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      • KCI등재후보

        제 2 형 당뇨병 환자 및 당뇨병과 심혈관질환이 없는 성인을 대상으로 조사한 심혈관계질환의 위험인자와 혈청 high sensitivity C - reactive protein 사이의 관련성 비교

        김형진(Hyeung Jin Kim),배상운(S. W. Pae),김대중(Dae Jung Kim),김수경(Soo Kyung Kim),김세화(Se Hwa Kim),이유미(Yu Mie Rhee),정상수(Sang Su Chung),안철우(Chul Woo Ahn),차봉수(Bong Soo Cha),송영득(Young Duk Song),임승길(Sung Kil Lim),김경 대한내과학회 2002 대한내과학회지 Vol.63 No.1

        N/A Background: High sensitivity C-reactive protein (hsCRP) is more sensitive than standard CRP assay for evaluation of risk of coronary heart diseases and other atherosclerotic events. But, there were no data of association of serum hsCRP with risk factors of cardiovascular diseases and nonalcoholic fatty liver in Korean type 2 diabetic and nondiabetic subjects. Methods: A hundred type 2 diabetic subjects (51 men and 49 women) from Severance Hospital and 200 nondiabetic subjects participating medical checkup in Health Promotion Center (105 men and 95 women) were recruited and subjects with acute illnesses and chronic inflammatory diseases such as upper respiratory infection, rheumatoid arthritis, osteoarthritis, or viral hepatitis were excluded. A standardized interview was conducted by trained personnel; detailed information was collected on medical history, dietary habits and lifestyle characteristics, including smoking, alcohol and physical activity. Body mass index (BMI) was computed and biochemical study were undergone using fasting blood. All subjects were done abdominal ultrasonography for evaluation of fatty liver. Serum hsCRP concentration was measured by Nephelometer AnalyzerⅡ (Behring Co.) and a lower detection limit of test was 0.18 mg/L. Results: There was no difference in sex, BMI, presence of fatty liver, concentration of total cholesterol, triglyceride, high density lipoprotein-cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and uric acid between diabetic and nondiabetic subjects. Age, total colesterol/HDL-C ratio, fasting blood glucose and incidence of hypertension were higher in diabetic than nondiabetic subjects, but a rate of smoking was higher in nondiabetic than diabetic subjects. The mean concentration of serum hsCRP was remarkably increased in type 2 diabetic subjects than nondiabetic subjects (1.34±1.87 vs 0.71±0.80 mg/L, p<0.05). After adjustment of different variables between both groups, there was significantly difference of the concentration of serum hsCRP (p<0.05). In nondiabetic subjects, by univariate analysis, there was a positive correlation between hsCRP and age (r=0.26, p<0.05), BMI (r=0.34, p<0.05), systolic blood pressure (r=0.21, p<0.05), diastolic blood pressure (r=0.16, p<0.05), triglyceride (r=0.27, p<0.05), total cholesterol/HDL-C ratio (r=0.22, p<0.05), uric acid (r=0.15, p<0.05) and a negative correlation between serum hsCRP and HDL-C (r=-0.16, p<0.05). Interestingly, subjects with fatty liver had shown increased serum hsCRP concentration than subjects without fatty liver (0.99±0.96 vs 0.58±0.69 mg/L, p<0.05). But there were no correlation of serum hsCRP with the history of smoking, sex, physical activity, fasting plasma glucose and presence of hypertension. After multiple regression analysis, only BMI and age were associated with serum hsCRP. In diabetic subjects, there were significant correlation of serum hsCRP with HDL-C and fasting plasma glucose, but other risk factors of cardiovascular diseases and fatty liver were not. When we compared serum hsCRP according to numbers of risk factors of cardiovascular diseases in nondiabetic subjects, group without risk factors had 0.41±0.55 mg/L, group with one risk factor had 0.48±0.40 mg/L, group with two risk factors had 0.75±0.88 mg/L, group with three risk factors had 1.08±0.87 mg/L and group with four risk factors had 1.55±1.21 mg/L. There was significant difference of serum hsCRP according to numbers of risk factors of cardiovascular diseases (p<0.05). Conclusion: Serum hsCRP is correlated with risk factors of cardiovascular diseases and may be useful tool for prediction of accelerated, atherosclerotic process in nondiabetic subjects. Although there is association of serum hsCRP with few risk factors of cardiovascular diseases, serum hsCRP is elevated in diabetic subjects. Therefore it is necessary to evaluate usefulness of serum hsCRP using carefully selected diabetic subjects. In addition, our study had show

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