Correlation of serum retinol-binding protein 4, sex hormone levels and endometrial hyperplasia

doi:10.3877/cma.j.issn.1673-5250.2016.06.021

Objective

To explore correlations between serum retinol-binding protein (RBP)4, sex hormone levels and endometrial hyperplasia (EH).

Methods

A total of 80 cases of EH were admitted into Shenzhen Baoan District Maternity & Child Heathcare Hospital from January to June, 2016. According to the results of pathological examination, they were divided into group A (n=60, patients with simple EH or complex EH) and group B (n=20, patients with atypical EH). The endometrial thickness of patients was detected by transvaginal color Doppler ultrasound. The levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, testosterone, dehydroepiandrosterone dehydroepiandrosterone (DHEA) and RBP4 expression levels were detected by chemiluminescence and enzyme linked immunosorbent assay (ELISA) method. The non-conditional multivariate logistic regression analysis was used to analyze the factors that caused EH. There were no statistical differences of the basic information between two groups, such as age, body mass index, menstrual cycle, gravidity, the ratio of diabetes and hypertension and so on (P>0.05). The study protocal was approved by the Ethical Review Board of Investigation in Human Being of Shenzhen Baoan District Maternity & Child Healthcare Hospital. All the patients signed the informed consents.

Results

① The serum RBP4, estradiol, testosterone, DHEA expression levels in group A were lower than those of group B, and the differences were statistically significant (P<0.05). There were no statistical differences between two groups in FSH and LH levels (P>0.05). ②Non-conditional multivariate logistic regression analysis showed that serum RBP4 level (OR=1.564, 95%CI: 7.655-16.54, P=0.006) and serum testosterone level (OR=1.652, 95%CI: 1.689-4.156, P=0.036) may be related to the thickness of EH.

Conclusions

Serum RBP4, estradiol, testosterone and DHEA levels may be associated with endometrial malignant diseases, serum RBP4 level and testosterone are closely related with endometrial thickness in EH patients .

Key words: Retinol-binding proteins, Sex hormone, Endometrial hyperplasia

表1 2组子宫内膜增生患者一般临床资料比较

组别	例数	年龄(岁，±s)	人体质量指数(kg/m²，±s)	月经周期(d，±s)	孕次(次，±s)	糖尿病史[例数(%)]	高血压史[例数(%)]
A组	60	35±11	22.3±2.4	28±9	1.5±0.8	5(8.3)	3(5.0)
B组	20	40±13	23.5±2.3	27±7	1.7±0.6	2(10.0)	1(5.0)
检验值	?	t＝－1.68	t＝－1.96	t＝0.45	t＝－1.02	χ²＝0.17	χ²＝0.34
P值	?	0.096	0.054	0.650	0.310	0.680	0.540

表1 2组子宫内膜增生患者一般临床资料比较

组别	例数	年龄(岁，±s)	人体质量指数(kg/m²，±s)	月经周期(d，±s)	孕次(次，±s)	糖尿病史[例数(%)]	高血压史[例数(%)]
A组	60	35±11	22.3±2.4	28±9	1.5±0.8	5(8.3)	3(5.0)
B组	20	40±13	23.5±2.3	27±7	1.7±0.6	2(10.0)	1(5.0)
检验值	?	t＝－1.68	t＝－1.96	t＝0.45	t＝－1.02	χ²＝0.17	χ²＝0.34
P值	?	0.096	0.054	0.650	0.310	0.680	0.540

表2 2组子宫内膜增生患者血清视黄醇结合蛋白4及性激素水平比较(±s)

组别	例数	血清RBP4水平(nmol/L)	FSH水平(mIU/mL)	LH水平(mU/mL)	雌二醇水平(pmol/L)	睾酮水平(nmol/L )	DHEA水平(nmol/L)
A组	60	25.9±4.2	9.4±0.1	7.5±0.6	94.5±5.6	6.8±0.5	11.4±2.1
B组	20	46.8±4.6	16.7±0.3	9.8±5.4	134.5±6.8	11.5±2.3	66.9±3.0
t值	?	5.213	3.879	3.987	5.346	8.562	5.126
P值	?	0.046	0.086	0.072	0.038	0.034	0.008

表2 2组子宫内膜增生患者血清视黄醇结合蛋白4及性激素水平比较(±s)

组别	例数	血清RBP4水平(nmol/L)	FSH水平(mIU/mL)	LH水平(mU/mL)	雌二醇水平(pmol/L)	睾酮水平(nmol/L )	DHEA水平(nmol/L)
A组	60	25.9±4.2	9.4±0.1	7.5±0.6	94.5±5.6	6.8±0.5	11.4±2.1
B组	20	46.8±4.6	16.7±0.3	9.8±5.4	134.5±6.8	11.5±2.3	66.9±3.0
t值	?	5.213	3.879	3.987	5.346	8.562	5.126
P值	?	0.046	0.086	0.072	0.038	0.034	0.008

表3 影响子宫内膜增生的多因素非条件logistic回归分析结果

影响因素	B	SE	Wald值	P值	OR值	OR值95%CI
血清RBP4水平	0.897	0.054	14.564	0.006	1.564	7.655～16.540
FSH水平	0.053	0.067	2.654	0.115	0.086	1.194～3.084
LH水平	0.083	0.054	2.154	0.192	1.034	1.234～5.698
雌二醇水平	0.121	0.174	6.308	0.068	2.985	2.654～10.563
泌乳素水平	0.246	0.824	5.897	0.127	1.006	3.025～8.470
睾酮水平	0.695	0.075	10.245	0.036	1.652	1.689～4.156
DHEA水平	0.153	0.069	3.689	0.098	0.967	5.239～8.754

表3 影响子宫内膜增生的多因素非条件logistic回归分析结果

影响因素	B	SE	Wald值	P值	OR值	OR值95%CI
血清RBP4水平	0.897	0.054	14.564	0.006	1.564	7.655～16.540
FSH水平	0.053	0.067	2.654	0.115	0.086	1.194～3.084
LH水平	0.083	0.054	2.154	0.192	1.034	1.234～5.698
雌二醇水平	0.121	0.174	6.308	0.068	2.985	2.654～10.563
泌乳素水平	0.246	0.824	5.897	0.127	1.006	3.025～8.470
睾酮水平	0.695	0.075	10.245	0.036	1.652	1.689～4.156
DHEA水平	0.153	0.069	3.689	0.098	0.967	5.239～8.754

[1]	WangY, ZhuY, ZhangL, et al. Insulin promotes proliferation, survival, and invasion in endometrial carcinoma by activating the MEK/ERK pathway[J]. Cancer Lett, 2012, 322(2): 223-231.
[2]	AshbeckEL, JacobsET, MartínezME, et al.Components of metabolic syndrome and metachronous colorectal neoplasia[J]. Cancer Epidemiol Biomarkers Prev, 2009, 18(4): 1134-1143.
[3]	Newcomer ME，Ong DE. P1asma retino1 binding protein: structure and function of the prototypic lipocalin[J]. Biochim Bio Phys Acta，2000，1482(12)：57-64.
[4]	Leal VdeO, MafraD．Adipokines in obesity[J]. Clin Chim Acta, 2013, 419: 87-94.
[5]	董闪闪，张力辉，王绵，等.2型糖尿病合并非酒精性脂肪性肝病患者血清视黄醇结合蛋白4水平变化及影响因素的研究[J]．中国糖尿病杂志，2013，21(12)：1063-1065.
[6]	OstA, DanielssonA, LidénM, et al. Retinol-binding protein-4 attenuates insulin-induced phosphorylation of IRS1 and ERK1/2 in primary human adipocytes[J]. FASEB J, 2007, 21(13): 3696-3704.
[7]	张明军．视黄醇结合蛋白4在胰岛素抵抗形成中的作用及其与运动关系的研究进展[J]．惠州学院学报：自然科学版，2012，32(3)：83-90.
[8]	RosatoV, ZucchettoA, BosettiC, et al. Metabolic syndrome and endometrial cancer risk[J]. Ann Oncol, 2011, 22(4): 884-889.
[9]	BurzawaJK, SchmelerKM, SolimanPT, et al. Prospective evaluation of insulin resistance among endometrial cancer patients[J]. Am J Obstet Gynecol, 2011, 204(4): 355.e1-e7.
[10]	FriedenreichCM, BielRK, LauDC, et al. Case-control study of the metabolic syndrome and metabolic risk factors for endometrial cancer[J]. Cancer Epidemiol Biomarkers Prev, 2011, 20(11): 2384-2395.
[11]	MöhligM, WeickertMO, GhadamgahiE, et al. Retinol-binding protein 4 is associated with insulin resistance, but appears unsuited for metabolic screening in women with polycystic ovary syndrome[J]. Eur J Endocrinol, 2008, 158(4): 517-523.
[12]	任涛，熊小英，蔡春芳. 多囊卵巢综合征患者视黄醇结合蛋白-4的水平变化及意义[J]．中国计划生育和妇产科，2013，5(4)：62-64.
[13]	国际病理学学会，国际病理学会中国分会，北京大学医学部．国际妇产科病理学大会暨第十三届海内外病理学术论坛[C]．北京：中华妇幼临床医学杂志，2016，11(3)：333.
[14]	中华医学会妇产科学分会内分泌学组，中华医学会妇产科学分会绝经学组．功能失调性子宫出血临床诊断治疗指南(草案)[J]．中华妇产科杂志，2009，44(3)：234-236.
[15]	UpsonK, AllisonKH, ReedSD, et al. Biomarkers of progestin therapy resistance and endometrial hyperplasia progression[J]. Am J Obstet Gynecol, 2012, 207(1): 36.e1-e8.
[16]	HubbsJL，SaigRM，AbaidLN，et al. Systemic and local hormone therapy for endometrial hyperplasia and early adenocarcinoma[J]. Obstet Gynecol，2013，121(6)：1172-1180.
[17]	GundersonCC，FaderAN，CarsonKA，et al. Oncologic and reproductive outcomes with progestin therapy in women with endometrial hyperplasia and grade 1 adenocarcinoma：a systematic review[J]. Gynecol Oncol，2012，125(2)：477-482.
[18]	Park JY，Kim DY，Kim TJ，et al. Hormonal therapy for women with stage Ⅰ_A endometrial cancer of all grades[J]．Obstet Gynecol，2013，122(1): 7-14.
[19]	陈琪，杨勇，杜静. 胰岛素与血清性激素水平与子宫内膜增生相关性研究[J]. 中国性科学，2015, 24(10): 49-52.
[20]	王艳杰，陈晓军. 血清性激素及胰岛素水平与子宫内膜增生程度的相关性分析[J]. 中国医药导报，2014, 11(12): 148-150.
[21]	易红，李晓红，李瑾. 代谢综合征与子宫内膜病变的相关性研究[J]. 生殖医学杂志，2013，22(7): 481-484.
[22]	孙茜，刘继晓. PCOS患者血清视黄醇结合蛋白-4水平与胰岛素抵抗的关系[J]. 中国妇幼保健，2010, 25(14): 1901-1902.
[23]	潘优津，赵向彤，吴朝明，等. 肥胖及糖调节受损患者血视黄醇结合蛋白4的变化及临床意义[J]. 中国糖尿病杂志，2008，16(7)：400-401.

[1]	Siyao Wu, Xiaolin Zheng, Qiuhong Xu, Xiang Huang, Chunyu Fan, Hongmei Guo, Haofeng Xie. Clinical value of transvaginal three-dimensional ultrasound combined with anti-Müllerian hormone in assessment of ovarian reserve function[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2019, 16(02): 131-137.
[2]	Lijun Meng, Weili Liu, Guotao Lu. Effect of sex hormones on the inflammatory level and prognosis in patients with acute pancreatitis[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2018, 11(01): 17-21.
[3]	Jia Xu, Lang Qiao, Yang Wang, Junxuan He, Mei Pan. Diagnostic values of contrast-enhanced ultrasonography in the diagnosis of endometrial lesions[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2018, 14(05): 535-541.
[4]	Xiaofang Li, Xiuying Li, Huirui Lin, Li Li. Research status of polycystic ovary syndrome and endometrial hyperplasia[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2018, 14(04): 470-476.
[5]	Sisi Chen, Caiyun Fang, Chunlian Zhang, Huarong Su. Values of narrow-band imaging hysteroscopy in the diagnosis of endometrial hyperplasia and endometrial cancer[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2018, 14(03): 353-359.
[6]	Wuzhi Li. Research progress of endometrial hyperplasia[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2017, 13(02): 244-248.
[7]	Yue Su, Zhisong Ma, Xianghua Yin, Yongsheng Huang, Yang Gu, Jianbo Xu. Clinical evaluation of ovarian reserve function after laparoscopic cystectomy on unilateral ovarian endometriotic cyst[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2017, 13(01): 93-98.
[8]	Tian-cheng WANG, Jian-lan ZHAO, Bin WANG. To Analyze Relative Questions on Postnatal Depression[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2008, 04(05): 440-442.
[9]	Hongfang Li, Li Li, Wei Yi, Yuqing Bai, Qianying Zhuang, Minglong GAO. Characteristics and influencing factors of serum sex hormones in female patients with chronic hepatitis B[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2017, 11(04): 335-338.
[10]	Longfei Zhang, Yong Gao, Yigang Zhang, Chaowen Yu, Delang Liu, Ya Liu, Shiyuan Chen. Expression and clinical significance of Apolipoprotein B, sex hormone binding globulin and tissue inhibitors of metalloproteinase 1 in Budd-Chiari syndrome of inferior vena cava in northern Anhui[J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(04): 252-256.
[11]	Xiaohui Li, Changsheng Shangguan, Ying Xiang, Zhijie Pei, Junzhi Che, Fei Xie. Relationship between body energy metabolism and sex hormone levels in patients with polycystic ovary syndrome after 3D laparoscopic sleeve gastrectomy[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(05): 538-541.
[12]	Hengda Zhang, Hongli Lin, Lulu Han, Chunsheng Xi, Xi Qiao, Xiujuan Liu, Guangyan Cai, Xuefeng Sun, Xiangmei Chen. Age-related eGFR change in healthy people and its association with nutrition, inflammation, and sex hormones[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2019, 08(02): 62-66.
[13]	Mingming Wei, Yujie He, Xiaolian Liu, Xiao Jing. Association of serum 25 (OH) D levels with semen parameters and sex hormones in infertility men[J]. Chinese Journal of Clinicians(Electronic Edition), 2017, 11(11): 1873-1877.
[14]	Shiyun Lu, Min Liu. Comparative analysis of sex hormone detection performance of different detection systems[J]. Chinese Journal of Clinical Laboratory Management(Electronic Edition), 2023, 11(03): 133-138.
[15]	Yusheng Hu, Haihui Liu, Yuguo Qiu. Correlation analysis of physical development indexes and salivary sex hormones in obese children[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2022, 08(01): 36-40.

Viewed

Full text

Abstract

Please choose a citation manager

Content to export