Department of Endocrinology, The First Affiliated Hospital of Jinan University, Guangzhou 510632, China.
Department of Endocrinology, The First Affiliated Hospital of Jinan University, Guangzhou 510632, China
Biosci Rep. 2018 Sep 12;38(5). doi: 10.1042/BSR20181100. Print 2018 Oct 31.
The retinol-binding protein 4 (RBP4) has been postulated to play a role in glucose homeostasis, insulin resistance, and diabetes mellitus in human and animal studies. The aim of the present study was to evaluate the role of RBP4 in Chinese patients with type 2 diabetes mellitus with and without diabetic retinopathy (DR). Plasma RBP4 concentrations were tested in 287 patients with type 2 diabetes. At baseline, demographic and clinical information including presence of DR and vision-threatening DR (VTDR) was collected. The relationship between RBP4 and DR (VTDR) was investigated using logistic regression. Patients with DR or VTDR had significantly higher plasma levels of RBP4 on admission (<0.0001). Receiver operating characteristics (ROCs) to predict DR and VDTR demonstrated areas under the curve for RBP4 of 0.79 (95% confidence interval (CI): 0.73-0.85) and 0.90 (95% CI: 0.85-0.94), respectively, which were superior to other factors. For each 1 μg/ml increase in plasma level of RBP4, the unadjusted and adjusted risk of DR would be increased by 8% (with the odds ratio (OR) of 1.08 (95% CI: 1.05-1.13), <0.001) and 5% (1.05 (1.02-1.11), =0.001), respectively. It was 12% (with the OR of 1.12 (95% CI: 1.07-1.18), <0.001) and 9% (1.09 (1.05-1.15), <0.001) for VTDR. The present study shows that elevated plasma levels of RBP4 were associated with DR and VDTR in Chinese patients with type 2 diabetes, suggesting a possible role of RBP4 in the pathogenesis of DR complications. Lowering RBP4 could be a new strategy for treating type 2 diabetes with DR.
视黄醇结合蛋白 4（RBP4）在人类和动物研究中被认为在葡萄糖稳态、胰岛素抵抗和糖尿病中发挥作用。本研究旨在评估 RBP4 在伴有或不伴有糖尿病视网膜病变（DR）的中国 2 型糖尿病患者中的作用。检测了 287 例 2 型糖尿病患者的血浆 RBP4 浓度。在基线时，收集了包括存在 DR 和威胁视力的 DR（VTDR）在内的人口统计学和临床信息。使用逻辑回归研究了 RBP4 与 DR（VTDR）之间的关系。DR 或 VTDR 患者入院时的血浆 RBP4 水平显著升高（<0.0001）。接受者操作特征（ROC）预测 DR 和 VDTR 的 RBP4 曲线下面积分别为 0.79（95%置信区间（CI）：0.73-0.85）和 0.90（95% CI：0.85-0.94），优于其他因素。血浆 RBP4 水平每增加 1μg/ml，未经调整和调整后的 DR 风险分别增加 8%（比值比（OR）为 1.08（95% CI：1.05-1.13），<0.001）和 5%（1.05（1.02-1.11），=0.001）。对于 VTDR，风险增加 12%（OR 为 1.12（95% CI：1.07-1.18），<0.001）和 9%（1.09（1.05-1.15），<0.001）。本研究表明，中国 2 型糖尿病患者血浆 RBP4 水平升高与 DR 和 VTDR 相关，提示 RBP4 可能在 DR 并发症发病机制中起作用。降低 RBP4 可能是治疗伴有 DR 的 2 型糖尿病的一种新策略。
