Association between plasma high-sensitivity C-reactive protein and insulin resistance and white matter lesions in Japanese type 2 diabetic patients

作者：Anan Futoshi^*; Masaki Takayuki; Kikuchi Hidetoshi; Iwao Tetsu; Shimomura Tsuyoshi; Umeno Yoshikazu; Eshima Nobuoki; Saikawa Tetsunori; Yoshimatsu Hironobu

来源：Diabetes Research and Clinical Practice, 2010, 87(2): 233-239.

DOI：10.1016/j.diabres.2009.10.017

• High-sensitivity C reactive protein
• Insulin resistance
• White matter lesions
• Type 2 diabetes mellitus

The presence of white matter lesions (WML) is an important prognostic factor for the development of stroke. High-sensitivity C-reactive protein (HSCRP), which is associated with diabetes, has been flagged as a novel predictor for cerebrovascular events. This preliminary study was therefore designed to test the hypothesis that the presence of WML correlates with HSCRP and insulin resistance in type 2 diabetic patients not receiving insulin treatment.
Based on brain magnetic resonance imaging (MRI) findings, 102 type 2 diabetic patients were divided into two groups; a WML-positive group (59 +/- 6 years, mean +/- SD, n = 40) and a WML-negative group (58 +/- 6 years, n = 62). The level of blood glucose was assessed by fasting plasma glucose (FPG), fasting immunoreactive insulin (F-IRI), homeostasis model assessment (HOMA) index, and Hemoglobin A1c (HbA1c).
The body mass index was higher in the WML-positive group than in the WML-negative group (p < 0.05). Plasma levels of triglycerides were higher while high-density lipoprotein cholesterol (HDL-C) was lower in the WML-positive group than in the WML-negative group (p < 0.01 and p < 0.005, respectively). Fasting plasma glucose (p < 0.005), insulin concentrations (p < 0.0001), HOMA index (p < 0.0001), and HSCRP (<0.0001) levels were higher in the WML-positive group than in the WML-negative group. Multivariate logistic analysis revealed that WML was independently predicted by the high HSCRP and insulin resistance (p < 0.005, p < 0.0005, respectively).
The results of this preliminary study indicate that the presence of WML was associated with the high HSCRP and insulin resistance in these Japanese patients with type 2 diabetes mellitus; larger cohort studies are warranted to confirm these findings.

• 出版日期2010-2