Abstract
The association of retinol binding protein 4 (RBP4) with atherosclerosis of the carotid artery in type 2 diabetes mellitus (T2DM) remains undefined. We aimed to investigate the correlation of RBP4 expression with atherosclerosis of the carotid artery in T2DM. A total of 1,076 subjects were investigated for intima-media thickness of the bilateral common carotid arteries, and they were divided into three groups: in group I, patients had normal neck vascular ultrasound, in group II, intimal carotid artery media thickness was equal to or more than 1 mm, and in group III, carotid artery plaque was present. Height, weight, blood pressure (BP), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A-1 (apoA-1), apolipoprotein B (apoB) and lipoprotein (a) [Lp(a)] were determined by routine laboratory methods. RBP4 and high sensitivity C reactive protein (HsCRP) were measured by an enzyme-linked immuno-sorbent assay, and insulin concentration was measured by an electrochemiluminescence sandwich immunoassay. Duration of diabetes, waist and BP, FPG, HbA1c, TG, TC, LDL-C, APOB, Lp(a), HsCRP, RBP4 and homeostasis model assessment insulin resistance index (HOMA-IR) were significantly lower in group I than in the other two groups (P<0.01, P<0.01). Plasma levels of HbA1c, RBP4, LDL-C, TC, HOMA-IR, HsCRP and Lp(a), waist and BP were significantly increased in group III than in group II (P<0.01). Multivariate logistic regression analysis showed that there were seven factors associated with the occurrence of carotid artery atherosclerosis and its risks in descending order were: high LDL-C, high waist, high HsCRP, duration of diabetes, high HOMA-IR, HbA1c and high RBP4. Our finding supported that RBP4 was positively correlated with carotid atherosclerosis in patients with T2DM and could be used as an early predictor of cardiovascular disease.
Highlights
Diabetes mellitus (DM) is a metabolic disorder that can be affected by genetic factors, environment and life styles
Waist, blood pressure (BP) and the serum levels of fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), TG, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (apoB), Lp(a), high sensitivity C reactive protein (HsCRP), retinol binding protein 4 (RBP4) and homeostasis model assessment insulin resistance index (HOMA-IR) were significantly lower in normal controls than in the other two groups (P,0.01)
FPG, apoB and TG showed no significant difference between Group II and Group III, waist, BP and plasma levels of HbA1c, Lp(a), RBP4, LDL-C, TC, HOMA-IR and HsCRP were significantly higher in patients with carotid artery plaque than in intimal thickening (P,0.01) (Table 1)
Summary
Diabetes mellitus (DM) is a metabolic disorder that can be affected by genetic factors, environment and life styles. Epidemiologic surveys have recently reported a high incidence of atherosclerosis in patients with DM which is an artery damage attributing to cholesterol deposition, immune substance infiltration, connective tissue hyperplasia and can cause severe ischemic heart disease, cerebrovascular disease and death. Quantitative assessment of atherosclerosis and its risks is very important. RBP are a family of proteins with diverse functions. They are carrier proteins that bind to retinol. RBP4 may play an important role in the origin of insulin resistance and metabolic syndrome[4,5]. There is scanty data on the relationship between RBP4 and IMT and subclinical atherosclerosis in type 2 diabetes mellitus (T2DM)
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