2型糖尿病患者血清视黄醇结合蛋白4与血清超敏C反应蛋白、胰岛素抵抗的相关性研究

Relationship of Serum Retinol Binding Protein 4 to High-sensitivity C-reactive Protein and Insulin Resistance in Patients with Type 2 Diabetes

目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清视黄醇蛋白4(RBP4)与血清超敏C反应蛋白(hs-CRP)、胰岛素抵抗(IR)的关系。方法选取61例首次诊断的T2DM患者作为T2DM组,25例健康体检者作为对照组,检测2组血清RBP4、空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、胰岛素(FINS)、hs-CRP水平。同时,测定身高、体质量,计算体质指数(BMI)。采用稳态模型法计算胰岛素抵抗指数(Homa-IR)。结果 T2DM组BMI、血清FBG、2 h PBG、FINS、hs-CRP、RBP4及Homa-IR均显著高于对照组(均P<0.05)。Pearson相关分析结果显示,血清RBP4水平与BMI、血清FINS及Homa-IR、血清hs-CRP水平呈正相关(r=0.230、0.244、0.393、0.511,P<0.05或P<0.01)。多元逐步回归分析结果显示,Homa-IR、血清hs-CRP为RBP4的独立相关因素。结论 T2DM患者血清RBP4、hs-CRP水平显著升高,RBP4可能参与了IR与T2DM的发生、发展,RBP4可能为一新的炎症标志物。

Objective To explore the relationship of serum retinal binding protein 4（RBP4） to high-sensitivity C-reactive protein（hs-CRP）and insulin resistance（IR） in patients with newly diagn-osed type 2 diabetes mellitus（T2DM）.Methods Levels of serum RBP4,fasting blood glucose（FBG）,fasting insulin（FINS）,hs-CRP and 2-hour postprandial glucose（2 h PBG）were detected in 61 newly dia-gnosed type 2 diabetic patients（T2DM group）and 25 healthy subjects（control group）.In addition,the height and weight were measured for body mass index（BMI） and insulin resistance index（Homa-IR）was determined by homeostasis model assessment.Results The BMI,Homa-IR and serum levels of FBG,2 h PBG,FINS,hs-CRP,RBP4 in T2DM group were significantly higher than those in control group（P0.05）.Pearson correlation analysis showed that serum levels of RBP4 were positively asso-ciated with BMI,FINS,Homa-IR and hs-CRP（r=0.230,0.244,0.393 and 0.511,respectively;P0.05 or P0.01）.Stepwise multiple regression analysis showed that Homa-IR and hs-CRP were the independent risk factors for RBP4.Conclusion Serum RBP4 and hs-CRP levels significantly increase in T2DM patients.RBP4 may contribute to the pathogenesis of IR and T2DM as a new marker of inflammation.