视黄醇结合蛋白4与糖脂代谢指标及胆汁胆固醇饱和指数之间的相关性

发布时间：2018-04-01 15:37

本文选题：型糖尿病　切入点：胆囊结石　出处：《中南大学学报(医学版)》2015年06期

【摘要】：目的:探讨血清及胆汁中视黄醇结合蛋白4(retinol binding protein 4,RBP4)的浓度与胰岛素抵抗、血脂异常、胆汁胆固醇饱和指数(cholesterol saturation index,CSI)之间的关系。方法:将住院手术治疗胆囊结石的患者随机分为糖尿病组和对照组,每组30例。采用ELISA法检测糖尿病组和对照组血清及胆汁中RBP4的浓度,酶比色法测定胆汁胆固醇、胆汁酸和磷脂的含量,采用Carey表计算胆汁CSI,分析血清及胆汁中RBP4水平与各项指标的相关性,并对相关指标进行多元线性回归分析。结果:糖尿病组血清及胆汁中RBP4的浓度均显著高于对照组(均P0.01)。两组血清总胆汁酸(total bile acid,TBA),TG,HDL,以及胆汁TBA,TC,磷脂及CSI之间的差异均无统计学意义(均P0.05)。糖尿病组血清TC,LDL,空腹血糖(fasting blood glucose,FBG)、空腹胰岛素(fasting insulin,FINS)以及稳态模型评估的胰岛素抵抗指数(homeostasis model assessment for insulin resistance index,HOMA-IR)均高于对照组,差异均有统计学意义(均P0.05)。校正年龄影响后的偏相关分析表明:胆汁RBP4与体质量指数(body mass index,BMI),腰围(waist circumference,WC),空腹血清胰岛素(fast serum insulin,FINS),FBG,TC,LDL,HOMA-IR呈正相关(分别r=0.283,0.405,0.685,0.667,0.553,0.424,0.735);血清RBP4与WC,FINS,FBG,TC,LDL,HOMA-IR呈正相关(分别r=0.317,0.734,0.609,0.528,0.386,0.751);逐步法多元线性回归分析表明HOMA-IR,BMI,WC与胆汁RBP4水平独立相关(回归方程如下:Y胆汁RBP4=2.372XHOMA-IR+0.420XBMI+0.178XWC-26.813);HOMA-IR,WC与血清RBP4水平独立相关(回归方程如下:Y血清RBP4=2.832XHOMA-IR+0.235XWC-20.128),HOMA-IR与RBP4的相关性最强。结论:糖尿病组血清及胆汁中RBP4的浓度显著高于对照组;HOMA-IR,BMI,WC与胆汁RBP4呈独立相关;HOMA-IR,WC与血清RBP4呈独立相关;HOMA-IR与RBP4的相关性最强。RBP4可能在2型糖尿病合并胆囊结石的发展过程中起着重要作用。
[Abstract]:Objective: to investigate the concentration of 4(retinol binding protein 4 (RBP4) in serum and bile, insulin resistance and dyslipidemia. The relationship between cholesterol saturation index (CSI) and cholecystolithiasis. Methods: patients with cholecystolithiasis were randomly divided into diabetic group and control group. The concentration of RBP4 in serum and bile of diabetic group and control group was detected by ELISA method, and the contents of cholesterol, bile acid and phospholipid in bile were determined by enzyme colorimetry. The Carey table was used to calculate the bile CSI, and the correlation between the serum and bile RBP4 levels and the indexes was analyzed. Multivariate linear regression analysis was carried out. Results: the concentrations of RBP4 in serum and bile in diabetic group were significantly higher than those in control group (P0.01). There was no significant difference between the two groups (P 0.05). The levels of serum TCA LDLs, fasting blood glucose, fasting insulin fasting insulin fins and homeostasis model assessment for insulin resistance index (HOMA-IRR) in diabetic group were significantly higher than those in the control group, and the homeostasis model assessment for insulin resistance index (HOMA-IRR) in diabetic group were higher than those in control group. The results of partial correlation analysis showed that bile RBP4 was positively correlated with body mass index (BMI) and body mass index (BMI), waist circumference (WCC), fasting serum insulin fast (FBG) and TBC LDLHOMA-IR (r = 0.283) and WCFINSING / TBGG / LLDLHOMA-IR (r = 0.283 / 0.405 / 0.685 / 0.6670.5530.424 / 0 ~ 0.735, respectively); serum RBP4 was positively correlated with WCFINSINSINSINSINSINSINSINSINSINSINSINSINSINSINSINSINSINSINSINSINSINSING. The stepwise multivariate linear regression analysis showed that HOMA-IRI BMI-WC was independently correlated with bile RBP4 level (regression equation as follows: RBP4=2.372XHOMA-IR 0.420XBMI 0.178XWC-26.813Homa IRWC is independent with serum RBP4 level (the regression equation is as follows: the regression equation is as follows: the regression equation is as follows: y, serum RBP4=2.832XHOMA-IR 0.235XWC-20.128- IR and RBP4). () the regression equation is as follows:% Y serum RBP4=2.832XHOMA-IR 0.235XWC-20.128- IR is independent of the level of RBP4 in bile (the regression equation is as follows:% Y bile RBP4=2.372XHOMA-IR 0.420XBMI 0.178XWC-26.813C) (the regression equation is as follows:% Y, serum RBP4=2.832XHOMA-IR 0.235 XWC-20.128). Conclusion: the concentration of RBP4 in serum and bile in diabetic group is significantly higher than that in control group. There is an independent correlation between HOMA-IRMA-IRWC and bile RBP4. HOMA-IRWC and serum RBP4 have the strongest correlation with RBP4. RBP4 may be in type 2 diabetes mellitus complicated with gallbladder node. Stone plays an important role in the development process.
【作者单位】：中南大学湘雅医院肝胆肠外科研究中心;
【分类号】：R587.1;R575.62

【参考文献】