Aeberli Isabelle, Biebinger Ralf, Lehmann Roger, L'allemand Dagmar, Spinas Giatgen A, Zimmermann Michael B
Human Nutrition Laboratory, Institute of Food Science and Nutrition, Swiss Federal Institute of Technology Zürich, 8092 Zürich, Switzerland.
J Clin Endocrinol Metab. 2007 Nov;92(11):4359-65. doi: 10.1210/jc.2007-0468. Epub 2007 Aug 28.
Although retinol-binding protein (RBP)-4 concentrations are elevated in animal models of obesity and insulin resistance (IR), the link between RBP4 and IR in humans is less clear. There are few published data on RBP4 levels in overweight children, and most previous studies did not control for vitamin A (VA) status and/or subclinical inflammation.
The objective of the study was to measure serum RBP4, serum retinol (SR), the RBP4-to-SR molar ratio, and dietary VA intakes in normal-weight and overweight children and investigate the relationship of these variables to IR, subclinical inflammation, and the metabolic syndrome in this age group.
This was a cross-sectional study.
The study was conducted in Northern Switzerland.
Patients included 6- to 14-yr-old normal-weight, overweight, and obese children (n = 79).
Body mass index, body fat percentage, waist-to-hip ratio, dietary VA intakes, serum RBP4, and SR were determined. IR was assessed using fasting insulin and the quantitative insulin sensitivity check index, and components of the metabolic syndrome and indices of subclinical inflammation were measured.
Only 3% of children had low VA status. Independent of age, VA intakes, and C-reactive protein, body mass index, body fat percentage, and waist-to-hip ratio were significant predictors of RBP4, SR, and RBP4/SR. Independent of adiposity, RBP4 and RBP4/SR were significantly correlated with serum triglycerides, and RBP4/SR was correlated with fasting insulin. The RBP4-to-SR ratio more strongly correlated with components of the metabolic syndrome than serum RBP4.
Independent of subclinical inflammation and vitamin A intakes, serum RBP4 and the RBP4-to-SR ratio are correlated with obesity, central obesity, and components of the metabolic syndrome in prepubertal and early pubertal children.
尽管在肥胖和胰岛素抵抗（IR）动物模型中视黄醇结合蛋白（RBP）-4浓度升高，但RBP4与人类IR之间的联系尚不清楚。关于超重儿童RBP4水平的已发表数据很少，并且大多数先前的研究未对维生素A（VA）状态和/或亚临床炎症进行控制。
本研究的目的是测量正常体重和超重儿童的血清RBP4、血清视黄醇（SR）、RBP4与SR的摩尔比以及膳食VA摄入量，并研究这些变量与该年龄组IR、亚临床炎症和代谢综合征的关系。
这是一项横断面研究。
该研究在瑞士北部进行。
患者包括6至14岁的正常体重、超重和肥胖儿童（n = 79）。
测定体重指数、体脂百分比、腰臀比、膳食VA摄入量、血清RBP4和SR。使用空腹胰岛素和定量胰岛素敏感性检查指数评估IR，并测量代谢综合征的组成部分和亚临床炎症指标。
只有3%的儿童VA状态较低。独立于年龄、VA摄入量和C反应蛋白，体重指数、体脂百分比和腰臀比是RBP4、SR和RBP4/SR的显著预测因素。独立于肥胖，RBP4和RBP4/SR与血清甘油三酯显著相关，RBP4/SR与空腹胰岛素相关。RBP4与SR的比值比血清RBP4与代谢综合征组成部分的相关性更强。
独立于亚临床炎症和维生素A摄入量，血清RBP4和RBP4与SR的比值与青春期前和青春期早期儿童的肥胖、中心性肥胖和代谢综合征组成部分相关。
