Tajtáková M, Semanová Z, Ivancová G, Petrovicová J, Donicová V, Zemberová E
I. interná klinika Lekárskej fakulty UPJS a FN L. Pasteura Kosice, Slovenská republika.
Vnitr Lek. 2007 Sep;53(9):960-3.
Is there a difference between the retinol-binding protein 4 (RBP4) levels in obese patients with insulin resistance (IR) without diabetes, in obese patients with type 2 diabetes mellitus (DM2T) treated with metformin and in nonobese healthy individuals?
28 obese individuals with insulin resistance, 11 type 2 diabetes patients treated with metformin and 17 control individuals were examined for serum level of retinol-binding protein 4 using the RIA method. The results were compared within the groups and RBP4 was correlated with insulin in the IR group and the control group.
The highest and the lowest RBP4 levels (561.6 +/- 209 ng/ml) were recorded, respectively, for obese individuals with IR (IR HOMA 3.9) and for obese type 2 diabetics treated with metformin (391.1 +/- 133,5 ng/ml) (P < 0.01). The RBP4 level of the control group was significantly lower as compared with the obese individuals with IR (452.8 +/- 104.6 ng/ml) (P < 0.05), but insignificantly higher as compared with the obese individuals with DM2T treated with metformin (391,1 +/- 133.5 ng/ml). RBP4 in the monitored group correlated with insulin r = 0.46 (p < 0.03).
The increase in RBP4 in obese individuals by GLUT4 regulation in adipocytes contributes to the development and aggravation of systemic IR. Through its effect on RBP4 expression in adipocytes, metformin may improve total insulin sensitivity in obese individuals including those with MS and delay the onset of manifest DM. RBP4 could by used as a marker of deteriorating glucose tolerance in obese individuals.
在无糖尿病的肥胖胰岛素抵抗（IR）患者、接受二甲双胍治疗的2型糖尿病（DM2T）肥胖患者和非肥胖健康个体之间，视黄醇结合蛋白4（RBP4）水平是否存在差异？
采用放射免疫分析法（RIA）检测28例肥胖胰岛素抵抗个体、11例接受二甲双胍治疗的2型糖尿病患者和17例对照个体的血清视黄醇结合蛋白4水平。对组内结果进行比较，并分析IR组和对照组中RBP4与胰岛素的相关性。
肥胖IR个体（IR HOMA 3.9）和接受二甲双胍治疗的肥胖2型糖尿病患者的RBP4水平分别为最高和最低（561.6±209 ng/ml）（391.1±133.5 ng/ml）（P<0.01）。对照组的RBP4水平与肥胖IR个体相比显著降低（452.8±104.6 ng/ml）（P<0.05），但与接受二甲双胍治疗的肥胖DM2T个体相比无显著升高（391.1±133.5 ng/ml）。监测组中RBP4与胰岛素的相关性r = 0.46（p<0.03）。
脂肪细胞中通过GLUT4调节导致肥胖个体RBP4增加，这有助于全身IR的发生和加重。通过对脂肪细胞中RBP4表达的影响，二甲双胍可能改善肥胖个体（包括患有代谢综合征的个体）的总体胰岛素敏感性，并延缓显性DM的发病。RBP4可作为肥胖个体糖耐量恶化的标志物。
