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目的探讨妊娠晚期孕妇血清及脐血视黄醇结合蛋白4(retinol binding protein 4,RBP4)与妊娠期糖尿病及胎儿体重的关系。方法选择2014年1—12月在嘉兴市妇幼保健院产科分娩的妊娠期糖尿病孕妇40例为妊娠期糖尿病组,糖耐量正常孕妇40例为对照组。行酶联免疫吸附法(ELISA)检测孕妇血清及脐血中RBP4水平,采用酶法检测总胆固醇及甘油三酯水平,并记录新生儿出生体重。运用SPSS 17.0统计学软件对结果进行统计分析。结果 1妊娠期糖尿病组血清及脐血RBP4水平均高于正常组,2组相比差异有统计学意义(P<0.01);与血清RBP4水平相比新生儿脐血RBP4水平明显降低,比较差异有统计学意义(P<0.01);2与正常组相比,GDM组血甘油三酯升高,比较差异有统计学意义(P<0.01);GDM组胎儿体重高于正常组,差异有统计学意义(P<0.01);3妊娠妇女血清RBP4水平与血甘油三酯呈正相关(r=0.489,P<0.01);脐血RBP4水平与新生儿出生体重呈正相关(r=0.327,P<0.05),血清RBP4水平与脐血RBP4水平无关(r=0.185,P>0.05)。结论妊娠期糖尿病时血清及脐血RBP4水平上升,且与胎儿体重正相关,提示RBP4与妊娠期糖尿病密切相关,但具体机制有待进一步研究。
Objective To investigate the relationship between serum and cord blood retinol binding protein 4 (RBP4) and gestational diabetes mellitus and fetal body weight in the third trimester of pregnancy. Methods Forty pregnant women with gestational diabetes who were delivered in Jiaxing Maternal and Child Health Hospital from January to December 2014 were selected as gestational diabetes mellitus group and 40 pregnant women with normal glucose tolerance as control group. The level of RBP4 in serum and umbilical cord blood of pregnant women was detected by enzyme-linked immunosorbent assay (ELISA), the levels of total cholesterol and triglyceride were detected by enzyme-linked immunosorbent assay (ELISA), and the birth weight of newborns was recorded. The results were statistically analyzed using SPSS 17.0 statistical software. Results The level of RBP4 in umbilical cord blood of pregnant women with gestational diabetes mellitus was significantly higher than that of normal group (P <0.01). Compared with RBP4, the levels of RBP4 in neonatal umbilical cord blood were significantly decreased (P <0.01). 2 Compared with the normal group, the levels of triglyceride in GDM group were significantly increased (P <0.01). The body weight of fetus in GDM group was higher than that in normal group (R = 0.489, P <0.01). There was a positive correlation between RBP4 level in cord blood and newborn birth weight (r = 0.327, P <0.05) ). Serum RBP4 level had no correlation with cord blood RBP4 level (r = 0.185, P> 0.05). Conclusions The level of RBP4 in serum and umbilical cord blood in gestational diabetes mellitus is increased, which is positively correlated with fetal body weight. It suggests that RBP4 is closely related to gestational diabetes mellitus, but the specific mechanism remains to be further studied.