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目的研究视黄醇结合蛋白4(retinolbinding protein 4,RBP4)与妊娠期糖尿病(gestational diabetes mellitus,GDM)发病的相关性,并探讨妊娠年龄对这一相关性的影响。方法选取2011年10月至2013年6月首都医科大学宣武医院治疗的GDM患者272例为GDM组,正常孕妇282例为对照组,比较两组患者血清RBP4和胰岛素相关指标的差异,采用逻辑回归法评估妊娠年龄对RBP4与GDM相关性的影响。结果 GDM患者的血清RBP4浓度(48.17±22.08)mg/L高于对照组(40.21±19.24)mg/L(t=4.528,P<0.05)。两组空腹血糖(fasting pasma glucose,FPG)、空腹胰岛素(fosting insulin,FINS)及胰岛素抵抗指数(HOMA-IR)的差异有统计学意义(t=24.563、30.935、46.677,P<0.05),但胰岛β细胞分泌功能指数(HOMA-β)差异无统计学意义(t=1.773,P>0.05)。≥35岁且血清RBP4较高(≥38.3mg/L)的妊娠妇女GDM发病率是<35岁且血清RBP4较低(<38.3mg/L)妇女的2.33倍(95%CI:1.25~4.24,P<0.05)。结论妊娠期血清RBP4升高与妊娠期糖尿病的发生存在相关,尤以高龄妊娠女性为著。
Objective To study the correlation between retinol binding protein 4 (RBP4) and gestational diabetes mellitus (GDM) and to explore the influence of gestational age on this correlation. Methods A total of 272 GDM patients treated with Xuanwu Hospital of Capital Medical University from October 2011 to June 2013 were selected as GDM group and 282 normal pregnant women as control group. The differences of serum RBP4 and insulin-related indexes between the two groups were compared using logistic regression Assessment of the effect of gestational age on the association of RBP4 with GDM. Results Serum RBP4 concentration in patients with GDM (48.17 ± 22.08) mg / L was significantly higher than that in controls (40.21 ± 19.24) mg / L (t = 4.528, P <0.05). The difference of fasting plasma glucose (FPG), fosting insulin (FINS) and insulin resistance index (HOMA-IR) between the two groups was statistically significant (t = 24.563,30.935,46.677, P <0.05) There was no significant difference in the secretion function index (HOMA-β) of pancreatic islet β cells (t = 1.773, P> 0.05). The incidence of GDM in pregnant women 35 years and older with high serum RBP4 (≥38.3 mg / L) was 2.33 times (95% CI: 1.25 to 4.24, P <0.05). Conclusion The increase of serum RBP4 in pregnancy is related to the occurrence of gestational diabetes mellitus, especially in older pregnant women.