目的 探讨血清视黄醇结合蛋白4(RBP-4)与妊娠肥胖、妊娠糖尿病的关系。方法 选用2015-01至2016-12住院的32例BMI＞28 kg/m2的妊娠糖尿病(GDM)孕妇(肥胖型GDM组),30例BMI 18.5～23.9 kg/m2 (单纯型GDM组),29例BMI＞28 kg/m2 (妊娠肥胖组),27例BMI18.5～23.9 kg/m2的健康孕妇(健康对照组),采用酶联免疫吸附法(ELISA)检测4组孕妇血清RBP-4水平、脂联素(APN)水平;同时测定所有受试者的糖、脂生化指标,并计算胰岛素抵抗指数(HOMA-IR)。结果 (1)肥胖型GDM组孕妇血清RBP-4明显高于其他3组孕妇(P<0.05),妊娠肥胖组孕妇血清RBP-4高于单纯型GDM组及健康对照组(P<0.05);(2)血清RBP-4与孕前BMI、FINS、TG、HOMA-IR呈正相关,与APN呈负相关(r分别为0.562,0.409,0.484,0.618,-0.412,P均<0.05)。结论 RBP-4水平在妊娠肥胖组及肥胖型GDM组均高于健康对照组,其中肥胖型GDM组孕妇血清升高明显,可见血清RBP-4水平与妊娠肥胖、妊娠糖尿病均有密切联系,特别是对肥胖型GDM患者易生产巨大儿起到非常关键的作用。
Abstract
Objective To investigate the change of serum retinol binding protein 4 (RBP-4)levels in obese pregnant women and pregnant women with GDM.Methods Serum RBP-4 and APN levels were detected by Enzyme-Linked Immnno Sorbent Assay(ELISA)in 32 cases of GDM with obesity(BMI＞28 kg/m2,Group A),30 cases of GDM with normal weight(BMI 18.5-23.9 kg/m2,Group B),29 cases of obese pregnant women without pregnancy complications(BMI＞28 kg/m2,Group C) and 27 cases of normal-weight pregnant women(BMI 18.5-23.9 kg/m2,Group D).Meanwhile, FPG and TG were measured. Insulin resistance was estimated using the homeostatic model assessment insulin resistance (HOMA-IR) index.Results (1)Serum RBP 4 levels in Group A were significantly higher than those of the other three groups. RBP 4 levels in Group C were higher than those of Group B and Group D (P<0.05). (2)There was a significant positive correlation between RBP4 levels and pregnant BMI,FINS,TG and HOMA-IR,but a negative correlation between RBP-4 and APN (r value was 0.562, 0.409, 0.584, 0.618 and -0.412 respectively, P<0.05).Conclusions Serum RBP-4 levels in Groups A, B and C were significantly higher than those of Group D. Serum RBP-4 levels are significantly elevated in obese women,and closely related to obesity.
关键词
视黄醇结合蛋白4 /
妊娠糖尿病 /
妊娠肥胖 /
巨大儿
Key words
serum retinol binding protein-4 /
GDM /
obesity /
large for gestational age
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 王 驰.视黄醇结合蛋白 4 与妊娠糖尿病相关性的研究进展[J].医学研究生学报,2012,25(8):868-870.
[2] 中华医学会围产医学分会妊娠合并糖尿病协作组.妊娠合并糖尿病临床诊断与治疗推荐指南[J].中华围产医学杂志,2007,10(4):283-285.
[3] 陈震宇,杜 鹃.妊娠肥胖、妊娠糖尿病患者血清视黄醇结合蛋白4水平变化及其相关影响因素[J].中国医科大学学报,2011,40(5):465-468.
[4] Maghbooli Z,Hossein-Nezhad A,Mirzaei K,et al.Association between retinol-binding protein 4 concentrations and gestational diabetes mellitus and risk of developing metabolic syndrome after pregnancy[J].Reprod Sci,2010,17(2):196-201.
[5] Hedderson M M, Williams M A, Holt V L, et al. Body mass index and weight gain prior to pregnancy and risk of gestational diabetes mellitus[J].Am J Obstet Gynecol,2008,198(4):409.e1-7.
[6] Ortega-Senovilla H,Schaefer-Graf U,Meitzner K,et al. Gestational diabetes mellitus causes changes in the concentrations of adipocyte fatty acid-binding protein and other adipocytokines incord blood[J].Diabetes Care,2011,34(9):2061-2066.
[7] Lain K Y, Daftary A R, N ess R B, et al. First trimester adipocytokine concentrations and risk of developing gestational diabetes later in pregnancy [J].Clin Endocrinol (Oxf), 2008, 69(3): 407-411.
[8] 张 云,陈 梁. GDM患者血清维生素D与HOMA-IR、HOMA-β、APN、RBP4及血糖水平的关系[J]. 中国妇幼保健,2017,32(16):3743-3745.
[9] 郭 永,付竹梅. 妊娠期糖尿病孕妇中视黄醇结合蛋白4的表达与胰岛素抵抗的关系[J]. 潍坊医学院学报,2017,39(2):108-110.
[10] 苏莉军,孙 虹,华绍芳. 妊娠期糖尿病患者孕晚期体质量增长与糖化血清白蛋白、内脂素水平及新生儿体成分的相关性研究[J]. 实用妇产科杂志,2017,33(3): 194-197.
[11] 杜习羽,董玉楠. 妊娠期糖尿病(A1及A2级)的高危因素及Chemerin、RBP4指标的研究[J]. 中国妇幼健康研究,2017,28(1):66-68.
[12] 王 珏,程海东. 妊娠期糖尿病母胎血清脂肪因子水平的差异及与胎儿代谢关系的研究[J]. 医药论坛杂志,2016,37(12):13-14,17.
[13] 黄 聪,黄顺彬,王艳君. 妊娠期糖尿病患者血清RBP4和SF的表达及与胰岛素抵抗的关系研究[J]. 中国妇幼保健,2016,31(22):4629-4631.
[14] 董金华,薛丽丽. 妊娠期糖尿病孕妇血清和脐血RBP4与胎儿体重的关系[J]. 中华全科医学,2016,14(10): 1786-1788.
[15] 黄海燕. 探讨非肥胖孕妇血清C-反应蛋白水平与妊娠期糖尿病的相关性[J]. 实用妇科内分泌杂志(电子版),2016,3(8):79-80.
[16] 彭笑菊,戴 楠,汪之顼,等. 孕妇不同孕期血脂指标分布和变化的观察性研究[J]. 南京医科大学学报(自然科学版),2016,36(7): 840-845.
[17] 王江平. 孕前肥胖、糖尿病患者妊娠期血清脂肪因子水平变化及其影响因素研究[J]. 糖尿病新世界,2016,19(8):109-110.
PDF(562 KB)
