代谢综合征患者血清视黄醇结合蛋白4的变化及其影响因素

Change of serum retinol-binding protein 4 levels in subjects with metabolic syndrome and their influencing factors

目的探讨代谢综合征(MS)患者血清视黄醇结合蛋白4(RBP4)的变化及其相关影响因素。方法将2007年1～8月沈阳军区总医院门诊及住院患者60例和体检健康者20名,分为MS组31例、非代谢综合征(NMS)组29例和健康对照(C)组20例。测量体脂参数、血压,检测临床生化指标,测定血清胰岛素(FINS)、脂联素(APN)、血清RBP4、高敏C反应蛋白(hsCRP)及尿微量白蛋白(UAE)等。计算胰岛素抵抗指数(HOMA-IR)。问卷调查吸烟、饮酒习惯。结果(1)MS组血清RBP4显著高于NMS组和C组(P均<0.01),NMS组血清RBP4显著高于C组(P<0.01)。(2)男性血清RBP4显著高于女性(P<0.05)。(3)血清RBP4与体重指数(BMI)、腰围(WC)、收缩压(SBP)、舒张压(DBP)、血浆总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、lnhsCRP、lnUAE、吸烟呈显著正相关,与ANP呈显著负相关。(4)多元逐步回归分析显示,性别和BMI是血清RBP4的独立相关因素。结论MS患者血清RBP4显著升高,血清RBP4与BMI、WC、血压、脂代谢、APN、吸烟等心血管危险因素相关。

Objective To investigate the change of serum retinol binding protein 4 （RBP4） levels in subjects with metabolic syndrome （ MS）, and their relationship with the components of MS. Methods Eighty subjects were enrolled and divided into different groups：MS,nonMS（NMS） and healthy controls（C）. Subjects＇ anthropometric parameters, blood pressure,glucose and lipid metabolism parameters and insulin resistance index were measured. Serum RBP4 level, adiponectin （APN） ,high-sensitivity C-reactive protein（hsCRP） and fasting insulin（FINS） were measured. Homeostatic model assessment of insulin resistance（HOMA-IR） was calculated. A questionnaire was used to obtain participants＇ medical history and lifestyle information,such as smoking and alcohol ingestion habits. Results Serum RBP4 levels were significantly higher in the MS group compared with the NMS and C group. Males had significantly higher RBP4 levels than females. Serum RBP4 levels were positively correlated with BMI, WC, SBP, DBP, TC, LDL-C, lnhsCRP, lnUAE and smoking, and negatively correlated with ANP. Multiple stepwise regression anlysis showed that sex and BMI were independent related factors influencing serum RBP4 levels. Conclusion Serum RBP4 levels are significantly increased in subjects with MS. In all subjects, RBP4 is positively correlated with adiposity index （ BMI, WC ）, blood pressure, lipid profile （ TC, LDL-C ） , inflammatory indice（ lnhsCRP）, lnUAE and smoking, and negatively correlated with ANP, which is cardiovascular disease risk factor. RBP4 is independently associated with sex and BMI.