High sensitive C Reactive Protein ：It''''s role in insulin resistance and Coronary Artery Disease

• Main Authors: joy, Shao Pin Ru, 蕭彬如
• Other Authors: 許惠恒
• Format: Others
• Language: zh-TW
• Published: 2002
• Online Access: http://ndltd.ncl.edu.tw/handle/46110185972182338409

碩士 === 國立中興大學 === 生命科學院碩士在職專班 === 90 === Coronary artery disease (CAD) has been a major cause of death in industrialized world. CAD is formed by atheroslcerosis result from interaction among aging, hypertension, dyslipidemia, smoking, diabetes mellitus (DM) and associated genetic factors. In addition, diabetes mellitus and its pathogenic mechanism, insulin resistance, have been shown to implicate in the development of CAD. Recently, emerging evidence indicate that subclinical inflammation within artery contribute to the formation of atherosclerosis. High sensitive C-reactive protein (hs-CRP), a circulatory protein, produced by liver and secreted into blood, have been shown in prediction of coronary events in several large scale clinical studies. We conducted a cross-sectional study in order to investigate the role of hs-CRP in association with insulin resistance and CAD. There were a total of two studies groups. First group consisted of 291 men (mean age 53 years) and 206 women (mean age 52 years) who came for physical check-up at Taichung Veterans General Hospital. The second group were 1231 men (mean age 67 years) and 439 women (mean age 66 years) who were hospitalized for coronary angiography. Anthropoemetric data were collected. Serum biochemical measurement including fasting glucose (FPG), insulin (FPI), cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglyceride (TG), calculated low density lipoprotein cholesterol (LDL-C) were determined. In addition, serum levels of hs-CRP were assessed by Latex method. Degree of insulin resistance was estimated by HOMA insulin resistance index. There were no significant difference of value of hs-CRP between gender. Hs-CRP concentrations were highest in subjects with CAD, intermediate in subjects without CAD and lowest in subjects for physical check-up independent of sex (all p<0.05). In subjects who came for physical check-up, hs-CRP levels correlated well with age, cholestrol, LDL-C, ratio of TC/HDL-C positively (all p<0.05) while negatively with HDL-C (p<0.05). In subjects with CAD, BMI and serum level of TG, TC, LDL-C, ratio of TC/HDL-C showed no significant difference among those with low, moderate and high levels of hs-CRP. However, these values were lowered in subjects with very high levels of hs-CRP. In all subjects received coronary angiography, hs-CRP concentrations increased along with values of FPG and HOMA insulin resistance index (p<0.05). Results of logistic regression analysis revealed that age, hypertension, hypercholesterolemia, smoking, HOMA insulin resistance index and hs-CRP were all independently associated with CAD. We conclude that hs-CRP related to insulin resistance and contribute the development of CAD in Chinese subjects at Taichung, Taiwan.