title: Retinol binding protein 4 and incident diabetes--the Atherosclerosis Risk in Communities Study (ARIC Study).
abstract: BACKGROUND
  Retinol binding protein 4 (RBP4) has been described as a link between impaired glucose uptake in adipocytes and systemic insulin sensitivity.
  
  
  OBJECTIVE
  To determine whether RBP4 fasting levels predict the development of type 2 diabetes.
  
  
  METHODS
  Using a case-cohort design, we followed 543 middle-aged individuals who developed diabetes and 537 who did not over ~9 years within the population-based Atherosclerosis Risk in Communities Study. Weighted Cox proportional hazards analyses permitted statistical inference of the RBP4 - incident diabetes associations to the entire cohort.
  
  
  RESULTS
  Women in the highest tertile of RBP4 presented greater risk of developing diabetes (HR = 1.74; 95%CI 1.03 - 2.94) in analyses adjusted for age, ethnicity, study center, parental history of diabetes, hypertension, glomerular filtration rate, body mass index, waist-hip ratio, nonesterified fatty acids, adiponectin, leptin, triglycerides and HDL-C. When additionally adjusted for fasting insulin, this association's significance became borderline (HR = 1.68; 95%CI 1.00 - 2.82). No association between RBP4 levels and incident diabetes was found in men.
  
  
  CONCLUSIONS
  These findings suggest that RBP4 levels may be directly involved in the pathogenesis of type 2 diabetes in women.
authors.affiliation: Federal University of Rio Grande do Sul, School of Medicine, Graduate Studies Program in Epidemiology, Porto Alegre,RS, Brazil.
authors.forename: Vivian C
authors.initials: VC
authors.lastname: Luft
authors.forename: Mark
authors.initials: M
authors.lastname: Pereira
authors.forename: James S
authors.initials: JS
authors.lastname: Pankow
authors.forename: Christie
authors.initials: C
authors.lastname: Ballantyne
authors.forename: David
authors.initials: D
authors.lastname: Couper
authors.forename: Gerardo
authors.initials: G
authors.lastname: Heiss
authors.forename: Bruce B
authors.initials: BB
authors.lastname: Duncan
mesh_terms: D001741:Black or African American; D050197:Atherosclerosis / Q000097:blood / Q000175:diagnosis; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005215:Fasting; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D054839:Retinol-Binding Proteins, Plasma / Q000032:analysis*; D018570:Risk Assessment; D013997:Time Factors; D044465:White People
chemical_list: C101326:RBP4 protein, human; D054839:Retinol-Binding Proteins, Plasma