Retinol-binding Protein 4 Levels Research Articles

Urinary Retinol-Binding Protein 4 is Associated With Renal Function and Rapid Renal Function Decline in Kidney Transplant Recipients

Urinary retinol-binding protein 4 (RBP4) has been known as a biomarker of chronic kidney disease. In this study, we evaluated the association of urinary RBP4 with renal function and progression of renal function in kidney transplant recipients (KTRs). A total 50 KTRs were included in this study. Proteomic analysis with liquid chromatography-mass spectrometry and tandem mass spectrometry was performed to discover potential urinary biomarkers. Several urinary proteins including RBP4 were identified and then validated by enzyme-linked immunosorbent assay. Rapid renal function decline was defined as estimated glomerular filtration rate (eGFR) decline of >3 mL/min/1.73 m2/year or initiation of dialysis, and 19 (38%) were included in rapid renal function decline group. Urinary RBP4/creatinine was inversely correlated with allograft function (r=-0.54, P < .001 with eGFR, and r=0.49, P < .001 with serum creatinine, respectively). Urinary RBP4/creatinine was higher in rapid renal function decline group than in stable renal function group (184.9 ± 156.7 vs 83.1 ± 99.9, P=.017). Log-transformed urinary RBP4/creatinine was significantly associated with rapid renal function decline in univariate logistic regression analysis (Odds ratio [OR] 7.59, confidence interval [CI] 2.04-36.70, P=.005). In multivariate logistic regression adjusted with recipient age and sex, donor age, number of HLA mismatch, and acute rejection episode, urinary RBP4/creatinine remained a significant factor for rapid renal function decline (OR 9.43, CI 1.99-65.65, P=.010). Receiver operating characteristic analysis showed that the area under the curve of urinary RBP4/creatinine was 0.747 (CI 0.608-0.886, P < .001) for rapid renal function decline. Urinary RBP4 levels are associated with renal function and might be used to predict rapid renal function decline in KTRs.

Factors that affect placental retinol transfer in preterm infants and mothers with retinol deficiency.

The retinol level and retinol delivery to the placenta may vary depending on various factors involving the mother and newborn. The present study evaluates the factors affecting retinol levels in newborns and the transplacental retinol passage in preterm newborns. In this prospective cohort study, the retinol and retinol binding protein (RBP) in the umbilical cord blood of 44 preterm infants with a gestation age of <30 weeks were studied. Serum retinol and RBP levels were determined using an enzyme-linked immunosorbent assay, and the rate of transplacental retinol passage was calculated. The demographic data of mothers and newborns, the use of vitamins by the mother, the application of antenatal corticosteroids, and any diseases diagnosed during pregnancy were recorded. An evaluation was made of the retinol, RBP, and other factors of the mother and newborn affecting transplacental retinol passage. A retinol deficiency was identified in 68.2% of the study population. Retinol and RBP levels in umbilical cord blood (273.7 ± 150.03 ng/mL, 7.88 ± 5.6 ng/mL, respectively) were significantly higher than the corresponding levels in the mother (206.4 ± 86.26 ng/ mL, 1.04 ± 0.97 ng/mL, respectively). Umbilical cord blood retinol deficiency was more common in the male participants, while the transplacental retinol passage rate was higher in females. The umbilical cord blood RBP was found to be lower in those administered antenatal corticosteroids than in those who did not receive antenatal corticosteroids, and median maternal RBP levels were lower in patients with anemia and pregnancy-induced hypertension than in those with no disease. Placental adaptation and contributing factors may vary in populations with severe retinol deficiency. The finding of significantly increased cord blood retinol levels when compared to maternal retinol levels in the present study suggests that some compensatory mechanisms, such as increased placental RBP levels, support the presentation of retinol to the fetus, even if the mother has a retinol deficiency.

Baseline Levels of Retinol-Binding Protein 4 and Vitamin A in Healthy Subjects, Stargardt Disease, and Geographic Atrophy Patients

Introduction: The accumulation of lipofuscin is a hallmark in the pathogenesis of Stargardt disease type 1 (STGD1) and geographic atrophy (GA) secondary to age-related macular degeneration. Limiting lipofuscin accumulation by inhibiting the retinol-binding protein 4 (RBP4) is being explored as a potential treatment target for those diseases. In this study, we aimed to establish the concentration of RBP4 in the systemic circulation in different age cohorts of healthy individuals and to check if patients with STGD1 or GA may show abnormal RBP4 levels. Methods: Forty healthy subjects of various age-groups, 15 Stargardt patients, and 15 GA patients were included in the study. We measured RBP4 levels, serum retinol (SR) levels, complete blood count, and blood chemistry including liver function tests. Results: Mean RBP4 for all cohorts was 26,911.40 ± 6,198.61 ng/mL, and mean SR 1.75 ± 0.36 µmol/L. Age was not found to significantly impact levels neither of RBP4 and SR nor of the RBP4-to-SR ratio. Also, the 2 patient groups showed similar blood levels to their age-matched controls. Conclusion: Serum RBP4 and SR do not appear to be affected by age in healthy individuals and remain within normal limits in both STGD1 and GA.

Role of Serum Retinol Binding Protein 4 (RBP4) Concentration in Patients with Primary Hypertension: A Case-control Study

Introduction: Serum Retinol Binding Protein 4 (RBP4), an adipokine that transports vitamin A from the liver to other tissues, is reported to be elevated in hypertensive subjects. Positive correlation between RBP4 and cardiovascular risk factors has been noted in a few studies. Aim: To evaluate serum RBP4 levels in newly diagnosed primary hypertensive cases and non hypertensive controls and to correlate serum RBP4 levels with lipid profile. Materials and Methods:This case-control study was conducted at the Department of Biochemistry in collaboration with the Department of Medicine, from August 2019 to June 2020 in MKCG Medical College and Hospital, Berhampur, Odisha, India. A total of 51 newly diagnosed primary hypertensive patients and 51 healthy age and sex-matched individuals between the ages of 18 to 50 years were enrolled in the study. Systolic and Diastolic Blood Pressure (SBP and DBP) were measured in both cases and controls.Serum RBP4 was measured by Enzyme-Linked Immunosorbent Assay (ELISA) and other biochemical parameters were measured by TBA120FR autoanalyser. Result: The mean age for controls was 36.98±8.7 years and that in cases was 39.00±8.4 years. Proportion of males was higher (56.8%) than females (43.2%). The mean systolic blood pressure in the case group was significantly higher as compared to the control group. The cases had a higher level of serum RBP4 (31.82 mg/L) compared to the control groups (15.5 mg/L) RBP4 (p&lt;0.001). The cases had a higher level of mean serum triglyceride (196.20±67.81 mg/dL) and lower level of mean serum High-Density Lipoprotein cholesterol (HDLc) (37.53±11.90 mg/dL) as compared to the control groups which had a mean triglyceride of 104.25±39.89 mg/dL and HDLc of 57.18±10.73 mg/dL (p&lt;0.001). The serum RBP4 level positively correlated with SBP (r=0.644, p&lt;0.001), DBP (r=0.444, p&lt;0.001), serum triglycerides (r=0.649, p&lt;0.001), and negatively correlated with HDLc (r=-0.313, p=0.025). Conclusion: A high serum RBP4 level was found in the newly diagnosed hypertensive cases as compared to normotensive controls. A significant positive correlation was observed between RBP4 with systolic and diastolic blood pressure along with triglyceride levels. A significant negative correlation was observed between RBP4 with HDLc.

Correlation between Retinol Binding Protein 4 and CT Perfusion Imaging and Prognosis in Patients with Acute Ischemic Stroke Based on Cell Imaging Data Analysis.

Objective In order to explore the correlation between the retinol binding protein 4 (RBP4) and prognosis of patients with acute ischemic stroke (AIS), CT perfusion imaging can be used to scan the brain tissue of patients, which can identify abnormal perfusion areas and ischemic penumbra brain tissue, so as to provide a basis for doctors to formulate a reasonable clinical treatment plan. Methods 200 patients with first-episode acute ischemic stroke were selected from the Department of Neurology of our hospital, including 128 males and 72 females, aged between 32 and 85 years, with an average age of 45 ± 4.3 years. After admission, the patients were tested for xanthol binding protein 4 in time, the patient's demographic data and the basic clinical data were recorded, the degree of brain injury was evaluated, and the short-term outcome was evaluated after treatment. Results A total of 200 AIS patients with different degrees of brain injury were included in this study, including 128 males and 78 females, aged between 32 and 85 years, with an average age of 45 ± 4.3 years. Among them, 100 patients used CT perfusion imaging for brain scanning as the observation group, 100 patients used traditional imaging methods as the reference group, and 100 healthy people were included as the blank group. At the same time, the contents of total cholesterol, triacylglycerol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were measured by using an automatic biochemical analyzer. The patients were evaluated in the early stage of treatment and the effect of prognostic intervention was recorded. Conclusion The application of CT perfusion imaging in the adjuvant treatment of AIS patients was helpful to identify the abnormal perfusion area and the brain tissue of ischemic penumbra, so as to provide a basis for doctors' follow-up treatment. At the same time, AIS patients with high serum RBP4 level had mild stroke severity, good short-term prognosis, and improved treatment effect, which improved patients' quality of life.

Serum level of retinol-binding protein 4 in alopecia areata: relation with recurrence and severity

BackgroundAlopecia areata (AA) is a common, clinically heterogeneous, autoimmune T-cell-mediated, nonscarring hair-loss disorder. Many researchers hypothesize that several components of the retinoic acid metabolic pathway are present in the hair follicles of healthy controls. The pathogenesis of AA may be related to increased serum retinol-binding protein-4 (RBP4) level.ObjectivesTo evaluate RBP4 level in serum obtained from patients with AA in comparison with controls and detect its relation with severity of alopecia areata tool score and recurrence of disease.Patients and methodsThe study included 52 AA patients (26 AA first episode, 26 patients with recurrent alopecia) and 26 patients in the control group.ResultsRBP4 was significantly elevated in serum level of AA patients in comparison with serum level of controls (P < 0.001), but there was no significant positive correlation between serum RBP4 and severity of alopecia areata tool score.ConclusionAA was associated with increased serum levels of RBP4 in comparison with controls. These results suggested the role of RBP4 in the pathogenic process of AA.

Optimised expression and purification of RBP4 and preparation of anti-RBP4 monoclonal antibody.

The expression level of retinol‐binding protein 4 (RBP4) protein is closely related to liver damage and plays an important role in the diagnosis and prognosis of cancer. However, the preparation of anti‐RBP4 mAb or exploration on the application of anti‐RBP4 mAb has not been reported thus far. In the present study, we constructed a pET30a‐RBP4 recombinant vector, used E. coli BL21 (DE3) as the vector to express the RBP4 recombinant protein and prepared anti‐RBP4 mAb using hybridoma technology. We performed immunohistochemical analysis on hepatocellular carcinoma (HCC) and adjacent tissues by using this anti‐RBP4 mAb. In addition to the high‐purity RBP4 recombinant protein, we successfully developed the anti‐RBP4 mAb with high affinity and specificity; it binds to natural RBP4 protein and is suitable for immunohistochemical analysis.

Urine β2-Microglobulin and Retinol-Binding Protein and Renal Disease Progression in IgA Nephropathy.

Background: Tubulointerstitial involvement has been reported to have a decisive influence on the progression of IgA nephropathy (IgAN). High levels of urine β2-microglobulin (β2-MG) and retinol-binding protein (RBP) were observed in patients with IgAN with tubulointerstitial lesions. However, their roles in disease progression remain unclear. This study aimed to evaluate the associations of urine β2-MG and RBP with the progression of IgAN.Methods: We retrospectively investigated a cohort of 2,153 patients with IgAN. Clinical and pathological features, outcomes, and urine β2-MG, and RBP at the time of biopsy were collected. The associations, of urine β2-MG and RBP with the composite renal outcome, defined as a decline in estimated glomerular filtration rate (eGFR) of ≥50% from baseline or end-stage renal disease (ESRD), were examined using restricted cubic splines and the Cox proportional hazards models.Results: During a median follow-up of 20.40 months, 140 (6.50%) patients reached the composite renal outcomes. Restricted cubic splines showed that patients with higher urinary β2-MG and RBP levels had worse renal outcomes. The Cox regression analysis revealed that urine β2-MG and RBP were associated with a risk of the composite renal outcome in the multivariate adjusted model [+1 SD for log β2-MG, hazard ratio (HR) = 1.462, 95% CI: 1.136–1.882, p = 0.003; +1 SD for log RBP, HR = 1.972, 95% CI: 1.486–2.617, p = 0.001]. The associations were detectable within patients with baseline eGFR <90 ml/min/1.73 m2 (+1 SD for log β2-MG, HR = 1.657, 95% CI: 1.260–2.180, p < 0.001; +1 SD for log RBP, HR = 1.618, 95% CI: 1.199–2.183, p = 0.002), but not among patients with eGFR ≥90 ml/min/1.73 m2.Conclusion: Higher levels of urine β2-MG and RBP were independent risk factors for renal disease progression in IgAN.

Serum levels of retinol binding protein - 4 are associated with the arterial stiffness in early postmenopausal women

Introduction: Earlier evidence on the general population is indicating that levels of retinol-binding protein 4 (RBP4) might be considered as possible surrogate marker of cardiovascular risk. Recent data in the postmenopausal population suggested no link between subclinical atherosclerosis and levels of RBP4., however, associations with arteriosclerosis remain unexplored. This study aimed to evaluate the possible link between RBP4 values and cardiovascular risk factors as well as homocysteine, which is directly involved in retinoic acid synthesis, in a sample of apparently healthy postmenopausal women.

Serum retinol-binding protein 4 levels and risk of gestational diabetes mellitus: A nested case-control study in Chinese women and an updated meta-analysis.

We prospectively evaluated the association of circulating retinol-binding protein 4 (RBP4) levels in early pregnancy and risk of incident gestational diabetes mellitus (GDM) in pregnant women. A nested case-control study was conducted among 332 women who developed GDM and 664 matched controls based on the Tongji-Shuangliu Birth Cohort. GDM was diagnosed during 24-28weeks of gestation according to the International Association of Diabetes and Pregnancy Study Group criteria. Serum RBP4 levels in early pregnancy (6-15weeks of gestation) were determined by ELISA assay. Multivariable conditional logistic regression models were used to analyse the association and generated the odds ratio (OR) and 95% confidence interval (CI). EMBASE and PubMed were searched up to 30 November 2020 to identify studies investigating the association between blood RBP4 levels in early pregnancy and incident GDM. In the multivariable model with adjustment of potential risk factors, the OR comparing the extreme quartiles of serum RBP4 levels was 2.26 (95% CI: 1.34, 3.81; p for trend <0.001), and each standard deviation (SD) increment of RBP4 was associated with 1.39-fold (95% CI: 1.15, 1.69) higher risk of GDM. The results were confirmed in a meta-analysis that included additional four studies with an overall OR of 1.47 (95% CI: 1.18, 1.83) per 1-SD increment of RBP4. Serum RBP4 levels in early pregnancy, independent of metabolic risk factors, are positively associated with the risk of GDM in pregnant women. Our findings may provide new insights into the mechanisms underlying the aetiology of GDM.

The Role of Retinol Binding Protein 4 (RBP4) in Prediction of Response to New Direct Acting Antiviral Drugs (DAAS) in Chronic Hepatitis C

Abstract Background Hepatitis c virus is global health burden and major health hazard in Egypt, since the virus is the etiological factor of chronic hepatitis that frequently progress to a cirrhosis and hepatocellular carcinoma (HCC). In addition to cirrhosis and hepatocellular carcinoma, HCV is thought to cause metabolic alterations, including steatosis, dyslipidemia, insulin resistance (IR), diabetes, obesity, and cardiovascular events. Objective To determine the value of RPB4 in the prediction of response to new DAAS treatment in chronic HCV infected patients and to correlate its level with the metabolic profile and fibrosis degree among chronic HCV Patients and Methods This study was Prospective cohort clinical study that was conducted at hepatology and virology outpatient clinic at Ain Shams University Hospital &amp;Hepatology and virology outpatient clinic at Kafr –El Sheikh liver institute from January 2019 to October 2019 after informed consent. Results The present study showed that the best level of RBP4 in prediction of hepatic fibrosis stage 4 was ≤ 46 pg/ml and had sensitivity of 100% while the specificity was 66.67%.The positive predictive value was 50%while the negative predictive value was 100% and test accuracy was 80.5%. Conclusion Serum RBP4 was found to be higher in chronic hepatitis C naïve patients than normal person; there was significant reduction of RBP4 post treatment. Fibroscan showed marked reduction of fibrosis degree after treatment with Directly acting antiviral in both cirrhotic and noncirrhotic patients regardless the treatment regimen used with improved overall liver function tests, liver enzymes and platelet count in patients who reached SVR and maintained negative PCR after treatment.

The role of urinary Retinol binding protein (RBP) as a novel biomarker in early detection of kidney affection in patients with psoriatic arthritis

Abstract Background PsA is a chronic multisystem inflammatory disorder with various systemic diseases. Renal involvement in patients with PsA is sparsely studied and its association is still unclear. This entity is called “Psoriatic Nephropathy”. RBP has been proposed as the most sensitive marker for detection of renal tubule function loss. Aim We aim at early detection of renal tubular damage by measuring the level of urinary RBP as a novel biomarker in patients with psoriatic arthritis in relation to activity and severity. Methods We conducted a Cross-sectional study of 30 PsA patients from Physical Medicine, Rheumatology and Rehabilitation and Dermatology outpatients’ clinics at Ain Shams University Hospitals. They were subjected to full medical history taking and thorough clinical examination with calculation of DAS 28, PASI and HAQ scores. Full Laboratory evaluation included CBC, ESR, CRP, serum creatinine, BUN, SGOT, SGPT, urine analysis, estimated GFR (eGFR) and urinary RBP were measured for all the participants. The urinary RBP and eGFR were compared with 30 age and sex matched healthy controls. Results The urinary RBP mean±SD (ng/ml) was found to be 351.667±119.397 in patients and was statistically significantly higher in them than in controls 93.16±30.836 (t = 11.482, p &amp;lt; 0.001) and it was statistically significantly correlated with disease duration, disease activity according to DAS 28 and the severity of skin affection according to PASI score. While eGFR (ml/min) was found to be 131.729±28.943 in patients and it was statistically significantly lower in them than in controls 146.708±16.607 (t=-2.459, p = 0.017), however there was no statistically significant correlations with either DAS 28 or PASI scores. Conclusion Urinary RBP has been described as a novel biomarker in early detection of kidney affection and renal tubular damage in psoriatic arthritis patients.

The Significance of the Rapid Turnover Protein Score as a Predictor of the Long-Term Outcomes in Hepatocellular Carcinoma After Hepatic Resection.

Nutritional status assessment is essential in cancer patients because a poor nutritional status has been associated with poor outcomes; however, the impact of rapid turnover proteins (RTPs), such as prealbumin, transferrin, and retinol-binding protein, on the outcomes of hepatocellular carcinoma (HCC) has not been well-investigated. We therefore examined the prognostic significance of RTPs in patients with HCC after curative resection. This study included 150 patients who underwent elective hepatic resection for HCC between January 2011 and December 2018. The prealbumin, transferrin, and retinol-binding protein levels were classified into two groups (high vs. low); the RTP score (0-3) was calculated as the sum of each RTP measurement (high=0; low=1). We retrospectively investigated the relationship between the RTP score and disease-free and overall survival. Multivariate analysis showed that a high RTP score (P=0.022), presence of sarcopenia (P=0.001), and stage III or higher (P=0.005) were independent predictors of disease-free survival, while a high RTP score (P<0.001), presence of sarcopenia (P=0.017), and stage III or higher (P=0.012) were independent predictors of overall survival. In patients with high RTP scores, positive hepatitis B and C viral infection, high indocyanine green (ICG) at 15 min (ICGR15), Child-Pugh grade B, poorly differentiated carcinoma, and postoperative ascites were more common than in patients with low RTP scores. The preoperative RTP score may be a prognostic factor in patients with hepatocellular carcinoma after hepatic resection, suggesting an important role of RTP in the assessment of nutritional status in cancer patients.

Retinol-Binding Protein-4-A Predictor of Insulin Resistance and the Severity of Coronary Artery Disease in Type 2 Diabetes Patients with Coronary Artery Disease.

Simple SummaryCytokines are cell-signaling molecules that cause cells to migrate to inflammation, infection, or trauma sites. An imbalance of cytokines in the body can result in severe illness. Increased cytokine retinol-binding protein-4 levels cause muscle, fat, and liver cells to become unresponsive to insulin and not absorb sugar from the blood. Type 2 diabetes, the most common type of diabetes, is caused by the unresponsiveness of insulin (insulin resistance). Moreover, elevated retinol-binding protein-4 causes fat and cholesterol buildup in the arteries of the heart. This results in coronary artery disease, a type of heart disease. These two diseases are hypothesized to share a common underlying cause, but the details have not been fully elucidated. Therefore, this study was conducted to find the association between retinol-binding protein-4 with insulin resistance and the severity of coronary artery disease. We postulated that retinol-binding protein-4 is linked to insulin resistance and the severity of coronary artery disease. This study proves a definitive relationship between retinol-binding protein-4 and insulin resistance and coronary artery disease severity. Hence, retinol-binding protein-4 may serve as a valuable biological indicator to depict insulin resistance and the severity of coronary artery disease. (1) Background: Insulin resistance (IR) is the fundamental cause of type 2 diabetes (T2D), which leads to endothelial dysfunction and alters systemic lipid metabolism. The changes in the endothelium and lipid metabolism result in atherosclerotic coronary artery disease (CAD). In insulin-resistant and atherosclerotic CAD states, serum cytokine retinol-binding protein-4 (RBP-4) levels are elevated. The adipocyte-specific deletion of glucose transporter 4 (GLUT4) results in higher RBP-4 expression and IR and atherosclerotic CAD progression. (2) Aim: This study aimed to investigate the association of RBP-4 and clinical factors with IR and the severity of CAD. (3) Methods: Patients were recruited from diabetes and cardiology clinics and divided into three subgroups, namely (i) T2D patients with CAD, (ii) T2D-only patients, and (iii) CAD-only patients. The severity of CAD was classified as either single-vessel disease (SVD), double-vessel disease (DVD), or triple-vessel disease (TVD). An enzyme-linked immunosorbent assay was conducted to assess the concentration of serum RBP-4. Univariate (preliminary analysis) and multivariate (secondary analysis) logistic regressions were applied to assess the associations of RBP-4 and clinical factors with IR and the severity of CAD. (4) Results: Serum RBP-4 levels were associated with IR and the severity of CAD in all the three groups (all p-values are less than 0.05). Specifically, serum RBP-4 levels were associated with IR (p = 0.030) and the severity of CAD (SVD vs. DVD, p = 0.044; SVD vs. TVD, p = 0.036) in T2D patients with CAD. The clinical factors fasting plasma glucose (FPG) and angiotensin-converting-enzyme inhibitor (ACEI) were also associated with both IR and the severity of CAD in T2D patients with CAD. (5) Conclusion: RBP-4, FPG, and ACEI are predictors of IR and severity of CAD in T2D patients with CAD.

Low Levels of Serum Fetuin-A and Retinol-Binding Protein 4 Correlate with Lipoprotein Subfractions in Morbid Obese and Lean Non-Diabetic Subjects.

Background: Fetuin-A and retinol-binding protein 4 (RBP4) are secreted as both hepatokine and adipokine. These are involved in insulin resistance, obesity-related dyslipidemia, and atherosclerosis. To date, correlations of circulating fetuin-A and RBP4 with lipoprotein subfractions as well as high-density lipoprotein (HDL)-linked proteins have not been entirely investigated in morbid obese and lean non-diabetic subjects. Methods: One-hundred obese non-diabetic patients (body mass index, BMI: 42.5 ± 8.1 kg/m2) along with 32 gender and age-matched normal weight controls (BMI: 24.5 ± 2.5 kg/m2) were enrolled in our study. Serum fetuin-A and RBP4 were measured by ELISA. Lipoprotein subfractions were distributed by Lipoprint gelelectrophoresis. Results: Serum fetuin-A and RBP4 were unexpectedly lower in obese patients (p < 0.01 and p < 0.01, respectively) compared to controls and correlated with each other (r = 0.37; p < 0.001). Fetuin-A had positive correlations with HDL-C (r = 0.22; p = 0.02), apolipoprotein AI (apoAI) (r = 0.33; p < 0.001), very-low density lipoprotein (VLDL) subfraction (r = 0.18; p = 0.05), and large HDL subfraction levels (r = 0.3; p = 0.001) but did not show correlation with carbohydrate parameters in all subjects. RBP4 correlated positively with HDL-C (r = 0.2; p = 0.025), apoAI (r = 0.23; p = 0.01), VLDL subfraction (r = 0.37; p < 0.001), intermediate HDL subfraction (r = 0.23; p = 0.01), and small HDL subfraction (r = 0.21; p = 0.02) concentrations, as well as C-peptide levels in overall participants. Backward stepwise multiple regression analysis showed that serum fetuin-A concentration is best predicted by RBP4 and large HDL subfraction. In model 2, VLDL subfraction was the independent predictor of serum RBP4 level. Conclusions: Our data may indicate a potential role of fetuin-A and RBP4 in impaired lipoprotein metabolism associated with obesity.

Retinol-binding protein 4 in combination with lipids to predict the regression phenomenon of autism spectrum disorders

BackgroundAbout 20–40 % of autistic people experience a phenomenon of regression. Retinol binding protein 4 (RBP4) plays an important role as an inflammatory neurotrophic adipokine and is a promising mediator of the fat-brain axis. Abnormal fatty acid metabolism and lipid mediators have been reported to be related to the etiological mechanism in autism, and amelioration of impaired lipid metabolism can be recognized as a treatment strategy for autism. The purpose of this study is to explore the relationship between RBP4, lipids, and the autistic regression phenomenon, and to discuss their potentials as biomarkers for the autistic regression phenomenon.MethodsA total of 60 autistic individuals (18 with regression phenomenon, 42 without regression phenomenon) (ASD group) and 36 healthy controls were enrolled in this case-control study. The levels of RBP4, total cholesterol (TC), high-density lipoprotein (HDLC), low–density lipoprotein (LDLC), and triglyceride (TG) were measured. Childhood Autism Rating Scale (CARS) is used to assess the severity of autism. Ethical measures were performed in compliance with the current Declaration of Helsinki and written informed consent was obtained from the parents before enrollment of the children and adolescents.ResultsCompared with control subjects, autistic individuals had lower levels of TC (P = 0.007), RBP4 (P = 0.001), and HDLC (P = 0.027). The levels of RBP4 in ASD group were positively correlated with TG (r = 0.355, P = 0.005), HDLC (r = 0.257, P = 0.047), TG/TC (r = 0.376, P = 0.003) and TG/LDLC (r = 0.363, P = 0.004), and were negatively correlated with CARS (r=-0.296, P = 0.003). Further logistic regression demonstrated that decreased RBP4 concentration was associated with the presentation of the autistic regression phenomenon even after the adjustment of the potential confounding factors.ConclusionsSerum RBP4 is associated with the autistic regression phenomenon and the severity of ASD. Further studies are needed to expound whether decreased RBP4 participates in the development of the autistic regression phenomenon.

ASSESSING THE RISK OF NON-ALCOHOLIC FATTY LIVER DISEASE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS BY THE COMBINED PATTERN OF RETINOLBINDING PROTEIN-4, HIGH MOLECULAR WEIGHT ADIPONECTIN AND BODY MASS INDEX

The diagnostic model to highlight the high-risk groups of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus by the level of retinol-binding protein-4, high molecular weight adiponectin and body mass index using discriminant analysis was developed.

Serum Retinol-Binding Protein Levels Are Associated with Nonalcoholic Fatty Liver Disease in Chinese Patients with Type 2 Diabetes Mellitus: A Real-World Study.

Background The association of serum retinol-binding protein (RBP) levels with nonalcoholic fatty liver disease (NAFLD) remains controversial. Furthermore, few studies have investigated their relationship in type 2 diabetes mellitus (T2DM) patients. Therefore, the aim of the present study was to explore the association between serum RBP levels and NAFLD in Chinese inpatients with T2DM.Methods This cross-sectional, real-world study included 2,263 Chinese T2DM inpatients. NAFLD was diagnosed by abdominal ultrasonography. The subjects were divided into four groups based on RBP quartiles, and clinical characteristics were compared among the four groups. The associations of both RBP levels and quartiles with the presence of NAFLD were also analyzed.Results After adjustment for sex, age, and diabetes duration, there was a significant increase in the prevalence of NAFLD from the lowest to the highest RBP quartiles (30.4%, 40.0%, 42.4%, and 44.7% for the first, second, third, and fourth quartiles, respectively, P<0.001 for trend). Fully adjusted multiple logistic regression analysis revealed that both increased RBP levels (odds ratio, 1.155; 95% confidence interval, 1.012 to 1.318; P=0.033) and quartiles (P=0.014 for trend) were independently associated with the presence of NAFLD in T2DM patients.Conclusion Increased serum RBP levels were independently associated with the presence of NAFLD in Chinese T2DM inpatients. Serum RBP levels may be used as one of the indicators to assess the risk of NAFLD in T2DM patients.

What Are the Clinical and Systemic Results of Periodontitis Treatment in Obese Individuals?

Purpose of ReviewPeriodontitis and obesity are characterized by a dysregulated inflammatory state. Obese individuals have a higher chance of presenting periodontitis. Clinical studies in different populations demonstrate that individuals with obesity have worse periodontal conditions. This current review aims to explore recent literature to understand what the impacts of obesity on periodontal treatment outcomes are and to learn whether periodontal treatment can improve systemic biomarkers in obese individuals.Recent FindingsShort- and long-term evaluations demonstrated that non-surgical periodontal treatment could improve clinical parameters in obese individuals, represented as the reduction in mean probing depth, sites with probing depth ≥ 4 mm, and extension of bleeding on probing. However, obese individuals may have less clinical improvement when compared to normal-weight individuals with a similar periodontal profile. Additionally, periodontal treatment may contribute to a reduction in systemic levels of retinol-binding protein 4 and leptin, while promoting an increase in systemic levels of adiponectin.SummaryOverall, obese individuals with periodontitis can significantly benefit from non-surgical periodontal treatment. However, clinical improvements seem to be less prominent in obese individuals with periodontitis compared to non-obese individuals with similar periodontal status. Nevertheless, periodontal treatment may impact significantly on the reduction of several biochemical biomarkers of obesity with or without weight reduction. Further investigations are needed to improve our comprehension of the mechanisms underlying those findings.

Changes in Serum Levels of Retinol Binding Protein 4, Glucose and Insulin in Adaptation to Nettle Supplementation and Combination Training in Overweight Men With Type 2 Diabetes

Background and Objectives Diabetes is one of the most common chronic diseases in the world, and its increasing growth has led to numerous health and socioeconomic problems in the community. Subjects and Methods In this quasi-experimental study, 40 men with type 2 diabetes were selected from the volunteers based on a nutritional questionnaire, exercise abilities, body mass index, and physical health. They were randomly divided into four groups: exercise, nettle, exercise plus nettle, and control. The resistance training program was performed for 8 weeks, 3 sessions per week with an intensity of 60% to 70% of a maximum repetition, and aerobic exercise with an intensity of 60% to 80% of maximum heart rate. The dose of nettle was 100 mg per day. Blood sampling was performed before fasting and 48 hours after the last training session. Data were analyzed using paired t test and analysis of variance. Results After eight weeks of intervention, there was a significant difference in fasting insulin and glucose levels between the groups (P= 0.001 and P= 0.001, respectively). There was no significant difference in the retinol levels bound to protein 4 between all groups (P= 0.096). Conclusion The results showed that both exercise and nettle interventions reduce fasting insulin and glucose levels, but reducing retinol levels bound to protein 4, exercise and nettle interventions are needed.