肥胖患者血清视黄醇结合蛋白4水平变化及与性激素的相关性

Change of Serum Retinol-binding Protein 4 Level in Obese Subjects and the Correlativity with Sex Hormones

目的探讨肥胖患者血清视黄醇结合蛋白4(RBP4)水平变化及与性激素水平的相关性。方法80名研究对象分为肥胖组和非肥胖组,测定人体测量参数、血压,检测生化指标、血清RBP4、空腹血浆胰岛素(FINS)、脂联素(APN)、高敏C反应蛋白CRP(hsCRP)、性激素及性激素结合蛋白(SHBG)等。计算胰岛素抵抗指数(HOMA-IR)。结果肥胖组血清RBP4水平显著高于非肥胖组(P<0.01)。男性血清RBP4水平显著高于女性(P<0.05)。总体分析,血清RBP4水平与体质指数(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、ln睾酮(T)呈显著正相关(P<0.01或P<0.05),与APN、性别、性激素结合蛋白(lnSHBG)呈显著负相关(P<0.01或P<0.05);多元逐步回归分析,性别、BMI、ln黄体生成素(LH)是血清RBP4水平的独立相关因素。不同性别组内,肥胖亚组血清RBP4水平均显著高于非肥胖亚组,lnT和lnE2呈与性别相反表达,且lnSHBG降低、lnLH及lnFSH增高;在男性,BMI、WHR、APN是影响血清RBP4水平的独立因素;在女性,BMI、lnLH是血清RBP4水平的独立相关因素。结论肥胖患者血清RBP4水平显著升高,血清RBP4水平存在性别特异性差异,与血浆性激素及SHBG水平密切相关。

Objective To investigate the change of serum retinol-binding protein 4 （RBP4） level in obese subjects,and the correlativity with sex hormones. Methods 80 subjects were included in this study,and divided into the obese group and nonobese group. Subjects＇ anthropometric parameters, blood pressure, glucose and lipid metabolism parameters, Senma RBP4, adiponectin （APN）, high-sensitivity C-reactive protein （hsCRP） ,fasting insulin （FINS）, sex hormones and SHBG,etc. were measured. Homeostatic model assessment of insulin resistance （HOMA-IR） was calculated. Results Serum RBP4 levels were significantly higher in the obese group than in the noubcese group. Males had significantly higher RBP4 levels than females. In all subjects,Serum RBP4 levels were positively correlated with BMI,WC,SBP,DBP, TC,LDL-C,lnhsCRP and lntestosterone （T）,and negatively correlated with APN,sex and lnSHBG. Multiple stepwise regression analysis showed that sex, BMI ,lnluteinizing hormone （LH） were independently related factors influencing serum RBP4 levels. In different sex groups, serum RBP4 levels were significantly higher in the obese group than in the nonbosse group, and serum sex-related hormones and lnSHBG levels were lower and InLH and lnfollicle stimulating hormone （FSH）were higher in obese subjects. Conclusion Serum RBP4 levels are significantly increased in obese group;Sex-related difference in serum RBP4 is significantly correlated with the levels of serum sex hormones and SHBG.