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目的探讨糖代谢异常孕妇血清视黄醇结合蛋白4(RBP4)、脂联素水平及其与胰岛素抵抗(IR)的关系。方法应用ELISA法检测35例妊娠期糖尿病孕妇(GDM组)、33例妊娠期糖耐量减低孕妇(GIGT组)和30例正常孕妇(NGT组)的血清RBP4和脂联素水平,并计算胰岛素抵抗指数(HOMA-IR)。结果血清RBP4在NGT组、GIGT组和GDM组逐渐升高(P<0.01),血清脂联素在NGT组、GIGT组和GDM组逐渐降低(P<0.01)。糖代谢异常孕妇血清RBP4与FPG、FINS、HOMA-IR呈显著正相关(P<0.01);血清脂联素与FPG、FINS、HOMA-IR呈显著负相关(P<0.01)。血清RBP4与脂联素呈显著负相关(P<0.01)。结论糖代谢异常孕妇血清RBP4明显升高,脂联素明显降低,且与IR密切相关,提示二者可能参与了IR和妊娠期糖尿病的发生、发展。
Objective To investigate the relationship between serum retinol binding protein 4 (RBP4), adiponectin and insulin resistance (IR) in pregnant women with abnormal glucose metabolism. Methods Serum levels of RBP4 and adiponectin in 35 pregnant women with gestational diabetes mellitus (GDM group), 33 pregnant women with impaired glucose tolerance (GIGT group) and 30 normal pregnant women (NGT group) were detected by ELISA. The levels of insulin resistance Index (HOMA-IR). Results Serum RBP4 increased gradually in NGT group, GIGT group and GDM group (P <0.01). Serum adiponectin decreased gradually in NGT group, GIGT group and GDM group (P <0.01). Serum levels of RBP4 and FPG, FINS and HOMA-IR in pregnant women with abnormal glucose metabolism were significantly correlated (P <0.01). Serum adiponectin was negatively correlated with FPG, FINS and HOMA-IR (P <0.01). Serum RBP4 was negatively correlated with adiponectin (P <0.01). Conclusions Serum levels of RBP4 in pregnant women with abnormal glucose metabolism are significantly increased, adiponectin is significantly decreased, and closely related to IR, suggesting that both may be involved in the occurrence and development of IR and gestational diabetes mellitus.