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目的:分析视黄醇结合蛋白4(retinol-binding protein4,RBP4)在妊娠期糖尿病患者和健康孕妇血清中的浓度差异及其与临床、病理特征的关系。方法:检测18例妊娠期糖尿病(GDM)和212例健康孕妇血清中RBP4的表达,分别于孕18周、孕20周、孕28周及产后8周空腹收集血清。利用酶联免疫吸附实验(ELISA)检测血清RBP4的表达。用HOMA-IR(homeosta-sis model assessment)模型评价胰岛素抵抗程度。结果:所有孕妇血清RBP4水平在产前各时间点呈时间依赖性升高。产后8周(中位数,15.35μg/mL;四分位数,11.32～27.85μg/mL)孕妇血清RBP4水平均下降。孕20周(中位数,45.72μg/mL;四分位数,33.34～58.69μg/mL)、孕28周(中位数,52.34μg/mL;四分位数,42.65～73.54μg/mL)时,GDM患者血清RBP4水平高于健康孕妇(孕20周:中位数,19.13μg/mL;四分位数,15.23～22.65μg/mL;孕28周:中位数,42.54μg/mL;四分位数,24.56～55.21μg/mL)。孕18周(中位数,16.80μg/mL;四分位数,14.58～28.67μg/mL)和产后8周(中位数,15.35μg/mL;四分位数,11.32～27.85μg/mL),GDM患者血清RBP4水平和健康孕妇无显著差异(孕18周:中位数,15.78μg/mL;四分位数,10.23～19.35μg/mL;产后8周:中位数,13.54μg/mL;四分位数,9.21～18.35μg/mL)。孕20周时血清RBP4水平和HOMA-IR(相关系数r=0.872;P=0.002)、体质量指数、血清三酰甘油和低密度脂蛋白呈正相关,和高密度脂蛋白呈负相关。结论:孕20周血清RBP4水平可能成为GDM的早期诊断指标。
OBJECTIVE: To analyze the difference of serum concentration of retinol-binding protein 4 (RBP4) between gestational diabetes mellitus and healthy pregnant women and its relationship with clinical and pathological features. Methods: The expression of RBP4 in serum of 18 pregnant women with gestational diabetes mellitus (GDM) and 212 healthy pregnant women was detected. The serum was collected at 18 weeks pregnant, 20 weeks pregnant, 28 weeks pregnant and 8 weeks postpartum. Serum RBP4 expression was detected by enzyme-linked immunosorbent assay (ELISA). HOMA-IR (homeosta-sis model assessment) model to assess the degree of insulin resistance. Results: Serum RBP4 levels in all pregnant women increased in a time-dependent manner at prenatal time points. Serum RBP4 levels decreased at 8 weeks postpartum (median, 15.35 μg / mL; quartile, 11.32-27.85 μg / mL). Pregnancy for 20 weeks (median, 45.72 μg / mL; quartile, 33.34-58.69 μg / mL), 28 weeks pregnant (median, 52.34 μg / mL; quartile, 42.65-73.54 μg / mL ), The level of RBP4 in GDM patients was higher than that in healthy pregnant women (20 weeks pregnant: median, 19.13μg / mL; quartiles, 15.23 ~ 22.65μg / mL; median pregnancy 28 weeks: 42.54μg / mL ; Quartiles, 24.56-55.21 μg / mL). Pregnancy 18 weeks (median, 16.80 μg / mL; quartile, 14.58-28.67 μg / mL) and postpartum 8 weeks (median, 15.35 μg / mL; quartile, 11.32-27.85 μg / mL ), Serum RBP4 levels in GDM patients and healthy pregnant women no significant difference (18 weeks pregnant: median, 15.78μg / mL; quartiles, 10.23 ~ 19.35μg / mL; postpartum 8 weeks: median, 13.54μg / mL; quartiles, 9.21-18.35 μg / mL). Serum RBP4 levels and HOMA-IR (correlation coefficient r = 0.872; P = 0.002), body mass index, serum triglyceride and LDL were positively correlated at 20 weeks’ gestation, and negatively correlated with HDL. Conclusion: Serum RBP4 level at 20 weeks’ gestation may be an early diagnostic indicator of GDM.