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目的:探讨2型糖尿病(type 2 diabetes mellitus,T2DM)合并代谢综合征(metabolic syndrome,MS)患者颈围与胰岛素抵抗、血清超敏C反应蛋白(hs-CRP)的关系.方法:选择研究对象165例,其中对照组55例,单纯2型糖尿病组(T2DM组)55例,T2DM合并MS组(MS组)55例.所有研究对象测量颈围,行口服葡萄糖耐量试验(OGTT)及胰岛素释放试验,并检测血脂、血清hs-CRP等相关生化指标.结果:MS组的颈围为(38.47 ±3.68) cm,大于正常对照组(35.17±3.09)cm及T2DM组(36.86±2.92)cm(P＜0.05或P＜0.01);MS组血清hs-CRP水平为[2.77(1.19～5.55)] mg/L,显著高于正常对照组[0.40(0.18 ～0.98)]mg/L及T2DM组[1.74(0.81 ～5.33)] mg/L(P ＜0.01).随着颈围水平的升高,体质量指数(BMI)、腰围、腰臀比、空腹胰岛素(FINS)、餐后2h胰岛素(PSI)、三酰甘油、胰岛素抵抗指数(HOMA-IR)及hs-CRP水平显著升高,高密度脂蛋白胆固醇(HDL-C)水平显著降低.简单相关分析显示,颈围与BMI、腰围、腰臀比、舒张压、空腹血糖、餐后2h血糖(2hPG)、FINS、PSI、三酰甘油、低密度脂蛋白胆固醇(LDL-C)、HOMA-IR及hs-CRP呈正相关(P＜0.05或P＜0.01),与HDL-C呈显著负相关(P＜0.01);Logistic回归分析显示,颈围、腰围、三酰甘油是T2DM合并MS的危险因素,HDL-C是其保护因素(P＜0.01).结论:新诊断T2DM合并MS患者颈围明显增加,其与胰岛素抵抗、血清hs-CRP水平密切相关,颈围是T2DM合并MS的危险因素.“,”Objective:To investigate neck circumferences in patients with type 2 diabetes mellitus (T2DM) with metabolic syndrome(MS),and to study the association between neck circumference,insulin resistance and highly sensitive C-reactive protein.Methods:A total of 165 subjects were enrolled in the study,including 55 healthy subjects and 110 patients with newly-diagnosed type 2 diabetes(T2DM) which were divided into T2DM group and T2DM with MS group.Oral glucose tolerance test(OGTT) and insulin releasing test were performed in all subjects,meanwhile,neck circumference,blood lipid,hs-CRP and other items were measured.Results:Compared with control group and T2DM group,the neck circumference was increased in MS group[(38.47 ±3.68) vs (35.17 ±3.09)cm,(38.47 ±3.68) vs (36.86 ± 2.92) cm,P ＜0.05 or P ＜0.01,respectively].The serum hs-CRP in MS group was higher than in normal control group and T2DM group [2.77 (1.19 ～ 5.55) vs 0.40 (0.18 ～ 0.98) mg/L,2.77 (1.19 ～ 5.55) vs 1.74(0.81 ～5.33)mg/L,P ＜0.01,respectively].Subjects in the upper neck circumference fertile had higher levels of BMI,WC,WHR,FINS,PSI,TG,HOMA-IR and hs-CRP,while lower levels of HDL-C when compared to subjects in the middle or lower neck circumference fertile(P ＜0.05 or P ＜0.01).The neck circumference was positively correlated with BMI,WC,WHR,DBP,FPG,2hPG,FINS,PSI,TG,LDL-C,HOMA-IR and hs-CRP,while negatively correlated with HDL-C (P ＜ 0.05 or P ＜ 0.01).Logistic regression analysis showed that neck circumference,WC and TG were independent risk factors for T2DM with MS,while HDL-C was the protective one(P ＜ 0.01).Conclusion:Newly-diagnosed type 2 diabetes mellitus patients with MS tend to have bigger neck circumference,the neck circumference was associated with insulin resistance and hs-CRP.The neck circumference was the risk factor for T2DM with MS.