Abstract 344: Association Between Serum Retinol Binding Protein -4 Level and Coronary Artery Disease: A Meta Analysis

Abstract

Background: Retinol binding protein 4 (RBP-4) is hepatokine/adipokine shown to be strongly associated with traditional and non-traditional (e.g. cytokines) cardiovascular risk factors via impairment of glucose and lipid metabolism and adipose tissue dysfunction. RBP-4 induce endothelial inflammation by stimulating expression of proinflammatory molecules whose effects are mediated via the activation of NADPH oxidase and NF-κB. The association of coronary artery disease (CAD) and RBP4 remains obscure. The objective of this study is to conduct a meta-analysis to evaluate the relationship between serum RBP-4 levels and CAD. Methods: We searched MEDLINE, CIINHAL and COCHRANE databases for studies reporting serum RBP-4 levels in the CAD and non CAD study population. We included case controls, cohort and cross-sectional studies. We calculated the weighted standardized mean difference (SMD) in serum RBP-4 levels between the CAD and control groups. Results: Our search strategy yielded 52 articles and we included 6 case control and 1 cohort study enrolling 4234 participants. The median age of the CAD group was 62yrs (56 - 65.4) compared to 59.4yrs (42.1 - 65.2) in the control group. The median percentage of female population in the CAD group was 63(IQR 53 -82.5) compared to 62(IQR 35.5 - 72) in the control group. The unweighted median serum RBP-4 levels in the CAD group was 33.4mcg/ml (26.59 - 65.7) compared to 29.8mcg/ml (16.5 - 62.5) in the control group. The SMD of RBP-4 level was 0.14 (95% CI 0.08 - 0.20) p<0.001 comparing those in the CAD group and control group. Conclusion: Elevated serum RBP-4 levels is significantly associated with CAD. Current findings warrant the need to further investigate the role of RBP-4 in the development of CAD and its potential to predict incident CAD events.