血清视黄醇结合蛋白-4同儿童肥胖和代谢综合征组分的关系

目的:探讨儿童血清视黄醇结合蛋白-4(retinol-binding protein4,RBP-4),视黄醇,甲状腺素运载蛋白(transthyretin,TTR)等维生素A相关指标与肥胖、胰岛素抵抗以及代谢综合征组分之间的关系。方法:分别随机选取本地区13-15岁体检学生,其中正常对照组和单纯性肥胖组儿童各50例,测定其血清RBP-4、视黄醇、TTR水平;利用空腹胰岛素和定量胰岛索敏感性检测指标评价其胰岛素抵抗;同时测定代谢综合征部分组分水平和亚临床炎症指标。结果:仅5%的青少年存在维生素A营养不足状态。排除年龄、性别、感染等因素的影响后,血清RBP-4水平、视黄醇、RBP-4/TTR摩尔比值以及RBP-4/视黄醇摩尔比值与体重指数、体脂含量以及体脂的中心分布(WHR)等密切相关;RBP-4与代谢综合征组分的甘油三酯水平则存在明显的正相关,而RBP-4/视黄醇摩尔比值则与空腹胰岛素水平存在显著的正相关。结论:RBP-4可能通过视黄醇依赖和/或非视黄醇依赖的方式参与肥胖和代谢综合征的病理过程。

Association of Serum Retinol-Binding Protein 4 Concentration with Obesity and Metabolic Syndrome Components in Children

Objective:To investigate the correlation of vitamin A metabolic index:serum retinol binding protein-4 (RBP-4), serum retinol and transthyretin (TTR) with obesity,insulin resistance (IR) and metabolic syndrome components in normal-weight and simple obesity children.Methods:This was a cross-sectional study and subjects included 13-15 yr old normal-weight children (n=50) and simple obesity children (n=50).Body mass index,body fat percentage,waist-to-hip ratio,serum RBP-4,serum retinol and serum TTR were determined.IR was assessed using fasting insulin and the quantitative insulin sensitivity check index,and components of the metabolic syndrome and indices of subclinical inflammation were measured.Results:Only 5% of children had low vitamin A status.In- dependent of age,gender and subclinical inflammation,body mass index,body fat percentage,and waist-to-hip ratio were significant pre- dictors of RBP4,serum retinol,RBP-4/retinol mole ratio and RBP-4/TTR mole ratio.Additionally,RBP-4 was significantly correlated with serum triglycerides,and RBP-4/retinol mole ratio was correlated with fasting insulin.Conclusion:These data suggested that RBP-4 may be linked to adiposity and the metabolic syndrome via both retinol-dependent and -independent mechanisms,at least in children.