Jin Chuyao, Lin Lizi, Han Na, Zhao Zhiling, Liu Zheng, Luo Shusheng, Xu Xiangrong, Liu Jue, Wang Haijun
1Department of Maternal and Child Health, School of Public Health, Peking University, No. 38 Xueyuan Rd, Haidian District, Beijing, 100191 People's Republic of China.
Maternal and Child Health Hospital of Tongzhou District, Beijing, 101101 China.
Nutr Metab (Lond). 2020 Jan 6;17:1. doi: 10.1186/s12986-019-0425-9. eCollection 2020.
To assess the association between plasma retinol-binding protein 4 (RBP4) levels both in the first trimester and second trimester and risk of gestational diabetes mellitus (GDM).
Plasma RBP4 levels and insulin were measured among 135 GDM cases and 135 controls nested within the Peking University Birth Cohort in Tongzhou. Multivariable linear regression analysis was conducted to assess the influence of RBP4 levels on insulin resistance. Conditional logistic regression models were used to compute the odds ratio (OR) and 95% confidence interval (CI) between RBP4 levels and risk of GDM.
The GDM cases had significantly higher levels of RBP4 in the first trimester than controls (medians: 18.0 μg/L vs 14.4 μg/L; < 0.05). Plasma RBP4 concentrations in the first and second trimester were associated with fasting insulin, homeostasis model assessment for insulin resistance (HOMA-IR), and the quantitative insulin sensitivity check index (QUICKI) in the second trimester (all < 0.001). With adjustment for diet, physical activity, and other risk factors for GDM, the risk of GDM increased with every 1-log μg/L increment of RBP4 levels, and the OR (95% CI) was 3.12 (1.08-9.04) for RBP4 in the first trimester and 3.38 (1.03-11.08) for RBP4 in the second trimester.
Plasma RBP4 levels both in the first trimester and second trimester were dose-dependently associated with increased risk of GDM.
评估孕早期和孕中期血浆视黄醇结合蛋白4（RBP4）水平与妊娠期糖尿病（GDM）风险之间的关联。
在北京大学通州出生队列中的135例GDM病例和135例对照中测量血浆RBP4水平和胰岛素。进行多变量线性回归分析以评估RBP4水平对胰岛素抵抗的影响。使用条件逻辑回归模型计算RBP4水平与GDM风险之间的比值比（OR）和95%置信区间（CI）。
GDM病例孕早期的RBP4水平显著高于对照组（中位数：18.0μg/L对14.4μg/L；<0.05）。孕早期和孕中期的血浆RBP4浓度与孕中期的空腹胰岛素、胰岛素抵抗稳态模型评估（HOMA-IR）和定量胰岛素敏感性检查指数（QUICKI）相关（均<0.001）。在调整饮食、身体活动和其他GDM风险因素后，GDM风险随RBP4水平每增加1个对数μg/L而增加，孕早期RBP4的OR（95%CI）为3.12（1.08 - 9.04），孕中期RBP4的OR（95%CI）为3.38（1.03 - 11.08）。
孕早期和孕中期的血浆RBP4水平均与GDM风险增加呈剂量依赖性关联。
