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目的了解妊娠期糖尿病(GDM)孕妇血清视黄醇结合蛋白4(RBP4)水平变化及临床意义。方法采用酶联免疫吸附试验(ELISA)测定50例孕晚期GDM孕妇及50例正常孕晚期孕妇血清RBP4水平,同时测定两组孕妇空腹血糖(FPG)、糖化血红蛋白(HbAlc)、空腹胰岛素(FINS)水平,计算稳态模型评估的胰岛素抵抗指数(HOMA-IR)及胰岛β细胞分泌功能指数(HOMA-β)。结果 (1)GDM组孕妇血清RBP4水平为(18.48±4.60)ng/ml,明显高于正常孕妇血清RBP4水平(13.26±2.35)ng/ml(P<0.01)。(2)GDM组孕妇FPG、HbA1c、FINS水平分别为(5.40±0.57)mmoL/L、(5.68±0.58)%、(9.32±1.30)mmol/L,明显高于正常孕妇血清水平(4.99±0.27)mmol/L、(4.75±0.51)%、(8.24±0.77)mmol/L(P均<0.01)。(3)GDM组孕妇HOMA-IR为(2.24±0.43),明显高于正常孕妇(1.82±0.24)(P<0.01);GDM组孕妇HOMA-β为(107.29±35.54),正常孕妇为(112.02±19.35)(P>0.05)。(4)Pearson相关分析结果显示,两组孕妇血清RBP4水平分别与HbA1c、FINS呈显著正相关性(r=0.400,0.266,P<0.05);与HOMA-IR、HOMA-β无明显相关性(r=0.072,0.029,P>0.05)。结论 GDM孕妇血清RBP4水平明显升高,RBP4可能参与了GDM孕妇糖代谢紊乱,但是RBP4与GDM孕妇胰岛素抵抗无明显相关性;GDM孕妇尚不存在胰岛β细胞功能异常。
Objective To investigate the serum level of retinol binding protein 4 (RBP4) in pregnant women with gestational diabetes mellitus (GDM) and its clinical significance. Methods Serum levels of RBP4 in 50 pregnant women with GDM in the third trimester and 50 normal pregnant women in the third trimester were measured by enzyme linked immunosorbent assay (ELISA). The levels of fasting blood glucose (FPG), HbAlc, FINS, HOMA-IR and HOMA-β in the steady-state model were calculated. Results (1) Serum RBP4 level in pregnant women with GDM was (18.48 ± 4.60) ng / ml, which was significantly higher than that of normal pregnant women (13.26 ± 2.35) ng / ml (P <0.01). (2) The levels of FPG, HbA1c and FINS in pregnant women in GDM group were significantly higher than those in normal pregnant women (4.99 ± 0.27), (5.40 ± 0.57) mmoL / L, (5.68 ± 0.58)% and ) mmol / L, (4.75 ± 0.51)%, (8.24 ± 0.77) mmol / L respectively (all P <0.01). (3) The HOMA-IR of pregnant women in GDM group was (2.24 ± 0.43), significantly higher than that of normal pregnant women (1.82 ± 0.24) (P <0.01); The HOMA-β of pregnant women in GDM group was (107.29 ± 35.54) ± 19.35) (P> 0.05). (4) The results of Pearson correlation analysis showed that serum RBP4 levels were positively correlated with HbA1c and FINS (r = 0.400,0.266, P <0.05), but not with HOMA-IR and HOMA-β r = 0.072, 0.029, P> 0.05). Conclusions Serum levels of RBP4 in GDM pregnant women are significantly increased, and RBP4 may be involved in the disorder of glucose metabolism in pregnant women with GDM. However, there is no significant correlation between RBP4 and insulin resistance in pregnant women with GDM. GDM pregnant women do not yet have pancreatic islet β-cell dysfunction.