• 四川省醫(yī)學(xué)科學(xué)院·四川省人民醫(yī)院（成都，610072）1 干部科，2 中心實驗室;

【摘要】　目的　 研究合并2型糖尿病的冠心病患者冠狀動脈病變程度與血清視黃醇結(jié)合蛋白4（retinol-binding protein 4，RBP4）水平的相關(guān)性。　方法　 2008年10月-2010年4月選擇性冠狀動脈造影確診的冠心病患者共120例，分為單純冠心病組（A組）60例和冠心病合并糖尿病組（B組）60例，檢測血糖、血脂、胰島素以及脂聯(lián)素、RBP4水平；根據(jù)冠狀動脈造影結(jié)果，以Gensini評分評判冠狀動脈病變程度。　結(jié)果　 B組空腹血糖、胰島素、RBP4均顯著高于A組（P lt;0.05）；冠狀動脈病變程度更重（P lt;0.05）。相關(guān)性分析顯示RBP4水平與低密度脂蛋白膽固醇、胰島素抵抗和冠狀動脈病變積分呈正相關(guān)（r=0.312、0.322、0.314，P lt;0.05）。與脂聯(lián)素水平呈負(fù)相關(guān)（r=-0.362，P lt;0.01）。　結(jié)論　 冠心病合并2型糖尿病患者RBP4明顯升高，且與冠狀動脈狹窄程度呈正相關(guān)。
【Abstract】　Objective　 To explore the relationship between the level of serum retinol-binding protein 4 (RBP4) and the extent of coronary lesions in coronary heart disease (CHD) patients accompanied with type 2 diabetes mellitus (T2DM).　Methods　 A total of 120 patients with CHD diagnosed by coronary arteriongraphy between October 2008 and April 2010 were enrolled. The patients were divided into two groups: CHD group (60 patients); CHD accompanied with T2DM group (60 patients). The levels of serum insulin, adiponectin and RBP4 were measured. All the patients underwent coronary angiography and the extent of coronary lesions was assessed quantitatively based on the Gensini′s scoring system.　Results　 The levels of serum insulin, plasma RBP4 and the extent of coronary artery stenosis in CHD accompanied with T2DM group were significantly higher than those in CHD group (P lt;0.05). Correlation analysis showed that the level of RBP4 was positively correlated with LDL-C, insulin resistance index and the coronary artery narrow degree（r=0.312, 0.322, 0.314; P lt;0.05); and negatively correlated with adiponectin (r=-0.362, P lt;0.01).　Conclusion　 The significant elevated plasma RBP4 in CHD patients accompanied with T2DM is positively correlated with the extent of coronary artery lesion.

引用本文： 張敏,唐榮珍,曹曉紅,張維,辜曉惠,董巍. 冠心病合并2型糖尿病血清視黃醇結(jié)合蛋白4水平與冠狀動脈病變程度的相關(guān)性研究. 華西醫(yī)學(xué), 2011, 26(12): 1818-1821. doi: 復(fù)制

1. 　王雙, 朱蘭, 李峻, 等. 羅格列酮在2型糖尿病治療中的循證證據(jù)[J]. 華西醫(yī)學(xué), 2003, 18(1): 1-2.
2. 　Yang Q, Graham TE, Mody N, et al. Serum retinol binding protein 4 contributes to insulin resistance in obesity and type 2 diabetes[J]. Nature, 2005, 436(7049): 356-362.
3. 　Cho YM, Youn BS, Lee H, et al. Plasma retinol　binding protein-4 concentrations are elevated in human subjects with impaired glucose tolerance and type2 diabetes[J]. Diabetes Care, 2006, 29(11): 2457-2461.
4. 　Qi Q, Yu Z, Ye X, et al. Elevated retinol2binding p rotein 4 levels are associated with metabolic syndrome in chinese people[J]. J Clin Endocrinol Metab, 2007, 92(12): 4827-4834.
5. 　von Eynatten M, Lepper PM, Liu D, et al. Retinol binding protein 4 is associated with components of the metabolic syndrome, but notwith insulin resistance, in men with type 2 diabetes or coronary artery disease[J].Diabetologia, 2007, 50(9): 1930-1937.
6. 　Cabré A, Lázaro I, Girona J, et al. Retinol-binding protein 4 as a plasma biomarker of renal dysfunction and cardiovascular disease in type 2 diabetes[J].J Intern Med, 2007, 262(4): 496-503.
7. 　劉更夫, 左華澤, 駱明波, 等. 血清視黃醇結(jié)合蛋白4水平與動脈粥樣硬化危險因素的相關(guān)性分析[J]. 微循環(huán)學(xué)雜志, 2009, 19(3): 62-63.
8. 　蔣伏松, 成興波, 李慧娟, 等. 血清視黃醇結(jié)合蛋白4與2型糖尿病頸動脈粥樣硬化的關(guān)系[J]. 蘇州大學(xué)學(xué)報(醫(yī)學(xué)版), 2009, 29(3): 508-510.
9. 　Lee JW, Im JA, Lee HR, et al. Visceral adiposity is associated with serum retinol binding protein-4 levels in healthy women[J]. Obesity(Silver Spring), 2007, 15(9): 2225-2232.
10. 　Yao-Borengasser A, Varma V, Bodles AM, et al. Retinol binding protein 4 expression in humans:relationship to insulin resistance, inflammation, and response to pioglitazone[J]. J Clin Endocrinol Metab, 2007, 92(7): 2590-2597.
11. 　徐良成, 高大勝. 腫瘤壞死因子β基因多態(tài)性與冠心病[J]. 華西醫(yī)學(xué), 2009, 24(9): 2487-2489.
12. 　Perseghin G, Lattuada G, De Cobelli F, et al. Serum retinol-binding protein-4, leptin, and adiponectin concentrations are related to ectopic fat accumulation[J]. J Clin Endocrinol Metab, 2007, 92(12): 4883-4888.
  1. 1. 　王雙, 朱蘭, 李峻, 等. 羅格列酮在2型糖尿病治療中的循證證據(jù)[J]. 華西醫(yī)學(xué), 2003, 18(1): 1-2.
  2. 2. 　Yang Q, Graham TE, Mody N, et al. Serum retinol binding protein 4 contributes to insulin resistance in obesity and type 2 diabetes[J]. Nature, 2005, 436(7049): 356-362.
  3. 3. 　Cho YM, Youn BS, Lee H, et al. Plasma retinol　binding protein-4 concentrations are elevated in human subjects with impaired glucose tolerance and type2 diabetes[J]. Diabetes Care, 2006, 29(11): 2457-2461.
  4. 4. 　Qi Q, Yu Z, Ye X, et al. Elevated retinol2binding p rotein 4 levels are associated with metabolic syndrome in chinese people[J]. J Clin Endocrinol Metab, 2007, 92(12): 4827-4834.
  5. 5. 　von Eynatten M, Lepper PM, Liu D, et al. Retinol binding protein 4 is associated with components of the metabolic syndrome, but notwith insulin resistance, in men with type 2 diabetes or coronary artery disease[J].Diabetologia, 2007, 50(9): 1930-1937.
  6. 6. 　Cabré A, Lázaro I, Girona J, et al. Retinol-binding protein 4 as a plasma biomarker of renal dysfunction and cardiovascular disease in type 2 diabetes[J].J Intern Med, 2007, 262(4): 496-503.
  7. 7. 　劉更夫, 左華澤, 駱明波, 等. 血清視黃醇結(jié)合蛋白4水平與動脈粥樣硬化危險因素的相關(guān)性分析[J]. 微循環(huán)學(xué)雜志, 2009, 19(3): 62-63.
  8. 8. 　蔣伏松, 成興波, 李慧娟, 等. 血清視黃醇結(jié)合蛋白4與2型糖尿病頸動脈粥樣硬化的關(guān)系[J]. 蘇州大學(xué)學(xué)報(醫(yī)學(xué)版), 2009, 29(3): 508-510.
  9. 9. 　Lee JW, Im JA, Lee HR, et al. Visceral adiposity is associated with serum retinol binding protein-4 levels in healthy women[J]. Obesity(Silver Spring), 2007, 15(9): 2225-2232.
  10. 10. 　Yao-Borengasser A, Varma V, Bodles AM, et al. Retinol binding protein 4 expression in humans:relationship to insulin resistance, inflammation, and response to pioglitazone[J]. J Clin Endocrinol Metab, 2007, 92(7): 2590-2597.
  11. 11. 　徐良成, 高大勝. 腫瘤壞死因子β基因多態(tài)性與冠心病[J]. 華西醫(yī)學(xué), 2009, 24(9): 2487-2489.
  12. 12. 　Perseghin G, Lattuada G, De Cobelli F, et al. Serum retinol-binding protein-4, leptin, and adiponectin concentrations are related to ectopic fat accumulation[J]. J Clin Endocrinol Metab, 2007, 92(12): 4883-4888.