Reinehr Thomas, Stoffel-Wagner Birgit, Roth Christian L
Department of Pediatric Nutrition Medicine, Vestische Hospital for Children and Adolescents-Datteln, University of Witten/Herdecke, Dr. F. Steiner Strasse 5, Datteln, Germany.
J Clin Endocrinol Metab. 2008 Jun;93(6):2287-93. doi: 10.1210/jc.2007-2745. Epub 2008 Apr 8.
There are limited and controversial data concerning the relationships between retinol-binding protein 4 (RBP4), weight status, and insulin resistance in obese humans and especially in children.
Our objective was to study the longitudinal relationships among RBP4, insulin resistance and weight status in obese children.
DESIGN, SETTING, AND PATIENTS: We conducted a 1-yr longitudinal follow-up study in a primary-care setting with 43 obese children (median age 10.8 yr) and 19 lean children of same the age and gender.
Our outpatient 1-yr intervention program was based on exercise, behavior, and nutrition therapy.
Changes of weight status (body mass index sd score), RBP4, molar RBP4/serum retinol (SR) ratio, insulin resistance index homeostasis model assessment (HOMA), and quantitative insulin sensitivity check index (QUICKI).
Obese children had significantly (P < 0.01) higher RBP4 concentrations and a higher RBP4/SR ratio compared with lean children. In multiple linear regression analyses adjusted to age, gender, and pubertal stage, RBP4 was significantly correlated to insulin and body mass index. Pubertal children demonstrated significantly decreased QUICKI and significantly increased HOMA index, insulin, and RBP4 concentrations compared with prepubertal children. Changes of RBP4 correlated significantly to changes of insulin (r = 0.29), HOMA index (r = 0.29), QUICKI (r = 0.22), and weight status (r = 0.31). Substantial weight loss in 25 children led to a significant (P < 0.001) decrease of RBP4, RBP4/SR, blood pressure, triglycerides, insulin, and HOMA index and an increase in QUICKI in contrast to the 18 children without substantial weight loss.
RBP4 levels were related to weight status and insulin resistance in both cross-sectional and longitudinal analyses, suggesting a relationship between RBP4, obesity, and insulin resistance in children.
关于视黄醇结合蛋白4（RBP4）、体重状况与肥胖人群尤其是儿童胰岛素抵抗之间的关系，现有数据有限且存在争议。
我们的目的是研究肥胖儿童中RBP4、胰岛素抵抗和体重状况之间的纵向关系。
设计、地点和患者：我们在初级保健机构对43名肥胖儿童（中位年龄10.8岁）和19名年龄及性别相同的瘦儿童进行了为期1年的纵向随访研究。
我们的门诊1年干预计划基于运动、行为和营养治疗。
体重状况（体重指数标准差评分）、RBP4、摩尔RBP4/血清视黄醇（SR）比值、胰岛素抵抗指数稳态模型评估（HOMA）和定量胰岛素敏感性检查指数（QUICKI）的变化。
与瘦儿童相比，肥胖儿童的RBP4浓度显著更高（P < 0.01），RBP4/SR比值也更高。在根据年龄、性别和青春期阶段进行调整的多元线性回归分析中，RBP4与胰岛素和体重指数显著相关。与青春期前儿童相比，青春期儿童的QUICKI显著降低，HOMA指数、胰岛素和RBP4浓度显著升高。RBP4的变化与胰岛素（r = 0.29）、HOMA指数（r = 0.29）、QUICKI（r = 0.22）和体重状况（r = 0.31）的变化显著相关。25名体重显著减轻的儿童与18名体重未显著减轻的儿童相比，RBP4、RBP4/SR、血压、甘油三酯胰岛素和HOMA指数显著降低（P < 0.001），QUICKI升高。
在横断面和纵向分析中，RBP4水平均与体重状况和胰岛素抵抗相关，提示儿童中RBP4、肥胖和胰岛素抵抗之间存在关联。
