Castro Ana Paula Pereira, Cândido Ana Paula Carlos, Nicolato Roney Luiz de Carvalho, Caldas Ivo Santana, Machado-Coelho George Luiz Lins
Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Brazil.
Eur J Nutr. 2014;53(2):433-40. doi: 10.1007/s00394-013-0543-5. Epub 2013 Jun 14.
Evidence suggests that plasma retinol-binding protein 4 (RBP4) and insulin resistance are related to body fat (BF). We aimed to assess the relationship between RBP4 and insulin resistance with obesity in a mixed (skin color) cohort of the Brazilian population.
A nested case-control study was conducted in 227 schoolchildren aged 7-14 years. Schoolchildren with a high BF percentage (% BF, ≥ 30 for girls and ≥ 25 for boys) were identified as the obese group (n = 137), and those with lower values were identified as the non-obese group (n = 90). Percentage of body fat (% BF) was determined by tetrapolar bioimpedance (Quantum II, RJL System), RBP4 by enzyme-linked immunosorbent assay (Immunology Consultants Laboratory), plasma fasting insulin by chemiluminescent immunoassay (Access(®) Immunoassay System) and insulin resistance by the homeostasis model insulin resistance (IR(HOMA)) index. Serum lipid profile and arterial blood pressure were evaluated.
The significant independent risk factors associated with obesity were as follows: male sex, increased serum LDL-C, RBP4 and IR(HOMA). Among children with higher RBP4, the association with obesity increased significantly (from 3.1 to 8.5) in the presence of insulin resistance, when compared to higher RBP4 and non-insulin resistance.
IR(HOMA) and RBP4 showed significant associations with obesity and traditional CVD risk factors. They might therefore be used as a marker for CVD risk and have clinical implications in the development of comorbidities associated with obesity.
有证据表明血浆视黄醇结合蛋白4（RBP4）与胰岛素抵抗和体脂（BF）有关。我们旨在评估巴西人群混合（肤色）队列中RBP4和胰岛素抵抗与肥胖之间的关系。
对227名7至14岁的学童进行了一项巢式病例对照研究。BF百分比高（BF%，女孩≥30，男孩≥25）的学童被确定为肥胖组（n = 137），BF值较低的学童被确定为非肥胖组（n = 90）。通过四极生物电阻抗法（Quantum II，RJL系统）测定体脂百分比（BF%），通过酶联免疫吸附测定法（免疫咨询实验室）测定RBP4，通过化学发光免疫测定法（Access®免疫测定系统）测定空腹血浆胰岛素，并通过稳态模型胰岛素抵抗（IR（HOMA））指数测定胰岛素抵抗。评估血清脂质谱和动脉血压。
与肥胖相关的显著独立危险因素如下：男性、血清低密度脂蛋白胆固醇（LDL-C）升高、RBP4和IR（HOMA）。与RBP4较高且无胰岛素抵抗的儿童相比，在存在胰岛素抵抗的情况下，RBP4较高的儿童与肥胖的关联显著增加（从3.1增至8.5）。
IR（HOMA）和RBP4与肥胖及传统心血管疾病（CVD）危险因素显著相关。因此，它们可能用作CVD风险的标志物，并对与肥胖相关的合并症的发展具有临床意义。
