title: Association of urinary RBP4 with insulin resistance, inflammation, and microalbuminuria.
abstract: OBJECTIVE
  Serum concentrations of retinol-binding protein 4 (RBP4) are elevated in type 2 diabetes and associated with the severity of insulin resistance; however, there are few data about the relationship between urinary RBP4 levels and metabolic parameters. We assessed urinary RBP4 as a new biomarker by establishing its relationship with clinical parameters associated with insulin resistance and urinary albumin excretion.
  
  
  METHODS
  We measured RBP4 in the serum and urine of 689 subjects with diverse glucose tolerance status. We also evaluated the relationship between urinary RBP4 and cardiometabolic risk factors, including insulin resistance, high-sensitivity C-reactive protein (hsCRP), arterial stiffness, and microalbuminuria.
  
  
  RESULTS
  Urinary RBP4 levels were higher in insulin-resistant subjects with prediabetes or type 2 diabetes than in subjects with normal glucose tolerance (NGT) (type 2 diabetes>prediabetes>NGT; all P<0.001). Urinary RBP4 correlated strongly with homeostasis model assessments of insulin resistance (HOMA-IR), fasting glucose, triglycerides, blood pressure, hsCRP, arterial stiffness, estimated glomerular filtration rate, and urinary albumin-to-creatinine ratio (all P<0.01). HOMA-IR and arterial stiffness were found to be independent determinants of urinary RBP4 concentration. Furthermore, urinary RBP4 was highly predictive of microalbuminuria (odds ratio 2.6, 95% CI 1.6-4.2), even after adjustment for other metabolic parameters. The area under the ROC curve for urinary RBP4 to detect the presence of microalbuminuria was 0.80±0.02 (95% CI 0.76-0.84) and the cut-off value was 157.01 μg/gCr.
  
  
  CONCLUSIONS
  Urinary RBP4 concentrations were elevated in patients with dysregulation of glucose metabolism and were related to various cardiometabolic risk factors including insulin resistance, inflammation, and microalbuminuria.
authors.affiliation: Division of Endocrinology and MetabolismDepartment of Internal medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaAdipoGen, Inc.Room 401, Venture Building B, Songdo Technopark, 7-50 Songdo-dong, Yeonsu-gu, Incheon, Republic of KoreaDepartment of AnatomyWonkwang University School of Medicine, #22 Wonkwang Daehak-ro, Iksan, Jeollabuk-do 570-749, Republic of KoreaOsteoNeuroGen 40 MiKeum-ROBundang-Gu, Sungnam-City, Gyeonggi-do 461-871, Republic of Korea.
authors.forename: Se Eun
authors.initials: SE
authors.lastname: Park
authors.affiliation: Division of Endocrinology and MetabolismDepartment of Internal medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaAdipoGen, Inc.Room 401, Venture Building B, Songdo Technopark, 7-50 Songdo-dong, Yeonsu-gu, Incheon, Republic of KoreaDepartment of AnatomyWonkwang University School of Medicine, #22 Wonkwang Daehak-ro, Iksan, Jeollabuk-do 570-749, Republic of KoreaOsteoNeuroGen 40 MiKeum-ROBundang-Gu, Sungnam-City, Gyeonggi-do 461-871, Republic of Korea.
authors.forename: Nam Seok
authors.initials: NS
authors.lastname: Lee
authors.affiliation: Division of Endocrinology and MetabolismDepartment of Internal medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaAdipoGen, Inc.Room 401, Venture Building B, Songdo Technopark, 7-50 Songdo-dong, Yeonsu-gu, Incheon, Republic of KoreaDepartment of AnatomyWonkwang University School of Medicine, #22 Wonkwang Daehak-ro, Iksan, Jeollabuk-do 570-749, Republic of KoreaOsteoNeuroGen 40 MiKeum-ROBundang-Gu, Sungnam-City, Gyeonggi-do 461-871, Republic of Korea.
authors.forename: Ji Woo
authors.initials: JW
authors.lastname: Park
authors.affiliation: Division of Endocrinology and MetabolismDepartment of Internal medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaAdipoGen, Inc.Room 401, Venture Building B, Songdo Technopark, 7-50 Songdo-dong, Yeonsu-gu, Incheon, Republic of KoreaDepartment of AnatomyWonkwang University School of Medicine, #22 Wonkwang Daehak-ro, Iksan, Jeollabuk-do 570-749, Republic of KoreaOsteoNeuroGen 40 MiKeum-ROBundang-Gu, Sungnam-City, Gyeonggi-do 461-871, Republic of Korea.
authors.forename: Eun-Jung
authors.initials: EJ
authors.lastname: Rhee
authors.affiliation: Division of Endocrinology and MetabolismDepartment of Internal medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaAdipoGen, Inc.Room 401, Venture Building B, Songdo Technopark, 7-50 Songdo-dong, Yeonsu-gu, Incheon, Republic of KoreaDepartment of AnatomyWonkwang University School of Medicine, #22 Wonkwang Daehak-ro, Iksan, Jeollabuk-do 570-749, Republic of KoreaOsteoNeuroGen 40 MiKeum-ROBundang-Gu, Sungnam-City, Gyeonggi-do 461-871, Republic of Korea.
authors.forename: Won-Young
authors.initials: WY
authors.lastname: Lee
authors.affiliation: Division of Endocrinology and MetabolismDepartment of Internal medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaAdipoGen, Inc.Room 401, Venture Building B, Songdo Technopark, 7-50 Songdo-dong, Yeonsu-gu, Incheon, Republic of KoreaDepartment of AnatomyWonkwang University School of Medicine, #22 Wonkwang Daehak-ro, Iksan, Jeollabuk-do 570-749, Republic of KoreaOsteoNeuroGen 40 MiKeum-ROBundang-Gu, Sungnam-City, Gyeonggi-do 461-871, Republic of Korea.
authors.forename: Ki-Won
authors.initials: KW
authors.lastname: Oh
authors.affiliation: Division of Endocrinology and MetabolismDepartment of Internal medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaAdipoGen, Inc.Room 401, Venture Building B, Songdo Technopark, 7-50 Songdo-dong, Yeonsu-gu, Incheon, Republic of KoreaDepartment of AnatomyWonkwang University School of Medicine, #22 Wonkwang Daehak-ro, Iksan, Jeollabuk-do 570-749, Republic of KoreaOsteoNeuroGen 40 MiKeum-ROBundang-Gu, Sungnam-City, Gyeonggi-do 461-871, Republic of Korea.
authors.forename: Sung-Woo
authors.initials: SW
authors.lastname: Park
authors.affiliation: Division of Endocrinology and MetabolismDepartment of Internal medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaAdipoGen, Inc.Room 401, Venture Building B, Songdo Technopark, 7-50 Songdo-dong, Yeonsu-gu, Incheon, Republic of KoreaDepartment of AnatomyWonkwang University School of Medicine, #22 Wonkwang Daehak-ro, Iksan, Jeollabuk-do 570-749, Republic of KoreaOsteoNeuroGen 40 MiKeum-ROBundang-Gu, Sungnam-City, Gyeonggi-do 461-871, Republic of Korea cydoctor@chol.com byung4jc@gmail.com.
authors.forename: Cheol-Young
authors.initials: CY
authors.lastname: Park
authors.affiliation: Division of Endocrinology and MetabolismDepartment of Internal medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaAdipoGen, Inc.Room 401, Venture Building B, Songdo Technopark, 7-50 Songdo-dong, Yeonsu-gu, Incheon, Republic of KoreaDepartment of AnatomyWonkwang University School of Medicine, #22 Wonkwang Daehak-ro, Iksan, Jeollabuk-do 570-749, Republic of KoreaOsteoNeuroGen 40 MiKeum-ROBundang-Gu, Sungnam-City, Gyeonggi-do 461-871, Republic of Korea Division of Endocrinology and MetabolismDepartment of Internal medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaAdipoGen, Inc.Room 401, Venture Building B, Songdo Technopark, 7-50 Songdo-dong, Yeonsu-gu, Incheon, Republic of KoreaDepartment of AnatomyWonkwang University School of Medicine, #22 Wonkwang Daehak-ro, Iksan, Jeollabuk-do 570-749, Republic of KoreaOsteoNeuroGen 40 MiKeum-ROBundang-Gu, Sungnam-City, Gyeonggi-do 461-871, Republic of Korea cydoctor@chol.com byung4jc@gmail.com.
authors.forename: Byung-Soo
authors.initials: BS
authors.lastname: Youn
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000097:blood*; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000378:metabolism*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D054839:Retinol-Binding Proteins, Plasma / Q000378:metabolism* / Q000652:urine; D012307:Risk Factors; D059289:Vascular Stiffness
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; C101326:RBP4 protein, human; D054839:Retinol-Binding Proteins, Plasma; D002097:C-Reactive Protein