血清视黄醇结合蛋白4及血清Lipasin与妊娠糖尿病血管并发症相关性分析

Correlation analysis of serum retinol binding protein 4 and serum Lipasin level with vascular complications in gestational diabetes mellitus

目的 探究血清视黄醇结合蛋白4及血清Lipasin水平与妊娠糖尿病(gestational diabetes mellitus,GDM)血管并发症相关性.方法 选取浙江温州市中心医院2016年1月至2018年1月80例产科门诊确诊为GDM孕妇为观察组,根据是否伴有血管病变分为2组,GDM合并血管并发症患者为A组、GDM未合并血管并发症患者为B组,同期选择40名健康孕妇作为对照组(C组).比较3组孕妇空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting serum lisulin,FINS)、胰岛素抵抗指数(homeostatic model assessment of insulin resistance,HOMA-IR)、血清视黄醇结合蛋白4(retinol binding protein 4,RBP4)、血清Lipasin水平,分析以上指标与GDM合并血管并发症的相关性.结果 GDM孕妇FPG(7.04±1.22 vs 4.49±1.29)、FINS(16.10±2.98 vs 9.62±1.69)、HOMA-IR(5.17±0.85 vs 1.92±0.51)水平高于健康孕妇(P<0.05);A组孕妇FPG(7.72±1.25 vs 6.57±1.23)、FINS(17.03±3.98 vs 15.83±2.81)、HOMA-IR(5.84±0.92 vs 4.62±0.69),水平高于B组孕妇(P<0.05).GDM孕妇血清RBP4(44.61±4.75 vs 22.47±3.09)、Lipasin(1209.37±164.74 vs 816.47±96.49)水平高于健康孕妇,差异具有统计学意义(P<0.05);A组孕妇血清RBP4 (48.25±5.15 vs 40.89±4.43)、Lipasin(1513.26±241.67 vs 1036.48±132.75)水平高于B组孕妇(P<0.05).Spearman单因素相关分析,血清RBP4水平与FPG、FINS呈正相关(P<0.05),血清Lipasin水平与FPG、FINS呈正相关(P<0.05).logistic回归分析,发现FPG、FINS、RBP4、Lipasin水平升高,为糖尿病视网膜病变的独立危险因素(P<0.05).结论 在GDM合并血管并发症孕妇中,血清RBP4、Lipasin水平较高,为GDM合并血管并发症的独立危险因素,可能参与其发生发展.

Objective To explore the relationship between serum retinol binding protein 4 and serum Lipasin levels and vascular complications in gestational diabetes mellitus (GDM). Methods From Jan. 2016 to Jan. 2018, 80 pregnant women with gestational diabetes diagnosed as GDM in Wenzhou Central Hospital of Zhejiang Province were selected as the study group. They were divided into two groups according to whether they had vascular lesions. Group A included patients with gestational diabetes mellitus complicated with vascular complications and group B included patients without vascular complications. Forty healthy pregnant women were selected as the control group (group C). The levels of fasting plasma glucose (FPG), fasting serum insulin (FINS), homeostatic model assessment of insulin resistance (HOMA-IR), serum retinol binding protein 4 (RBP4) and serum Lipasin were compared among three groups of pregnant women. The vascular complications of GDM were analyzed. Results The levels of FPG, FINS and HOMA-IR in gestational diabetes mellitus pregnant women were higher than those in healthy pregnant women (P<0.05), and those in group A were higher than those in group B (P<0.05). The levels of RBP4 and Lipasin in serum of pregnant women with GDM were higher than those of healthy pregnant women (P<0.05), and those of group A were higher than those of group B (P<0.05). Spearman univariate correlation analysis showed that serum RBP4 levels were positively correlated with FPG and FINS (P<0.05), and serum Lipasin levels were positively correlated with FPG and FINS (P<0.05). Logistic regression analysis showed that the levels of FPG, FINS, RBP4 and Lipasin increased, which were independent risk factors for diabetic retinopathy (P<0.05). Conclusion In GDM with vascular complications, the serum RBP4 and Lipasin levels are higher, which are independent risk factors for vascular complications in GDM, and may participate in the occurrence and development of vascular complications in gestational diabetes mellitus.