Sun Lei-Fang, Chen Wei-Ping, Li Jing, Ye Yuan-Hua
Department of Obstetrics, Affiliated Hospital of Qingdao University Medical College, Qingdao 266003, China.
Zhonghua Fu Chan Ke Za Zhi. 2009 Dec;44(12):915-9.
To investigate the expression of retinol binding protein 4 (RBP-4) in maternal serum and subcutaneous adipose tissue and its relationship with insulin resistance (IR) in gestational diabetes mellitus (GDM).
From May 2008 to April 2009, 62 pregnant women who underwent elective cesarean section in the Department of Obstetrics, Affiliated Hospital of Qingdao University Medical College, were recruited, including 32 with GDM (GDM group) and 30 with normal glucose tolerance test (control group). Enzyme-linked immunosorbent assay (ELISA) was used to determine the serum concentrations of RBP-4 and radio immunoassay to measure the serum levels of fasting insulin (FINS). Fasting plasma glucose (FPG) was tested by glucose oxidase, and the Home model insulin resistance index (HOMA-IR) was calculated. Reverse transcription PCR (RT-PCR) and Western blot were applied to investigate the expression of RBP-4 mRNA and protein in subcutaneous adipose tissue. The correlations between the expression of RBP-4 mRNA and protein in subcutaneous adipose tissue and the serum RBP-4 concentrations and HOMA-IR were analyzed.
(1) The serum concentrations of RBP-4, FINS, FPG, HOMA-IR in GDM group were significantly higher compared with the control group [(27.0 +/- 1.2) mg/L vs. (19.4 +/- 1.8) mg/L, (12.1 +/- 1.4) mU/L vs. (8.3 +/- 0.8) mU/L, (5.3 +/- 0.9) mmol/L vs. (4.1 +/- 0.6) mmol/L, 2.5 +/- 0.2 vs. 1.5 +/- 0.1, P < 0.05, respectively]. (2) The expression of RBP-4 mRNA and protein in subcutaneous adipose tissue in the GDM group were significantly higher than that of the control group (0.76 +/- 0.12 vs. 0.53 +/- 0.06, 0.74 +/- 0.09 vs 0.54 +/- 0.06, P < 0.05). (3) In the GDM group, the expression of both RBP-4 mRNA and protein in the subcutaneous adipose tissue were positively correlated with HOMA-IR (r = 0.575 and 0.851, P < 0.05). The serum concentration of RBP-4 were also positively correlated with HOMA-I (r = 0.635, P < 0.05). No correlations was found between the expressions of RBP-4 mRNA and protein in subcutaneous adipose tissue with the serume RBP-4 concentrations.
High expression of RBP-4 mRNA in subcutaneous adipose tissue and the elevation of serum RBP-4 levels in GDM women may contribute to IR.
探讨视黄醇结合蛋白4（RBP-4）在妊娠期糖尿病（GDM）孕妇血清及皮下脂肪组织中的表达及其与胰岛素抵抗（IR）的关系。
选取2008年5月至2009年4月在青岛大学医学院附属医院产科行择期剖宫产的62例孕妇，其中GDM患者32例（GDM组），葡萄糖耐量试验正常者30例（对照组）。采用酶联免疫吸附试验（ELISA）测定血清RBP-4浓度，放射免疫法测定空腹胰岛素（FINS）水平。用葡萄糖氧化酶法检测空腹血糖（FPG），计算稳态模型胰岛素抵抗指数（HOMA-IR）。应用逆转录聚合酶链反应（RT-PCR）和蛋白质印迹法检测皮下脂肪组织中RBP-4 mRNA和蛋白的表达。分析皮下脂肪组织中RBP-4 mRNA和蛋白表达与血清RBP-4浓度及HOMA-IR的相关性。
（1）GDM组血清RBP-4、FINS、FPG、HOMA-IR水平均显著高于对照组[（27.0±1.2）mg/L对（19.4±1.8）mg/L，（12.1±1.4）mU/L对（8.3±0.8）mU/L，（5.3±0.9）mmol/L对（4.1±0.6）mmol/L，2.5±0.2对1.5±0.1，P均<0.05]。（2）GDM组皮下脂肪组织中RBP-4 mRNA和蛋白表达均显著高于对照组（0.76±0.12对0.53±0.06，0.74±0.09对0.54±0.06，P<0.05）。（3）GDM组皮下脂肪组织中RBP-4 mRNA和蛋白表达均与HOMA-IR呈正相关（r=0.575和0.851，P<0.05）。血清RBP-4浓度也与HOMA-I呈正相关（r=0.635，P<0.05）。皮下脂肪组织中RBP-4 mRNA和蛋白表达与血清RBP-4浓度之间无相关性。
GDM孕妇皮下脂肪组织中RBP-4 mRNA高表达及血清RBP-4水平升高可能与IR有关。
