2型糖尿病患者视黄醇结合蛋白4与炎症因子、脂代谢及胰岛素抵抗的相关分析

目的探讨RBP-4对与2型糖尿病患者炎症因子超敏C反应蛋白（hs—CRP）、脂代谢及胰岛素抵抗的关系。方法105例门诊初诊患者及同期门诊或体检中心健康体检者，正常葡萄糖耐量（NGT）组34例和T2DM组71例，按BM1分为正常体重组（NW）56例及超重／肥胖组（OW／OB）49例。用ELISA测定血清RBP-4。全自动生化仪检测hs—CRP、游离脂肪酸（FFA）、甘油三酯（TG）、总胆固醇（Tc）；化学发光法检测胰岛素。结果T2DM组ln（HOMA—IR）、TG、FFA、In（hs—CRP）均高于NGR组1．20±0．38VS0．76±0．34，（2．74±2．20）mmol／L vs（1．88±1．41）mmol／L，（0．80±0．29）mmol／L vs（0．61±0．22）mmol／L，0．62±1．00 vs -0．17±1．07]，差异有统计学意义。单因素简单相关分析显示，NGR组lnRBP-4与In（HOMA-IR）存在正相关（r=0．382，P〈0．05），与TC、TG、FFA、in（hs．CRP）无关。T2DM组，lnRBP-4与FFA、In（hs—CRP）呈正相关（r=0．242，P〈0．05；r=0．346，P〈0．01），但与in（HOMA—IR）、TC、TG均无相关性。NW组，lnRBP-4与ln（HOMA—IR）、TC、TG、FFA、ln（hs-CRP）均无相关性。而OW／OB组，lnRBP-4与ln（HOMA—IR）、In（hs—CRP）呈正相关（r=0．290，0．295，P〈0．05），但与TC、TG、FFA无关。逐步多元线性回归分析显示，各组的ln（hs—CRP）、TC、TG、FFA、in（HOMA—IR）均非lnRBP-4的独立影响因素。结论在T2DM患者中，RBP-4与ln（hs．CRP）、FFA正相关，可作为一新的炎症标志物。

The relationship between serum retinol binding protein 4 and the parameters of inflammatory, lipid metabolism, insulin resistance in patients with type 2 diabetes

Objective To investigate the relationships between serum concentration of RBP-4 and the parameters of inflammatory, lipid metabolism, insulin resistance in patients with T2DM. Methods 71 patients newly diagnosed with T2DM and 34 subjects with normal glucose tolerance (NGT) were enrolled in this cross-sectional study. Additionally, another subset analysis was performed. Subjects were divided into normal weight (NW) and overweight or obesity (OW/OB) group on the basis of BMI. Serum RBP-4 was measured with ELISA. Serum concentrations of hs-CRP, free fatty acids (FFA), triglyceride (TG), total cholesterol (TC) and insulin were measured in fasting status. Insulin resistance was assessed by HOMA-IR. Results Ln (HOMA-IR) and the concentrations of TG, FFA, In(hs-CRP) in T2DM were significant-ly higher than that of NGR group1.20±0.38 vs 0.76±0.34,(2.74±2. 20)mmol/L vs (1.88±1.41),(0. 80±0. 29)mmol/L vs (0.61±0.22)retool/L,0.62±1.00 vs -0. 17±1.07] . InRBP-4 showed a positive relationship with In (HOMA-IR) ( r =0. 382, P <0. 05), but no association with TC, TG, FFA and In(hs-CRP). In the group of T2DM, InRBP-4 showed a positive relationship with FFA ( r =0. 242, P <0.05) and In (hs-CRP) ( r =0.346, P <0.01), but no association with TC, TG and In (HOMA-IR). There were no relationships between InRBP-4 and In (HOMA-IR), TC, TG, FFA and In (hs-CRP)in NW, while in OW/OB group, InRBP-4 showed a positive relationship with In (HOMA-IR) ( r =0. 290,P < 0. 05 ) and In (hs-CRP) ( r = 0. 295, P <0.05 ), but no association with TC, TG and FFA. In a mul-tiple linear regression analysis, In( hs-CRP), TC, TG, FFA or In(HOMA-IR) was not the independent de-terminant of InRBP-4 in any group. Conclusion In patients with T2DM, InRBP-4 is positively correlatedwith In (hs-CRP) and FFA, and it may be a new marker of inflammation.