Retinol-binding protein 4, visceral fat, and the metabolic syndrome: effects of weight loss.
Retinol-binding protein 4 (RBP-4) has been reported to be associated with visceral-fat accumulation and parameters of the metabolic syndrome (MetS). In this study, we investigated the relationship between RBP-4, visceral fat, and the MetS during pronounced weight loss after bariatric surgery. Thirty-six subjects were examined before and 2 years after surgery. Abdominal-fat distribution was determined by ultrasound, metabolic parameters, and serum RBP-4 levels by standard methods. After surgery BMI decreased by 9.07 kg/m(2), visceral-fat diameter (VFD) decreased by 60.6%, and RBP-4 serum levels by 16.6%. Change of RBP-4 levels was associated with reductions of waist (r = 0.364, P = 0.037), waist-to-hip ratio (WHR) (r = 0.415, P = 0.016), and VFD (r = 0.425, P = 0.010). MetS, as defined by International Diabetes Federation (IDF), was present in 19 patients at baseline and in nine patients at follow-up. Change in RBP-4 levels was the best predictor for the diagnosis of MetS at follow-up. In the subgroup without MetS at baseline, the decrease in RBP-4 levels (-28.1% vs. -6.3%, P = 0.020) and reduction in VFD (-66.9% vs. -55.0%, P = 0.038) were significantly greater compared to the subgroup with MetS. We demonstrate a marked decrease of RBP-4 levels after bariatric surgery, which correlates with reduction in visceral-fat mass. Furthermore, the extent of changes in RBP-4 levels differs according to the severity of the MetS.
Tschoner
Alexander
A
Department of Internal Medicine, Clinical Division of General Internal Medicine, Innsbruck Medical University, Innsbruck, Austria.
Sturm
Wolfgang
W
Engl
Julia
J
Kaser
Susanne
S
Laimer
Markus
M
Laimer
Elisabeth
E
Weiss
Helmut
H
Patsch
Josef R
JR
Ebenbichler
Christoph F
CF
D054392:Adipokines / Q000378:metabolism; D000328:Adult; D050110:Bariatric Surgery; D001823:Body Composition / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D050152:Intra-Abdominal Fat / Q000378:metabolism*; D008297:Male; D024821:Metabolic Syndrome / Q000378:metabolism*; D011446:Prospective Studies; D054839:Retinol-Binding Proteins, Plasma / Q000378:metabolism*; D012720:Severity of Illness Index; D015431:Weight Loss / Q000502:physiology*
D054392:Adipokines; C101326:RBP4 protein, human; D054839:Retinol-Binding Proteins, Plasma