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目的探讨妊娠糖尿病个体与非妊娠糖尿病个体血清视黄醇结合蛋白4(retinol binding protein4,RBP4)水平的差异及影响因素。方法收集36例妊娠糖尿病个体,应用ELISA测定血清RBP4水平,同时测定血糖、血脂、胰岛素代谢水平,计算胰岛素抵抗指数(HOMA-IR),并与45例非妊娠糖尿病个体比较。结果妊娠糖尿病个体血清RBP4水平明显低于非妊娠糖尿病对照组[(28.38±22.60)vs(55.20±65.51),P=0.013],年龄、HOMA-IR、胰岛素分泌功能(B)高于对照组。多元线性回归分析显示HOMA-IR对RBP4水平没有影响,HDL-c(P=0.021)、TC(P=0.004)、B(P=0.016)是影响妊娠糖尿病个体血清RBP4水平的主要因素。结论妊娠糖尿病个体血清RBP4水平低于非妊娠糖尿病对照个体,这提示单纯血清RBP4水平可能不是评估妊娠时胰岛素-葡萄糖稳态的有效指标。
Objective To investigate the differences and influencing factors of serum retinol binding protein 4 (RBP4) in individuals with gestational diabetes mellitus and non-gestational diabetes mellitus. Methods 36 cases of gestational diabetes mellitus were collected. Serum RBP4 levels were measured by ELISA. The levels of blood glucose, lipids and insulin were also measured. The insulin resistance index (HOMA-IR) was calculated and compared with 45 cases of non-gestational diabetes mellitus. Results The level of RBP4 in gestational diabetes mellitus was significantly lower than that in non-gestational diabetes mellitus (28.38 ± 22.60 vs 55.20 ± 65.51, P = 0.013), and the age, HOMA-IR and insulin secretion (B) were higher than those in control group. Multivariate linear regression analysis showed that HOMA-IR had no effect on RBP4 level. HDL-c (P = 0.021), TC (P = 0.004) and B (P = 0.016) were the main factors influencing RBP4 level in gestational diabetes mellitus. Conclusions The level of RBP4 in gestational diabetes mellitus is lower than that in non-gestational diabetes mellitus, which suggests that serum RBP4 level may not be an effective measure to assess insulin-glucose homeostasis during pregnancy.