Henze Andrea, Frey Simone K, Raila Jens, Tepel Martin, Scholze Alexandra, Pfeiffer Andreas F H, Weickert Martin O, Spranger Joachim, Schweigert Florian J
Department of Physiology and Pathophysiology of Nutrition, Institute of Nutritional Science, University of Potsdam, Potsdam, Germany.
Diabetes. 2008 Dec;57(12):3323-6. doi: 10.2337/db08-0866. Epub 2008 Sep 16.
It has been suggested that retinol-binding protein 4 (RBP4) links adiposity, insulin resistance, and type 2 diabetes. However, circulating RBP4 levels are also affected by kidney function. Therefore, the aim of this study was to test whether RBP4 serum levels are primarily associated with kidney function or type 2 diabetes.
RBP4 serum concentration was determined by enzyme-linked immunosorbent assay in 126 nondiabetic and 104 type 2 diabetic subjects. The study population was divided according to estimated glomerular filtration rate (eGFR) into the following groups: eGFR >90 ml/min per 1.73 m(2) (n = 53), 60-90 ml/min per 1.73 m(2) (n = 90), 30-60 ml/min per 1.73 m(2) (n = 38), and <30 ml/min per 1.73 m(2) (n = 49). Each group was subdivided into nondiabetic and type 2 diabetic subjects.
RBP4 serum concentration was elevated (2.65 vs. 2.01 micromol/l; P < 0.001) and eGFR was reduced (56 vs. 74 ml/min per 1.73 m(2); P < 0.001) in type 2 diabetic vs. nondiabetic subjects, respectively. By stratifying for eGFR, no more differences in RBP4 serum concentration were detectable between type 2 diabetic and nondiabetic subjects. A linear regression analysis revealed an influence of eGFR (r = -0.477; P < 0.001) but not A1C (r = 0.093; P = 0.185) on RBP4 serum concentration.
Existing human data showing elevated RBP4 levels in type 2 diabetic patients may be the result of moderate renal insufficiency rather than support for the suggestion that RBP4 links obesity to type 2 diabetes.
有人提出视黄醇结合蛋白4（RBP4）与肥胖、胰岛素抵抗及2型糖尿病相关。然而，循环中RBP4水平也受肾功能影响。因此，本研究旨在检验RBP4血清水平主要与肾功能还是2型糖尿病相关。
采用酶联免疫吸附测定法测定了126例非糖尿病患者和104例2型糖尿病患者的RBP4血清浓度。根据估计肾小球滤过率（eGFR）将研究人群分为以下几组：eGFR>90 ml/（min·1.73 m²）（n = 53）、60 - 90 ml/（min·1.73 m²）（n = 90）、30 - 60 ml/（min·1.73 m²）（n = 38）以及<30 ml/（min·1.73 m²）（n = 49）。每组再细分为非糖尿病患者和2型糖尿病患者。
2型糖尿病患者的RBP4血清浓度升高（2.65对2.01 μmol/L；P < 0.001），而eGFR降低（56对74 ml/（min·1.73 m²）；P < 0.001），分别与非糖尿病患者相比。通过按eGFR分层，2型糖尿病患者和非糖尿病患者之间在RBP4血清浓度上未检测到更多差异。线性回归分析显示eGFR对RBP4血清浓度有影响（r = -0.477；P < 0.001），而糖化血红蛋白（A1C）对其无影响（r = 0.093；P = 0.185）。
现有的显示2型糖尿病患者RBP4水平升高的人体数据可能是中度肾功能不全的结果，而非支持RBP4将肥胖与2型糖尿病联系起来这一观点的证据。
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