Association of serum retinol binding protein 4 with atherogenic dyslipidemia in morbid obese patients.
Retinol binding protein 4 (RBP4) is an adipokine that may contribute to the development of insulin resistance. However, how this adipokine is affected and its possible involvement in lipid metabolism in obese patients with varying degrees of insulin resistance is yet to be determined. A total of 299 middle-aged morbid obese patients (BMI>40 kg/m(2)) were divided in euglycemic, metabolic syndrome or type 2 diabetic. Anthropometric measurements, biochemical variables and systemic RBP4 levels were determined. RBP4 levels were significantly higher in patients with metabolic syndrome and type 2 diabetes than in euglycemic subjects (42.9±14.6; 42.3±17.0 and 37.4±11.7 µg/ml, respectively) and correlated with triglycerides but not with those of HOMA-IR in the whole population. The multivariate regression model revealed that triglycerides were the strongest predictor of systemic RBP4 levels. Analysis of lipoprotein subfractions in a subpopulation of 80 subjects showed an altered profile of insulin resistant states characterized by higher VLDL, sdLDL and small HDL percentages and lower large HDL percentage. Although RBP4 levels correlated significantly with LDL particle size and small HDL percentage, the latter parameter was independently associated only with RBP4. Our study reveals that systemic RBP4 levels could play an important role in lipid metabolism in morbid obesity, increasing triglyceride levels and contributing to the formation of small HDL.
Service of Endocrinology, University Hospital Dr. Peset, Valencia, Spain ; Foundation for the Promotion of Healthcare and Biomedical Research in the Valencian Community (FISABIO), Valencia, Spain ; CIBER CB06/04/0071 Research Group. CIBER Hepatic and Digestive Diseases, Faculty of Medicine, University of Valencia, Valencia, Spain ; Institute of Health Research INCLIVA, Valencia, Spain.
Milagros
M
Rocha
Celia
C
Bañuls
Lorena
L
Bellod
Susana
S
Rovira-Llopis
Carlos
C
Morillas
Eva
E
Solá
Víctor M
VM
Víctor
Antonio
A
Hernández-Mijares
D000328:Adult; D050197:Atherosclerosis / Q000097:blood* / Q000150:complications; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015243:Cholesterol, VLDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D050171:Dyslipidemias / Q000097:blood* / Q000150:complications; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D050356:Lipid Metabolism; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000150:complications; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000097:blood* / Q000150:complications; D054839:Retinol-Binding Proteins, Plasma / Q000378:metabolism*; D014280:Triglycerides / Q000097:blood
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D015243:Cholesterol, VLDL; C101326:RBP4 protein, human; D054839:Retinol-Binding Proteins, Plasma; D014280:Triglycerides