视黄醇结合蛋白4在妊娠期糖尿病患者中的表达及其临床意义

目的：分析视黄醇结合蛋白4（retinol-binding protein4,RBP4）在妊娠期糖尿病患者和健康孕妇血清中的浓度差异及其与临床、病理特征的关系。方法：检测18例妊娠期糖尿病（GDM）和212例健康孕妇血清中RBP4的表达,分别于孕18周、孕20周、孕28周及产后8周空腹收集血清。利用酶联免疫吸附实验（ELISA）检测血清RBP4的表达。用HOMA-IR（homeosta-sis model assessment）模型评价胰岛素抵抗程度。结果：所有孕妇血清RBP4水平在产前各时间点呈时间依赖性升高。产后8周（中位数,15.35μg/mL;四分位数,11.32～27.85μg/mL）孕妇血清RBP4水平均下降。孕20周（中位数,45.72μg/mL;四分位数,33.34～58.69μg/mL）、孕28周（中位数,52.34μg/mL;四分位数,42.65～73.54μg/mL）时,GDM患者血清RBP4水平高于健康孕妇（孕20周：中位数,19.13μg/mL;四分位数,15.23～22.65μg/mL;孕28周：中位数,42.54μg/mL;四分位数,24.56～55.21μg/mL）。孕18周（中位数,16.80μg/mL;四分位数,14.58～28.67μg/mL）和产后8周（中位数,15.35μg/mL;四分位数,11.32～27.85μg/mL）,GDM患者血清RBP4水平和健康孕妇无显著差异（孕18周：中位数,15.78μg/mL;四分位数,10.23～19.35μg/mL;产后8周：中位数,13.54μg/mL;四分位数,9.21～18.35μg/mL）。孕20周时血清RBP4水平和HOMA-IR（相关系数r=0.872;P=0.002）、体质量指数、血清三酰甘油和低密度脂蛋白呈正相关,和高密度脂蛋白呈负相关。结论：孕20周血清RBP4水平可能成为GDM的早期诊断指标。

Expression and Roles of Retinol-Binding Protein 4 in Patients with Gestational Diabetes Mellitus: a Prospective Study

Objective：This study was performed to analysis the expression of retinol-binding protein 4（RBP4） in serum of patients with gestational diabetes mellitus（GDM） and healthy pregnant woman？and the relationship between RBP4 and clinicopathological features of GDM patients.Methods：We prospectively collected and measured the serum RBP4 levels by enzyme-linked immunosorbentassay（ELISA） of 18 patients with GDM and 212 healthy pregnant women at gestational weeks 18,20,28,and postpartum weeks 8.The extent of insulin resistant was evaluated by homeostasis model assessment（HOMA-IR）.Results：The serum RBP4 level presented a time-dependent increase in all pregnant women.The serum RBP4 level of GDM was higher than that of healthy pregnant women at gestational weeks 20 and 28.The serum RBP4 level had positive relations with HOMA-IR and fasting blood-glucose（FPG） at gestational weeks 20.Conclusions：The serum RBP4 level at gestational weeks 20 is potential to be an early diagnostic marker for GDM.