2型糖尿病患者血清视黄醇结合蛋白4水平的临床意义

Significance of serum levels of retinol binding protein 4 in patients with type 2 diabetes mellitus

目的检测2型糖尿病(T2DM)患者正常体重组和肥胖组的血清视黄醇结合蛋白4(RBP4)水平,探讨与血脂和胰岛素敏感性等的相关性。方法以体重指数(BMI)将63例糖尿病患者分成两组:T2DM超重/肥胖组和T2DM正常体重组,均采用HOMA-IR评价各组胰岛素敏感性,测定受试者的BMI、腰臀比(WHR),检测空腹状态下血清RBP4、血糖、糖化血红蛋白(HbAlc)、血浆葡萄糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)和胰岛素水平,并以55例健康体检者作对照。结果 T2DM超重/肥胖组血清RBP4浓度明显高于对照组和T2DM正常体重组,差异均有统计学意义(t分别=3.04、2.77,P均<0.05);RBP4与HOMA-IR、BMI、WHR、TG明显正相关(r分别=0.33、0.28、0.24、0.32,P均<0.05);多元线性逐步回归分析发现:HOMA-IR、BMI、TG、性别和年龄是血清RBP4的独立相关因素(r分别=0.33、0.56、0.55、-0.41、0.37,P均<0.05)。结论血清RBP4与胰岛素抵抗呈正相关,可能与T2DM发病有一定关系。

Objective To study the relationship between serum levels of RBP4 and insulin resistance in patients with type 2 diabetes.Methods A total of 63 patients with DM were divided into 2 groups by body mass index（BMI）.Insulin sensitivity was assessed with insulin resistance index（HOMA-IR）,the anthropometrical parameters such as BMI,waist hip ratio（WHR） were evaluated and fasting blood glucose（FBG）,HBA1C,TC,TG,HDL-C,LDL-C and fasting insulin levels were also measured.Fasting serum RBP4 levels in subjects with type 2 diabetes（T2DM） and control group were measured.55 healthy volunteers were as controls.Results Serum RBP4 levels in T2DM with overweight or obesity were significantly higher than those in other groups（t=3.04,2.77,P0.05）;Serum RBP4 levels were found to correlate positively with HOMA-IR,BMI,WHR and TG（r =0.33,0.28,0.24,0.32,P0.05） in type 2 diabetic patients.HOMA-IR,BMI,TG,gender and age were significant determinant of RBP4（r =0.33,0.56,0.55,-0.41,0.37,P0.05）.Conclusions There is a positive relationship between RBP4 and IR in type 2 diabetic patients.RBP4 may play a role in pathogenesis of T2DM.