血清视黄醇结合蛋白联合脂联素对妊娠期糖尿病的早期预测价值

The value of combination of maternal retinol binding protein and adiponectin in predicting gestational diabetes mellitus

目的：探讨妊娠妇女血清视黄醇结合蛋白（RB P ）、脂联素以及两者比值早期预测妊娠期糖尿病的价值。方法采用病例对照研究，检测并比较88例妊娠期糖尿病及88例正常妊娠妇女孕16～20周血清RBP和脂联素浓度水平。结果妊娠期糖尿病组，血清RBP浓度以及其与脂联素的比值显著高于对照组（ P＜0．01），血清脂联素浓度显著低于对照组（ P＜0．01）。RBP≥30．45 mg／L时，预测妊娠期糖尿病的敏感性为63．6％，特异性为75．0％；脂联素≤9．93 mg／L时，预测妊娠期糖尿病的敏感性为80．7％，特异性为65．1％；RBP与脂联素的比值大于或等于3．18时，预测妊娠期糖尿病的敏感性为81．8％，特异性为76．7％。结论孕16～20周孕妇RBP和脂联素的联合运用对于妊娠期糖尿病的预测价值高于单独使用。

Objective To detect the levels of retinol binding protein（RBP）and adiponectin during the second trimester in the serum of women in normal pregnancy and women who subsequently develop gestational diabetes mellitus（GDM ）and to evaluate their role in predicting GDM .Methods A case‐control study was performed to detect and compare the levels of RBP and adiponec‐tin between women who subsequently develop GDM （n= 88）and normal control from 16 to 20 pregnancy weeks （n= 88） . Results Maternal serum RBP levels and the RBP/adiponectin ratio were significantly higher in GDM women than that in normal controls（P〈0 .01） .The levels of maternal serum adiponectin were significantly lower in GDM women than that in normal controls （P〈0 .01） .The levels of RBP≥30 .45 mg/L ,adiponectin≤9 .93 mg/L and the ratio of RBP/adiponetin≥3 .18 as early markers for predicating development of GDM ,their sensitivities were 63 .6% ,80 .7% and 81 .8% ,and specificities were 75 .0% ,65 .1% and 79 .7% ,respectively .Conclusion The combination of RBP and adiponetin as early marker for predicating development of GDM from 16 to 20 pregnancy weeks was more valuable than single use of them .