The Changes Of C-reactive Protein And Adiponectin In Different Stages Of Glycometabolism And Different Numbers Of Components Of Metabolic Syndrome

【Objective】To evaluate the changes of C-reactive protein and adiponectin in different stages of glycometabolism and different numbers of components of metabolic syndrome and to explore their roles in the development and progression of diabetes mellitus(DM)and metabolic syndrome(MS).【Methods】According to the criteria of DM from WHO(1999)and the new impaired fasting glucose(IFG)definition from ADA(2003),the subjects from the diabetic epidemiologic survey conducted in Guangxi were divided into five groups on the basis of oral glucose tolerance test(OGTT):normal glucose tolerance(NGT),isolated impaired fasting glucose(I-IFG),isolated impaired glucose tolerance(I-IGT),both impaired fasting glucose and impaired glucose tolerance(IFG/IGT)and diabetes mellitus(DM).The cases in each group were randomly drawn by age and sex,32 cases with NGT,31 cases with I-IFG,34 cases with I-IGT,29 cases with IFG/IGT and 36 cases with DM,totalling of 162 cases.Impaired glucose regulation(IGR)was composed of I-IFG,I-IGT and IFG/IGT.According to the criteria of MS from IDF(2005),162 cases were divided into different numbers of components of MS:A group with zero component of MS,B group with one or two components,and C group with three or more components.Serum CRP was measured by nephelometry,and APN by enzyme-linked immunosorbentassay(ELISA).At the same time,BMI,waist circumference,SBP,DBP,FPG,2hPG,TC,TG,HDL,LDL,UA,and FINS were determined in all subjects.Insulin resistance index was calculated in homeostasis model assessment.【Results】①The CRP levels of NGT,IGR and DM were 2.80,3.70 and 4.95 respectively.Compared with NGT group,IGR and DM groups had higher CRP,DM group had the highest level(P＜0.01).As for I-IFG,I-IGT and IFG/IGT groups,the CRP levels were 3.80,3.15 and 3.80 respectively.There were no differences among these three groups(P＞0.05).②.The CRP levels of A,B and C groups were 2.95,3.20 and 4.50 respectively.C group had higher CRP than A or B group,but there was no difference between A and B group(P＞0.05).③.The APN levels of NGT,IGR and DM were 16.40,9.70 and 4.95 respectively. Compared with NGT group,IGR and DM groups had lower APN,DM group had the lowest level(P＜0.01).As for I-IFG,I-IGT and IFG/IGT groups,the APN levels were 6.80,10.85 and 10.50 respectively.Compared with I-IGT group, I-IFG group had the lower level.But there was no difference between I-IFG and IFG/IGT group,also I-IGT and IFG/IGT group(P＞0.05).④.The APN levels of A,B and C groups were 15.10,12.10 and 6.20 respectively.C group had lower APN than A or B group,but there was no difference between A and B group(P＞0.05).⑤.In a multiple regression model,APN,HOMA-IR,sex,BMI and TG remained significantly and independently related to CRP level.Among these factors,HOMA-IR,BMI and TG showed a direct correlation with CRP,while and APN showed a inverse correlation.Women had higher CRP level than men.⑥.In a multiple regression model,CRP,HDL,HOMA-IR,TG and LDL remained significantly and independently related to APN level.Among these factors,HDL showed a direct correlation with APN,while CRP,HOMA-IR,TG,LDL showed a inverse correlation.⑦.CRP,APN,2hPG entered the logistic equation with statistic significance,and CRP,2hPG were the risk factors of insulin resistance,while APN was the protective fator. 【Conclusions】①.From NGT to DM,the serum level of CRP increased,along with the increasing HOMA-IR,indicated that there was inflammatory reaction in the early stage of abnormal glycometabolism,and related to insulin resistance.②.Along with the rising numbers of components of MS,the serum CRP level increased,indicated that people who had higher CRP level tend to get metabolic syndrome.③.From NGT to DM,the serum APN level decreased,while the HOMA-IR level increased,indicated lower serum APN may anticipate the occurrence of insulin resistance and type 2 diabetes mellitus.④.People who got the lower APN level risked to have metabolic syndrome.⑤.The relationship between CRP,APN and IR indicate that CRP showed a inverse correlation with APN,CRP was the risk factor of IR,while APN was a protective factor.