Abstract：Objective To explore the relationship between serum retinol binding protein 4 (RBP4) levels and insulin resistance in patients with gestational diabetes mellitus.Methods From May 2011 to April 2012, 65 pregnant women who had prenatal examinations and delivered in the Department of Obstetrics, Pudong Hospital of Shanghai, were recruited, including 35 cases with GDM (GDM group) and 30 with normal glucose tolerance test (control group). The GDM-group was divided into medical nutrition therapy group and insulin treatment group. Enzyme-linked immunosorbent assay (ELISA) was used to determine serum concentrations of RBP4 and radio immunoassay to measure the serum levels of fasting insulin (FINS). Fasting plasma glucose was tested by glucose oxidase, and home model insulin resistance index (HOMA-IR) was calculated. Correlations between the expression of serum of RBP4 and HOMA-IR were analyzed.Results BMI, newborn birth weight, levels of serum RBP4, FINS, FPG and HOMA-IR of the GDM group[(27.6±2.1) kg/cm2, (3.6±0.5) kg, (29.1±1.4) mg/L, (11,6±2.3) mU/L, (5.3±1.4) mmol/L, (3.1±0.4)] were higher than the control group [(26.7±1.2) kg/cm2, (3.4±0.6) kg, (19.6±1.9) mg/L, (8.0±0.7) mU/L, (4.7±0.8) mmol/L, (1.7±0.2)]. BIM, levels of serum RBP4, FINS and HOMA IR of the insulin-treated group [(28.2±2.7) kg/cm2, (30.0±1.4) mg/L, (13.1±3.6) mU/L, (3.8±0.4)] were higher than the nutrition therapy group [(27.3±1.5) kg/cm2, (28.1±1.4) mg/L, (10.8±1.8) mU/L, (2.4±0.3)]. The differences were statistically significant. Serum concentrations of RBP4 were positively correlated with HOMA-IR (r=0.486, P<0.05).Conclusion Serum concentrations of RBP4 were positively correlated with HOMA-IR.
顾佳士, 杨晓宁, 邱丽华. 妊娠期糖尿病血清视黄醇结合蛋白4和胰岛素抵抗指数变化的相关性[J]. 中国生育健康杂志, 2014, 25(5): 393-395.
Department of Obstetrics, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200127, China. Relationship between serum retinol binding protein 4 levels and insulin resistance in gestational diabetes mellitus. Chinese Journal of Reproductive Health, 2014, 25(5): 393-395.
1 乐杰,主编.妇产科学.第7版.北京:人民卫生出版社,2012:150. 2 Coward P,Conn M,Tang J,et al.Application of an allosteric model to describe the interactions among retinol binding protein 4,transthyretin,and small molecule retinol binding protein 4 ligands.And Biochem,2009,384:312-320. 3 Kloting N,Craham TE,Berndt J,et al.Serum retinol binding protein is more highly expressed in visceral than in subcutaneous adipose tissue and is a marker of intra-abdominal fat mass.Cell Metab,2007,6:79-87. 4 Yang Q,Graham TE,Mody N,et al.SERUM retinol binding protein 4 contributes to insulin resistance in obesity and type 2 diabetes.Nature,2005,436:3563-3562. 5 Klein K,Bancher-Todesca D,Leipold H,et al.Retinol-binding protein 4 in patients with gestational disbetes mellit.J womens Health,2010,19:517-521. 6 Maggbooli Z,Hossein-Nezhad A,Mirzaei K,et al.Association between retinlo-binding protein 4 concentrations and gestational diabetes mellitus and risk of developing metabolic syndrome after pregnancy.Reprod Sci,2010,17:196-201. 7 Krzyzanowska K,Zemany L,Krugluger W,et al.Serum concerntrations of retinol-binding protein4 in women with and without gestational diabetes.Diabetologia,2008,51:1115-1122. 8 Smirnakis KV,Martinez A,Blatman KH ,et al.Early pregnancy insulin resistance and subsequent gestational diabetes mellitus.Diabetes Care,2005,28:1207-1208. 9 Catalano PM,Tybir ED,Wolfe RR,et al.Carbohydrate metabolism during pregnancy in control subjects and women with gestational diabetes.Am J Physiol Endocrinol Metab,1993,264:60-67. 10 Quadro,Blaner WS,Hamberger L,et al.The role of extrahepatic retinol in the mobilizationg of retinoid astores.Lipid Res,2004,11:1975-1182. 11 吴海娅,魏丽,王琛,等.高脂、高糖诱导胰岛素抵抗大鼠附睾脂肪组织视黄醇结合蛋白4表达增加.上海医学杂志,2007,6:422-425. 12 孙蕾芳,陈维萍,李静,等.妊娠期糖尿病孕妇血清及皮下脂肪组织中视黄醇结合蛋白4的表达及其与胰岛素抵抗的关系.中华妇产科杂志,2009,44:913-991.
