The relationship between serum retinol binding protein 4 and inflammatory factors,insulin resistance in patients with Gestational diabetes mellitus / 中国医师杂志

ABSTRACT

Objective To investigate the relationships between serum concentration of RBP-4 and inflammatory factors,insulin resistance in patients with gestational diabetes mellitus.Methods20 patients newly diagnosed with impaired glucose tolerance (IGT),27 patients newly diagnosed with gestational diabetes mellitus(GDM) and 50 subjects with normal glucose tolerance(NGT) were enrolled in this cross-sectional study.Additionally,another subset analysis was performed,subjects were divided on the basis of BMI into normal weight (NW) and overweight or obesity (OW/OB).Serum RBP-4 was measured with ELISA;serum concentrations of hs-CRP,free fatty acids (FFA),triglyeride(TG),total cholesterol (TC) and insulin were measured in fasting status.Insulin resistance was assessed by HOMA-IR.ResultsLn(HOMA-IR) and the concentrations of FFA,ln(hs-CRP) in IGT or in GDM were significantly higher than that of NGT(P＜0.05).In the group of OW/OB,FFA[(0.90±0.31)mmol/L vs (0.71±0.28)mmol/L,t＝2.73,P＜0.05)],ln(hs-CRP)(0.62±1.00 vs -0.17±1.07,t＝2.90,P＜0.05),ln(HOMA-IR),lnRBP(0.56±0.27 vs 0.30±0.14,t＝2.86,P＜0.05)were significantly higher than that of NW.In the group of GDM,lnRBP-4 showed a positive relationship with FFA (r＝0.231,P＜0.05)and ln(hs-CRP) (r＝0.237,P＜0.05).There was a positive relationship between lnRBP-4 and FFA(r＝0.371,P＜0.05) or ln(hs-CRP)(r＝0.247,P＜0.05) in the group of OW/OB,but no association in the group of NGT,IGT or NW.There was no relationship between lnRBP-4 and ln(HOMA-IR) in IGT,GDM and NW,while in the group of NGT and OW/OB,lnRBP-4 showed a positive relationship with ln(HOMA-IR) (r＝0.276,0.290,P＜0.05).In a multiple linear regression analysis,ln(hs-CRP),FFA or ln(HOMA-IR) was not the independent factor of lnRBP-4 in any group.ConclusionsIn patients with gestational diabetes mellitus,lnRBP-4 may be a new marker of inflammation.