摘要
目的:了解妊娠期糖尿病(GDM)孕妇在不同孕周(孕中期、孕晚期)血清视黄醇结合蛋白4(RBP4)水平的变化及其与糖代谢等指标的相关性。方法:采用酶联免疫吸附法测定168例GDM患者(GDM组)及35例糖耐量正常孕妇(对照组)孕中期及孕晚期的血清RBP4、空腹血糖(FPG)、空腹胰岛素(FINS)、不同孕期的体质量指数(BMI)数值等,计算胰岛素抵抗指数(HOMA-IR),并进行比较,采用Pearson分析两组孕妇RBP4与以上指标的相关性,并对GDM组中孕晚期是否使用胰岛素情况进行分组,比较两组FINS、HOMA-IR、BMI、RBP4值。结果:①GDM组在孕中期及孕晚期时的FINS、HOMA-IR及RBP4均明显高于对照组(P<0.01)。②GDM组孕妇孕晚期RBP4值高于孕中期(P<0.01),FPG及HOMA-IR值低于孕中期(P<0.01)。对照组孕妇FPG、FINS、HOMA-IR、RBP4在孕中期与孕晚期比较,差异均无统计学意义(P>0.05)。③两组孕妇血清RBP4在孕中期及孕晚期时与FINS及HOMA-IR均呈中度或高度正相关(r>0.60,P<0.01),而与BMI值及FPG均无相关性(P>0.05)。孕中期仅GDM组孕妇血清RBP4值与服糖后1小时、2小时的血糖值呈低度正相关(r=0.16,r=0.23;P<0.05),而对照组无相关性(P>0.05)。结论:RBP4与胰岛素抵抗及GDM发病密切相关,RBP4数值不受即时空腹血糖高低的干扰,但可能反映出GDM孕妇服糖后糖代谢的紊乱,且随孕周增加其数值增高的现象,可能反映出GDM的发展程度。
Objective：To study the changes of from different pregnancy（ the second trimester and Methods：The serum RBP4 levels in 168 cases of serum RBP4 level to gestational diabetes mellitus（GDM） third trimester）and its correlation with glucose metabolism. patients with GDM（GDM group） and in 35 cases of preg- nant women with normal glucose tolerance（control group） of the second trimester and third trimester were de- termined individually by Enzyme-linked immunosorbent assay（ ELISA）. Fasting plasma glucose （FPG）, fasting Insulin levels（ FINS）, Body Mass Index （ BMI ）, insulin resistance index （ HOMA-IR）, from different pregnancy were also tested and compared. Pearson analysis was used to analyze the correlation between the two groups of pregnant women with RBP4 and the glucose metabolism index. In the GDM group, there were divided into two subgroups according to whether or not to use insulin in the late pregnancy, the values of FINS, HOMA-IR、 BMI,RBP4 were compared between the two subgroups. Results： ①The serum level of RBP4, FINS and HO- MA-IR were significantly higher in GDM group than those in control group of the second trimester and third trimester（ P〈0.01 ）. ②The serum level of RBP4 with GDM group in the third trimester of pregnancy was higher than that of the second trimester（ P〈0.01 ） ,FPG and HOMA-IR in the third trimester of pregnancy was lower than that of the second trimester（ P 〈 0.01 ）. In the control group, there was no significant difference in FPG, FINS, HOMA-IR, RBP4 in the second trimester of pregnancy and the third trimester of pregnancy（ P 〉 0.05）. The serum levels of RBP4 in the two groups were positively correlated with FINS and HOMA-IR in the second trimester and third trimester（ r 〉 0.60, P 〈 0.01 ）, and there were no significant correlation with BMI value and FPG （P 〉0.05）. In the second trimester,the serum RBP4 value of GDM group was positively correlated with the blood glucose value of 1 h and 2h after taking gl
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2016年第10期747-751,共5页
Journal of Practical Obstetrics and Gynecology
基金
深圳市科技创新委员会知识创新计划基础研究项目(编号:JCYJ20130402094702483)
关键词
视黄醇结合蛋白4
妊娠期糖尿病
胰岛素抵抗
Retinol-binding protein 4
Gestational diabetes mellitus
Insulin resistance
