Jia Weiping, Wu Haiya, Bao Yuqian, Wang Chen, Lu Junxi, Zhu Jiehua, Xiang Kunsan
Department of Endocrinology and Metabolism, Shanghai Jiaotong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China.
J Clin Endocrinol Metab. 2007 Aug;92(8):3224-9. doi: 10.1210/jc.2007-0209. Epub 2007 Jun 5.
Previous studies have shown that adipose-derived serum retinol-binding protein 4 (RBP4) levels are increased in insulin-resistant mouse models and in subjects with insulin resistance or type 2 diabetes. However, the association of visceral fat and serum RBP4 has not been studied. The purpose of this study was to investigate the relationship between serum RBP4 and regional fat distribution in Chinese subjects with and without type 2 diabetes.
We measured serum RBP4 concentrations from 1033 Chinese subjects with various degrees of obesity and tested the association between visceral adiposity and serum RBP4. In a subgroup of this study, euglycemic-hyperinsulinemic clamp was performed to measure insulin sensitivity. The association between visceral adiposity and serum RBP4 was also determined in response to rosiglitazone treatment in a subgroup of patients with diabetes.
Serum RBP4 level was positively correlated with visceral adipose area in male (r = 0.171; P < 0.001) and female (r = 0.215; P < 0.001) subjects. However, there was no correlation between serum RBP4 and body mass index. Subjects with visceral obesity had higher serum RBP4 concentrations than those without visceral obesity in both men and women. Rosiglitazone treatment in patients with diabetes resulted in a lower serum RBP4 level (35.2 +/- 10.2 vs. 24.9 +/- 5.6 microg/ml, before vs. after treatment). These changes were accompanied by improved insulin sensitivity and reductions in visceral fat area. The latter was found to be highly correlated with the decline of serum RBP4 levels (r = 0.471; P = 0.027).
Serum RBP4 level is positively associated with visceral adiposity in both men and women. Our data suggest that RBP4 may contribute to the development of insulin resistance along with other adipokines.
既往研究表明，在胰岛素抵抗小鼠模型以及胰岛素抵抗或2型糖尿病患者中，脂肪源性血清视黄醇结合蛋白4（RBP4）水平升高。然而，内脏脂肪与血清RBP4之间的关联尚未得到研究。本研究旨在探讨中国2型糖尿病患者和非2型糖尿病患者血清RBP4与局部脂肪分布之间的关系。
我们测定了1033名不同程度肥胖的中国受试者的血清RBP4浓度，并检测了内脏肥胖与血清RBP4之间的关联。在本研究的一个亚组中，进行了正常血糖-高胰岛素钳夹试验以测量胰岛素敏感性。在糖尿病患者亚组中，还测定了罗格列酮治疗后内脏肥胖与血清RBP4之间的关联。
血清RBP4水平与男性（r = 0.171；P < 0.001）和女性（r = 0.215；P < 0.001）受试者的内脏脂肪面积呈正相关。然而，血清RBP4与体重指数之间无相关性。内脏肥胖的男性和女性受试者的血清RBP4浓度均高于无内脏肥胖者。糖尿病患者接受罗格列酮治疗后血清RBP4水平降低（治疗前为35.2±10.2 vs.治疗后为24.9±5.6 μg/ml）。这些变化伴随着胰岛素敏感性的改善和内脏脂肪面积的减少。发现后者与血清RBP4水平的下降高度相关（r = 0.471；P = 0.027）。
血清RBP4水平在男性和女性中均与内脏肥胖呈正相关。我们的数据表明，RBP4可能与其他脂肪因子一起促进胰岛素抵抗的发生。
