血清视黄醇结合蛋白4在胆固醇结石病中的表达  

Expression of serum retinol-binding protein 4 in patients with cholesterol gallstone disease

作　　者：张杰[1] 褚亮[1] 蒋磊[1] 刘群[2] 郭安河[3] 

机构地区：[1]蚌埠医学院第二附属医院普外一区,233040 [2]蚌埠医学院第二附属医院中心实验室,233040 [3]蚌埠医学院第二附属医院病理科,233040

出　　处：《中国医师进修杂志》2012年第23期29-32,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨血清视黄醇结合蛋白4（RBP4）在胆固醇结石病中是否发生异常表达。方法采用酶联免疫吸附法分别对100例胆固醇结石病患者（胆固醇结石病组）和147例健康人（健康对照组）的血清RBP4水平以及与之相关的临床生化指标进行检测，包括胰岛素水平和肾功能。胆石的化学构成分析由术后病理检查确定。结果胆固醇结石病组血清RBP4水平显著低于健康对照组[（30．57±13．64）mg／L比（41．52±20．25）mg／L]（P〈0．01）。胆固醇结石病发生与血清RBP4水平有关（优势比为0．93，95％可信区间0．88～O．96，P=0．004）。相关性分析显示血清RBP4水平与总胆固醇（TC）、三酰甘油（TG）、肌酐（Cr）、胰岛素抵抗指数及白蛋白（ALB）水平呈正相关（P〈0．05或〈0．01），而与天冬氨酸氨基转移酶（AST）水平呈负相关（P〈0．01）。多变量分析发现低RBP4水平与胆固醇结石病显著相关（优势比为2．97；95％可信区间1．15～7．68，P=0．025）。将胆固醇结石病组和健康对照组按照血清Cr水平分为≥88．40μmol／L组和〈88．40μmol／L组，两组中胆固醇结石病组血清RBP4水平均显著低于健康对照组（P值分别为0．012和0．045）。再将胆固醇结石病组和健康对照组按照肾小球滤过率（GFR）的测定值分为≥90ml／（min·1．73m^2）组、60～89ml／（min·1．73m^2）组和〈60ml／（min·1．73m^2）组，发现在健康对照组中，低GFR与血清高RBP4水平有关，而在胆固醇结石病组则未能观察到这种趋势。结论胆固醇结石病患者血清RBP4水平下降且不依赖肾功能。患者的肝功能和血清RBP4水平之间的关系值得进一步研究。Objective To evaluate if expression of serum retinol-binding protein 4 （RBP4） concentrations in cholesterol gallstone disease. Methods Serum RBP4 levels of 100 cholesterol gallstone disease patients （cholesterol gallstone disease group ） and 147 healthy controls （healthy control group ） were measured by enzyme-linked immunosorbent assay and further correlated with clinical and biochemical characteristics, including insulin resistance and renal function. The chemical composition of gallstones was determined by postoperative pathology. Results The level of RBP4 in cholesterol gallstone disease group was significantly lower than that in healthy control group[ （30.57 ± 13.64） mg/L vs. （41.52 ± 20.25） mg/L] （P〈 0.01 ）. The level of RBP4 was also associated with gallstone occurrence （OR = 0.93, 95% C/：0.88 - 0.96,P = 0.004）. Serum RBP4 levels of all subjects were positively correlated with total cholesterol, triglyceride, creatinine, insulin resistance and albumin （P 〈 0.05 or 〈 0.01 ）, and negatively correlated with aspartate aminotransferase （P 〈 0.01 ）. In multivariate analysis, cholesterol gallstone formation was significantly associated with a lower serum RBP4 level （OR = 2.97, 95% CI： 1.15 - 7.68, P = 0.025 ）. Both gallstone patients and controls were subdivided into two groups according to ceatinine： ≥88.40μ mol/L group and 〈 88.40 μmol/L group. Patients with gallstones were found to have significantly lower serum RBP4 levels than controls in both subgroups （P = 0.012, 0.045 ）. According to GFR, both gallstone patients and controls were subdivided into ≥90 ml/（min· 1.73 m^2） group, 60 - 89 ml/（min· 1.73 m^2） group and 〈 60 ml/ （min· 1.73 m^2） group. It showed that a lower GFR was associated with greater serum RBP4 level in healthy control group. This trend was not noted in cholesterol gallstone disease group. Conclusions Serum RBP4 decreases in cholesterol gallstone disease independent of renal function. The relationship between

关 键 词：结石 胆固醇 视黄醇结合蛋白质类 

分 类 号：R657.4[医药卫生—外科学]