員會通

過，並且得受試者同意後進行收案。共計有效樣本33人，依病情

將患者進行分組：DM + L組：有糖尿病以及血脂異常患者，

n=12；DM - L組：患有糖尿病但沒有血脂異常患者，n=8；H組為

健康受試者，n=13。在不改變受試者原醫療照護程序下，在收案

後第1個月與第4個月進行資料收集：血液樣本、人體測量學數值

及飲食記錄。至第4個月時部份受試者因某些因素(如：失去聯

絡、搬家等等)，使得剩下18人繼續參與實驗。利用 SAS 9.1 版

統計分析軟體進行統計分析。

DM + L組與 DM - L組在 hs-CRP 的濃度上沒有顯著的差

異，hs-CRP與年齡、腰圍、臀圍有顯著的相關性存在，臀圍更可

作為預測 hs-CRP的因子(r

2

_{= 0.1855)。}

Ridker et al. 指出使用 Statin 類的藥物可以降低體內

CRP 的濃度（Ridker et al., 2005）。所以DM + L組與 DM

-L組在 hs-CRP 的濃度上沒有顯著的差異，原因可能是因為藥

物的使用所造成。所以臨床上還是建議在糖尿病的醫療照護中

可以加入腰圍、臀圍等人體測量學的項目，則有助於更早發現

疾病的發生並加以預防。

表一、第一個月受試者基本資料.1,3

Table 1. Subject’s characteristics by sex at 1stmonth.1,3

Male (n = 11) Female (n = 22) Age (y) 57 ± 12 55 ± 8 Height (cm) 168 ± 4a _{157 ± 5}b Weight (kg) 77 ± 10 59 ± 10b BMI (kg/m2₎2 _{27.2 ± 3.6}a _{24.1 ± 3.8}b Body fat (%) 27.8 ± 4.8b _{34.7 ± 5.0}a Waist circumference (cm) 96 ± 9a _{81 ± 7}b Hip circumference (cm) 105 ± 8a 98 ± 6b WHR2 0.92 ± 0.05a 0.83 ± 0.06b 1Values are mean ± SD

2BMI, body mass index; WHR, waist hip ratio

3Data were analysis using ANOVA with scheffe's test

4Mean with the different symbol (a or b) are significantly different

表二、第一個月分組別受試者的基本資料1 ,3

Table 2. Subject characteristics by group at 1stmonth.1,3

H group DM - L group DM + L group (n = 13) (n = 8) (n = 12) male/female 5/8 3/5 3/9 Age (y) 52 ± 7 56 ± 12 61 ± 11 Height (cm) 162 ± 7 162 ± 8 166 ± 6 Weight (kg) 63 ± 14 69 ± 12 77 ± 10* BMI (kg/m2)2 23.8 ± 3.9 26.3 ± 3.7 27.9 ± 3.2* Body fat (%) 29.7 ± 6.6 31.2 ± 5.9 33.0 ± 4.9 Waist circumference (cm) 85 ± 10 89 ± 10 101 ± 9* Hip circumference (cm) 99 ± 7 102 ± 8 108 ± 6* WHR2 _{0.86 ± 0.07} _{0.88 ± 0.06} _{0.93 ± 0.06} 1_{Values are mean ± SD}

2_{BMI, body mass index; WHR, waist hip ratio} 3_{Data were analysis using ANOVA with scheffe's test}

*value has significant difference compare with H group ( p < 0.05)

表四、hs-CRP 與各人體測量值的相關性1,2

Table 4. Correlation coefficient of hs-CRP and anthropometric data.1,2

hs-CRP Sex Age Height Weight BMI Body fat Waist circumference Hip circumference WHR hs-CRP 1 -0.03709 0.30571* 0.02783 0.29342 0.38571 0.23781 0.3333* 0.4307* 0.11583 Sex 1 -0.15144 -0.76929* -0.64387* -0.41556 0.62024* -0.60239* -0.39882* -0.57318* Age 1 0.17650 0.24795 0.22176 0.24894 0.25011 0.39415* -0.00542 Height 1 0.68921* 0.33962 -0.48079* 0.53427* 0.40234* 0.46507* Weight 1 0.91317* -0.00694 0.88652* 0.84714* 0.56883* BMI 1 0.23881 0.84993* 0.87803* 0.47319* Body fat 1 0.00542 0.31656 -0.34362* Waist circumference 1 0.81079* 0.79186* Hip circumference 1 0.28812 WHR 1

1.Data is representing in r-value by Pearson correlation coefficient. 2. BMI, body mass index; WHR, waist hip ratio.

*Data has correlation significantly. (p < 0.05)

前言與目的

材料與方法

結果

討論

表三、分組別受試者的血液生化數值分析1,2,3

Table 3. Biochemical data by group.1,2,3

H group DM - L group DM + L group 1st month (n = 13) 4th month (n = 10) 1st month (n = 8) 4th month (n = 3) 1st month(n = 12) 4th month (n = 5) TC (mg/dL) 181.8 ± 26.1b 178.5 ± 19.2 214.4 ± 21.8a 196.0 ± 16.8 172.1 ± 31.0b 192.2 ± 13.4 TG (mg/dL) 82.2 ± 28.9b _{82.2 ± 21.6} _{111.1 ± 45.5}a,b _{131.3 ± 62.3} _{172.5 ± 92.3}a _{185.6 ± 130.1}

HDL-C (mg/dL) 59.5 ± 14.8a _{61.1 ± 20.7} _{51.5 ± 13.7}a _{58.3 ± 18.9} _{35.1 ± 6.3}b _{41.2 ± 9.9}

LDL-C (mg/dL) 109.8 ± 30.2b _{105.7 ± 22.1} _{146.1 ± 17.5}a _{119.3 ± 9.1}ξ 108.0 ± 23.9b _{118.4 ± 20.1}

TC/HDL-C 3.22 ± 0.91b _{3.11 ± 0.69}b _{4.37 ± 1.04}a,b _{3.52 ± 0.80}a,b _{5.03 ± 1.25}a _{4.92 ± 1.40}a

HbA1C (%) 5.5 ± 0.2b _{5.6 ± 0.3}b _{7.5 ± 1.4}a _{6.9 ± 0.4a} _{7.6 ± 0.7}a _{6.6 ± 0.5}a,ξ

CRP (mg/L) 1.025 ± 0.774b 1.369 ± 1.072 2.350 ± 1.460a,b 1.177 ± 0.806 2.509 ± 2.136a 1.988 ± 1.933

1Values are mean ± SD

2_{Mean with the different symbol (a or b) are significantly different according to the comparisons.}

3TC, total cholesterol; TG, triglyceride; HDL-C, high density lipoprotein- cholesterol; LDL-C, low density lipoprotein - cholesterol; HbA1C, hemoglobin A1C; CRP, C-reactive protein.