Santoro N, Perrone L, Cirillo G, Brienza C, Grandone A, Cresta N, Miraglia del Giudice E
Department of Pediatrics F. Fede Second University of Naples, Naples, Italy.
J Endocrinol Invest. 2009 May;32(5):411-4. doi: 10.1007/BF03346477.
Retinol binding protein 4 (RBP4) is an adipokine involved in the pathogenesis of insulin resistance in obese adults and children. Since insulin resistance occurs during puberty, independently of adiposity, a role for RBP4 in the onset of this phenomenon may be hypothesized. In order to verify our hypothesis, we studied 90 subjects (45 obese and 45 lean controls). A complete physical examination was assessed, the z-score body mass index (BMI) was calculated, fat mass was assessed by bioelectric impedance analysis, and pubertal stage was assessed according to Tanner. Serum insulin and serum RBP4 levels were assayed. Obese and lean children differed for z-score BMI, fat mass, homeostasis model assessment of insulin resistance (HOMA-IR) and RBP4 levels. z-score BMI and HOMA-IR showed a direct correlation with RBP4 in the total population. When the subjects were divided in lean and obese, this correlation was evident only in obese (r2: 0.2; p=0.009 and r2: 0.2; p=0.01), but not in lean subjects (r2: 0.09; p=0.1 and r2: 0.03; p=0.4). Both in obese and lean HOMA-IR values were higher in pubertal subjects than in pre-pubertal (p<0.001), while serum RBP4 levels were similar in pubertal and in pre-pubertal subjects (>0.1). We conclude that RBP4 is correlated with adiposity and insulin resistance in obese children, but it is not involved in the insulin resistance occurring during puberty.
视黄醇结合蛋白4（RBP4）是一种脂肪因子，参与肥胖成人和儿童胰岛素抵抗的发病机制。由于胰岛素抵抗在青春期出现，与肥胖无关，因此可以推测RBP4在这一现象的发生中起作用。为了验证我们的假设，我们研究了90名受试者（45名肥胖者和45名瘦对照者）。进行了全面的体格检查，计算了z评分体重指数（BMI），通过生物电阻抗分析评估了脂肪量，并根据坦纳法评估了青春期阶段。检测了血清胰岛素和血清RBP4水平。肥胖和瘦儿童在z评分BMI、脂肪量、胰岛素抵抗稳态模型评估（HOMA-IR）和RBP4水平方面存在差异。在总人群中，z评分BMI和HOMA-IR与RBP4呈正相关。当将受试者分为瘦者和肥胖者时，这种相关性仅在肥胖者中明显（r2：0.2；p=0.009和r2：0.2；p=0.01），而在瘦者中不明显（r2：0.09；p=0.1和r2：0.03；p=0.4）。在肥胖和瘦者中，青春期受试者的HOMA-IR值均高于青春期前受试者（p<0.001），而青春期和青春期前受试者的血清RBP4水平相似（>0.1）。我们得出结论，RBP4与肥胖儿童的肥胖和胰岛素抵抗相关，但它不参与青春期发生的胰岛素抵抗。
