title: Retinol binding protein: marker for insulin resistance and inflammation postburn?
abstract: BACKGROUND
  Burn injury leads to vast changes in both metabolic and inflammatory responses and is associated with increased morbidity and mortality. Insulin resistance (IR) and hyperglycemia are major components of the hypermetabolic response found in burn-injured patients and subsequently contribute to adverse outcomes. Studies have shown that increased systemic retinol binding protein (RBP) levels are associated with IR and hyperinflammation in diabetic and obese patients. The aim of this study was to determine RBP profiles and to test the hypothesis that elevated RBP levels are associated with both IR and the inflammatory response in burned patients.
  
  
  METHODS
  RBP was measured in 372 patients during the acute stay postburn. Patients' demographics, glucose levels, and insulin administration were recorded. Cytokines, hormones, plasma proteins, and organ markers were measured. The average of all measurements of RBP (2.1 mg/dL) was used to divide patients into high and low groups. Statistical analysis was performed by Student t test. Statistical significance was accepted at P < .05.
  
  
  RESULTS
  Fifty-one patients (high group) had elevated RBP levels during acute hospitalization and demonstrated a significant higher incidence of multiorgan failure, sepsis, and mortality (P < .05). Moreover, in the high group, a significant increase of IR, inflammatory cytokines, and catabolic and organ-specific markers were detected (P < .05).
  
  
  CONCLUSIONS
  Increased RBP levels postburn correlate with increased IR, inflammatory and catabolic responses, incidence of multiorgan failure, and mortality. RBP may be a novel biomarker to monitor these detrimental responses postburn.
authors: Shriners Hospitals for Children, and Department of Surgery, University of Texas Medical Branch Galveston, Texas, USA.
authors: Robert
authors: R
authors: Kraft
authors: David N
authors: DN
authors: Herndon
authors: Gabriela A
authors: GA
authors: Kulp
authors: Gabriel A
authors: GA
authors: Mecott
authors: Heiko
authors: H
authors: Trentzsch
authors: Marc G
authors: MG
authors: Jeschke
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002056:Burns / Q000097:blood / Q000150:complications* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood; D005260:Female; D006760:Hospitalization; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000209:etiology; D007249:Inflammation / Q000097:blood* / Q000209:etiology; D018836:Inflammation Mediators / Q000097:blood; D007328:Insulin / Q000008:administration & dosage / Q000378:metabolism*; D007333:Insulin Resistance; D008297:Male; D009102:Multiple Organ Failure / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D012177:Retinol-Binding Proteins / Q000378:metabolism*; D054839:Retinol-Binding Proteins, Plasma / Q000378:metabolism*; D018805:Sepsis / Q000097:blood / Q000453:epidemiology / Q000209:etiology
chemical_list: D015415:Biomarkers; D016207:Cytokines; D018836:Inflammation Mediators; D007328:Insulin; D012177:Retinol-Binding Proteins; D054839:Retinol-Binding Proteins, Plasma