妊娠中期血清视黄醇结合蛋白4(RBP-4)与胰岛素抵抗的关系  

Correlation between RBP-4 expression and insulin resistance in pregnant women at mid trimester of pregnancy

作　　者：白力伟 牛紫如 贾晓娇[2] 华天书 陆强[2] 韩忠厚 BAI Liwei;NIU Ziru;JIA Xiaojiao(Qinhuangdao Hospital for Maternal and Child Health,Hebei,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市妇幼保健院,066000 [2]河北省秦皇岛市第一医院内分泌科

出　　处：《河北医药》2022年第18期2760-2763,共4页Hebei Medical Journal

基　　金：秦皇岛市科技支撑计划项目(编号:201501B047)。

摘　　要：目的了解正常糖耐量(NGT)孕妇与妊娠糖尿病(GDM)孕妇妊娠中期血清脂肪因子视黄醇结合蛋白4(RBP-4)水平的差异,分析妊娠中期RBP-4水平与糖脂代谢指标及脂肪因子瘦素(Leptin)、酯联素(Adiponection)水平的关系,为妊娠糖尿病的防治提供理论依据。方法纳入166例妊娠中期女性,依据OGTT结果分为NGT组81例和GDM组85例,记录一般信息,测量身高、体重、血压参数,测定血糖、血脂、胰岛素及、RBP-4、Leptin、Adiponection水平,计算BMI、HOMA-IR、HOMA-β及AUCG。分析比较2组上述指标的差异,并采用Pearson及多元线性回归分析统计RBP-4的主要影响因素。结果2组年龄、收缩压、舒张压、孕前BMI、TC、HDL-c、LDL-c、TG、UA差异均无统计学意义(P>0.05),而孕期BMI、孕期增重水平差异有统计学意义(P<0.05)。GDM组的FBG、1 h血糖、2 h血糖、FINS、HbA1c、HOMA-IR及AUGG水平均高于对照组,HOMA-β低于NGT组(P<0.05)。多元回归结果提示,RBP-4水平与Adiponection、Leptin、HOMA-IR、AUCG、1 h血糖及孕期增重相关。结论GDM患者血清RBP-4水平升高,RBP-4与孕期增重、1 h血糖、HOMA-IR、AUCG及leptin,Adiponection水平相关。Objective To investigate and compare the differences in the serum levels of adipokine retinol binding protein 4(RBP-4)between the pregnant women with normal glucose tolerance(NGT)and those with gestational diabetes(GDM),and to analyze the correlation between RBP-4 levels and adipokine leptin(Leptin),exonectin(Adiponection)levels,so as to provide theoretical basis for the prevention and treatment of gestational diabetes.Methods A total of 166 pregnant women at mid trimester of pregnancy were enrolled in the study,who were divided into NGT group(n=81)and GDM group(n=85)according to OGTT results.The general information,body height,body weight,blood pressure parameters,blood glucose,blood lipid,insulin and the levels of RBP-4,Leptin,Adiponection,and BMI,HOMA-IR,HOMA-and AUCG were detected and compared between the two groups.Moreover Pearson analysis and multiple linear regression analysis were used to analyze the main influencing factors of RBP-4.Results There were no significant differences in patient’s age,systolic blood pressure,diastolic blood pressure,BMI,TC,HDL-c,LDL-c,TG and UA between the two groups(P>0.05),however,there were significant differences in BMI and weight gain levels during pregnancy between the two groups(P<0.05).Moreover the levels of FBG,1h glucose,2h glucose,FINS,HbA1c,HOMA-IR and AUGG in GDM group were significantly higher than those in NGT group,but,HOMA levels were significantly lower than those in NGT group(P<0.05).The multiple regression results showed that RBP-4 levels were associated with Adiponection,Leptin,HOMA-IR,AUCG,1-hour blood glucose,and weight gain during pregnancy.Conclusion The BMI,weight gain during pregnancy,and serum levels of RBP-4 in pregnant women at mid trimester of pregnancy are increased,moreover,RBP-4 is associated with weight gain during pregnancy,1h blood glucose,HOMA-IR,AUCG and leptin as well as Adiponection levels.

关 键 词：视黄醇结合蛋白4(RBP-4) 妊娠糖尿病 脂肪因子 

分 类 号：R587.1[医药卫生—内分泌]