妊娠期糖尿病血清视黄醇结合蛋白4和胰岛素抵抗指数变化的相关性

目的：探讨妊娠期糖尿病（GDM）血清视黄醇结合蛋白4（RBP4）的表达变化及其与胰岛素抵抗指数的关系。方法选择在上海市浦东医院门诊行常规产前检查并分娩的GDM孕妇35例（GDM组），根据治疗方式分为改善饮食组20例和胰岛素组15例。选择同期在本院门诊产前检查并住院分娩正常孕妇30例（对照组）。分别测定3组血清RBP4，空腹血糖（FPG）和空腹胰岛素（FINS）水平，并计算稳态模型的胰岛素抵抗指数（HOMA-IR），研究RBP4和HOMA-IR的相关性。结果 GDM组BMI、新生儿出生体重、血清RBP4、FINS、FPG及HOMA-IR[（27.6±2.1）kg/cm2、（3.6±0.5）kg、（29.1±1.4）mg/L、（11.6±2.3）mU/L、（5.3±1.4）mmol/L、（3.1±0.4）]高于对照组[（26.7±1.2）kg/cm2、（3.4±0.6）kg、（19.6±1.9）mg/L、（8.0±0.7）mU/L、（4.7±0.8）mmol/L、（1.7±0.2）]；胰岛素组BIM、血清RBP4、FINS水平及HOMA-IR[（28.2±2.7）kg/cm2、（30.0±1.4）mg/L、（13.1±3.6）mU/L、（3.8±0.4）]均高于改善饮食组[（27.3±1.5）kg/cm2、（28.1±1.4）mg/L、（10.8±1.8）mU/L、（2.4±0.3）]；差异均有统计学意义。血清RBP4和HOMA-IR正相关（r＝0.486）。结论 GDM血清RBP4水平和胰岛素抵抗密切相关。

Relationship between serum retinol binding protein 4 levels and insulin resistance in gestational diabetes mellitus

Objective Toexploretherelationshipbetweenserumretinolbindingprotein4（RBP4）levelsand insulin resistance in patients with gestational diabetes mellitus. Methods From May 201 1 to April 2012,65 pregnant women who had prenatal examinations and delivered in the Department of Obstetrics,Pudong Hospital of Shanghai,were recruited,including 35 cases with GDM （GDM group）and 30 with normal glucose tolerance test （control group）.The GDM-group was divided into medical nutrition therapy group and insulin treatment group.Enzyme-linked immunosorbent assay （ELISA）was used to determine serum concentrations of RBP4 and radio immunoassay to measure the serum levels of fasting insulin （FINS）.Fasting plasma glucose was tested by glucose oxidase,and home model insulin resistance index （HOMA-IR） was calculated.Correlations between the expression of serum of RBP4 and HOMA-IR were analyzed. Results BMI,newborn birth weight,levels of serum RBP4,FINS,FPG and HOMA-IR of the GDMgroup[（27.6 ±2.1） kg/cm2,（3.6 ±0.5）kg,（29.1 ±1.4）mg/L,（11,6 ±2.3）mU/L,（5.3 ±1.4）mmol/L,（3.1 ±0.4）]were higher than the control group [（26.7 ±1.2）kg/cm2,（3.4 ±0.6）kg,（19.6 ±1.9）mg/L,（8.0 ±0.7）mU/L,（4.7 ±0.8） mmol/L,（1.7 ±0.2）]. BIM,levels of serum RBP4,FINS and HOMA IR of the insulin-treated group [（28.2 ±2.7） kg/cm2 ,（30.0 ±1.4）mg/L,（13.1 ±3.6）mU/L,（3.8 ±0.4）]were higher than the nutrition therapy group [（27.3 ± 1.5）kg/cm2,（28.1 ±1.4）mg/L,（10.8 ±1.8）mU/L,（2.4 ±0.3）].The differences were statistically significant. Serum concentrations of RBP4 were positively correlated with HOMA-IR （r=0.486,P＆lt;0.05 ）. Conclusion Serum concentrations of RBP4 were positively correlated with HOMA-IR.