妊娠期糖尿病患者血清视黄醇结合蛋白4的临床研究

目的：探讨血清视黄醇结合蛋白4（RBP4）和超敏C反应蛋白（hsCRP）水平与妊娠期糖尿病（GDM）的关系及其临床意义。方法选取GDM患者50例为GDM组，葡萄糖耐量试验正常孕妇50例为NGT组，健康的非妊娠妇女50例为NC组，对三组采用酶联免疫吸附法检测血清RBP4的水平，用免疫散射比浊法检测血清hsCRP的水平，检测体重指数（BMI）、糖脂代谢指标和胰岛素抵抗指数（HOMA-IR），并作相关分析。结果 GDM组血清RBP4和hsCRP水平均明显高于NGT组和NC组，差异均有统计学意义（t分别=2.87、3.19；2.55、2.96， P均＜0.05），GDM组患者血清RBP4均与空腹血糖（FBG）、空腹血清胰岛素（FINS）、糖化血红蛋白（HbA1c）、hsCRP和HOMA-IR呈正相关（r分别=0.37、0.29、0.31、0.42、0.33， P均＜0.05）；GDM组中HbA1c和HOMA-IR还是RBP4浓度的影响因素（OR分别=1.04、0.98， P均＜0.05）。结论 GDM患者体内存在RBP4异常表达，RBP4与FBG、HbA1c、hsCRP和HOMA-IR相关，并且GDM组中HbA1c和HOMA-IR还是血清RBP4水平的影响因素，提示RBP4可能参与了GDM和IR的发生与发展。

Clinical research of serum RBP4 level in patients with gestational diabetes mellitus

Objective To evaluate the relationship between the levels of RBP4, hsCRP and gestational diabetes mellitus and its clinical significance. Methods A total of 50 patients with gestational diabetes mellitus were selected as GDM group, 50 cases of pregnant whose oral glucose tolerance test were normal were selected as NGT group and 50 cases of healthy unpregnancy as NC group. RBP4 was detected with ELISA and hsCRP was measured with immune nephelometry. The BMI, the index of glycometabolism and HOMA-IR were detected. Results The RBP4 and hsCRP levels of GDM group were significantly higher than those of the NGT group and NC group （t=2.87,3.19;2.55,2.96,P〈0.05）. The RBP4 level of GDM group were positively related with FBG, FINS, HbA1c, hsCRP and HOMA -IR （r =0.37,0.29,0.31,0.42,0.33,P〈0.05）. HbA1c and HOMA-IR were independent factors of serum RBP4 level （OR=1.04,0.98,P〈0.05）. Conclusions The expression of RBP4 in GDM patient were abnormal. Serum RBP4 levels were pos-itively related with FBG, HbA1c, hsCRP and HOMA-IR. HbA1c and HOMA-IR was independently factors of RBP4 levels. It suggests that serum RBP4 may play an important role in the development of gestational diabetes mellitus and insulin resistance.