Wang Wen, Li Nianfeng
Hepatobiliary ﹠ Enteric Surgery Research Center, Xiangya Hospital, Central South University, Changsha 410008, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2015 Jun;40(6):657-65. doi: 10.11817/j.issn.1672-7347.2015.06.014.
To measure retinol binding protein 4 (RBP4) levels in serum and bile and to analyze their relationship with insulin resistance, dyslipidemia or cholesterol saturation index (CSI).
A total of 60 patients with gallstone were divided into a diabetes group (n=30) and a control group (n=30). The concentrations of RBP4 in serum and bile were detected by enzyme-linked immunosorbent assay (ELISA). Enzyme colorimetric method was used to measure the concentration of biliary cholesterol, bile acid and phospholipid. Biliary CSI was calculated by Carey table. Partial correlation and multiple linear regression analysis were used to evaluate the correlation between the RBP4 levels in serum or bile and the above indexes.
The RBP4 concentrations in serum and bile in the diabetes group were significantly elevated compared with those in the control group (both P<0.01). There was no significant difference in the serum total bile acid (TBA), serum triglyceride (TG), serum high-density lipoprotein (HDL), bile TBA, bile total cholesterol (TC) , bile phospholipids and bile CSI between the 2 groups (all P>0.05); but the serum TC, low density lipoprotein (LDL), fasting blood glucose (FBG), fasting insulin (FINS), and homeostasis model assessment for insulin resistance (HOMA-IR) in the diabetes group were significantly increased compared to those in the control group (all P<0.05). The partial correlation analysis, which was adjusted by age, showed that the bile RBP4 was positively correlated with body mass index (BMI), waist circumference (WC), FINS, FBG, TC, LDL and HOMA-IR (r=0.283, 0.405, 0.685, 0.667, 0.553, 0.424 and 0.735, respectively), and the serum RBP4 was also positively correlated with the WC, FINS, FBG, TC, LDL and HOMA-IR (r=0.317, 0.734, 0.609, 0.528, 0.386 and 0.751, respectively). Stepwise multivariate linear regression analysis suggested that the HOMA-IR, BMI and WC were independently correlated with the level of bile RBP4 (multiple regression equation: Ybile RBP4=2.372XHOMA-IR+0.420XBMI+0.178XWC-26.813), and the serum RBP4 level was correlated with the HOMA-IR and WC independently (multiple regression equation: Yserum RBP4=2.832XHOMA-IR +0.235XWC-20.128). Multiple regression equations showed that HOMA-IR was the strongest correlation factor with RBP4.
RBP4 concentrations in serum and bile in the diabetes group are significantly higher than those in the control group. HOMA-IR, BMI and WC are independently correlated with the level of bile RBP4. HOMA-IR and WC are independently correlated with the serum RBP4 level. HOMA-IR is the strongest correlation factor with RBP4. RBP4 might play an important role in the course of gallstone formation in Type 2 diabetes mellitus.
检测血清和胆汁中视黄醇结合蛋白4（RBP4）水平，并分析其与胰岛素抵抗、血脂异常或胆固醇饱和指数（CSI）的关系。
将60例胆结石患者分为糖尿病组（n = 30）和对照组（n = 30）。采用酶联免疫吸附测定（ELISA）法检测血清和胆汁中RBP4的浓度。采用酶比色法测定胆汁中胆固醇、胆汁酸和磷脂的浓度。通过凯里表计算胆汁CSI。采用偏相关和多元线性回归分析评估血清或胆汁中RBP4水平与上述指标之间的相关性。
糖尿病组血清和胆汁中RBP4浓度均显著高于对照组（均P < 0.01）。两组间血清总胆汁酸（TBA）、血清甘油三酯（TG）、血清高密度脂蛋白（HDL）、胆汁TBA、胆汁总胆固醇（TC）、胆汁磷脂和胆汁CSI比较，差异均无统计学意义（均P > 0.05）；但糖尿病组血清TC、低密度脂蛋白（LDL）、空腹血糖（FBG）、空腹胰岛素（FINS）及胰岛素抵抗稳态模型评估（HOMA-IR）均显著高于对照组（均P < 0.05）。经年龄校正的偏相关分析显示，胆汁RBP4与体重指数（BMI）、腰围（WC）、FINS、FBG、TC、LDL及HOMA-IR呈正相关（r分别为0.283、0.405、0.685、0.667、0.553、0.424和0.735），血清RBP4与WC、FINS、FBG、TC、LDL及HOMA-IR也呈正相关（r分别为0.317、0.734、0.609、0.528、0.386和0.751）。逐步多元线性回归分析提示，HOMA-IR、BMI和WC与胆汁RBP4水平独立相关（多元回归方程：Y胆汁RBP4 = 2.372XHOMA-IR + 0.420XBMI + 0.178XWC - 26.813），血清RBP4水平与HOMA-IR和WC独立相关（多元回归方程：Y血清RBP4 =
