Role Of Retinol-binding Protein Research Articles

Role of retinol binding protein 4, visfatin, omentin-1 and vaspin in gout patients with various obesity phenotypes

Role of retinol binding protein 4, visfatin, omentin-1 and vaspin in gout patients with various obesity phenotypes

The Hepatokine RBP4 Links Metabolic Diseases to Articular Inflammation.

This study investigates the role of retinol binding protein 4 (RBP4) in an articular context. RBP4, a vitamin A transporter, is linked to various metabolic diseases. Synovial fluid RBP4 levels were assessed in crystalline arthritis (CA) patients using ELISA. RBP4's impact on articular cell types was analysed in vitro through RT-PCR and flow cytometry. Proteomic analysis was conducted on primary human osteoarthritis chondrocytes (hOACs). Synovial fluid RBP4 concentrations in CA patients correlated positively with glucose levels and negatively with synovial leukocyte count and were elevated in hypertensive patients. In vitro, these RBP4 concentrations activated neutrophils, induced the expression of inflammatory factors in hOACs as well as synoviocytes, and triggered proteomic changes consistent with inflammation. Moreover, they increased catabolism and decreased anabolism, mitochondrial dysfunction, and glycolysis promotion. Both in silico and in vitro experiments suggested that RBP4 acts through TLR4. This study identifies relevant RBP4 concentrations in CA patients' synovial fluids, linking them to hypertensive patients with a metabolic disruption. Evidence is provided that RBP4 acts as a DAMP at these concentrations, inducing robust inflammatory, catabolic, chemotactic, and metabolic responses in chondrocytes, synoviocytes, and neutrophils. These effects may explain RBP4-related metabolic diseases' contribution to joint destruction in various rheumatic conditions like CA.

Role of Retinol Binding Protein -4(RBP-4) and some Biochemical Parameters in Type II Diabetes Mellitus Patients

Diabetes is an important public health issue that adversely affects the lives of millions of individuals worldwide. RBP4 involvement in the pathogenesis of insulin resistance and type 2 diabetes. The aim of this study to assessment of role retinol binding protein -4 and other biochemical parameters in T2DM. Eighty eight participated in this study. Forty four T2DM, age between (40-60) years and forty four healthy control age between (40-55). there was a highly significant increase of FBS, HbA1C, TC, TG, LDL-C and VLDL-C, while a significant decreased of HDL-C between control and T2DM patients. There was a highly significant increase of RBP-4 level between different group (control and T2DM patients). Conclusion: Elevation of retinol in diabetic patients is considered a risk indicator for them with the early onset of cardiovascular disease, and this is a result of the continuous increase in the concentrations of sugar levels in the blood, and thus a defect in the metabolism of fats occurs, which leads to its rise, and this is an indicator of the entry of a diabetic patient with one of the complications, which is heart disease.

A-102 Development and Validation of Turbidimetric Retinol Binding Protein (RBP) Assay

Abstract Background Retinol-binding protein (RBP) is a non-glycosylated protein synthesized by the liver. The role of RBP is to transport retinol (vitamin A) from the liver to the target tissues. RBP is also a sensitive marker of undernutrition. Serum/plasma RBP levels decrease with Vitamin A deficiency, hepatocellular insufficiency, and severe inflammation. Serum/plasma RBP levels increase with renal failure, type-2 diabetes, and steatosis. Methods The immunoassay was developed and validated on the turbidimetric instrument Cobas c501 from Roche Diagnostics. The antibodies against RBP in the assay react with RBP in the sample, and the turbidity formed by formation of antibody-antigen complexes is measured at 340 nm and 700 nm. The analytical sensitivity was tested in a study including 4 samples, analysed in 3 replicates over 3 days using a protocol based on the CLSI guideline EP17. The limit of quantification (LoQ) is defined as the lowest concentration of an analyte that can be reliably detected and at which the total error meets the requirements for accuracy. Interference with triglycerides, haemoglobin and bilirubin was tested using a protocol based on the CLSI guideline EP07. Precision of the assay was tested in a 22-day precision study using a protocol based on the CLSI guideline EP05. 3 controls were measured 2 times a day in 2 replicates each time. Results The assay has a calibration range from 7.5 to 120 mg/L. Samples with higher concentrations are automatically diluted and reanalysed. No antigen excess was observed up to 600 mg/L. Precision achieved a total CV of <4 % for samples with concentrations in the range 34–63 mg/L. Analytical sensitivity of RBP was measured as 7.81 mg/L with a total error (TE) of ≤20%. No clinically relevant interference towards triglycerides (13 g/L), haemoglobin (6.9 g/L) and bilirubin (0.3 g/L) was observed. Conclusion The Gentian RBP assay is a turbidimetric assay based on the formation of antibody-antigen complexes and can be used for assessment of undernutrition, vitamin A deficiency, hepatocellular insufficiency, severe inflammation, renal failure, type-2 diabetes, and steatosis. The assay can be installed on high-throughput platforms from different manufacturers and provides accurate, cost efficient and fast results.

413-P: The Role of Retinol-Binding Protein 4 in the Regulation of Adipocyte Renin-Angiotensin System via Toll-Like Receptor 4

Objective: To explore the relationship between serum adipokine retinol binding protein 4 (RBP4) levels and essential hypertension as well as the role of RBP4 in activating adipocyte renin-angiotensin system (RAS) . Methods: From December 2016 to March 2019, 96 essential hypertension patients without any anti-hypertensive drugs and 64 age- and gender-matched healthy subjects were recruited. Serum RBP4 was determined by enzyme linked immunosorbent assay (ELISA) . Mouse primary white adipocytes were exacted and treated with adenovirus carrying the expression sequence of RBP4 with or without Toll-like receptor 4 (TLR4) inhibitor TAK242. The level of Angiotensin II (Ang II) in the cell supernatant was measured by ELISA. Western Blot and qRT-PCR were used to detect the expression of adipocyte differentiation-related genes and key genes of RAS system. Results: RBP4 was significantly higher in patients with essential hypertension [median (interquartile range) : 30.14 (23.76-40.65) ng/mL] than in healthy controls [25. (20.05-31.04) ng/mL] (P<0.01) . Multivariate logistic regression analysis showed that RBP4 was an independent risk factor for hypertension (OR=1.12, P=0.002) . In adipocytes, overexpression of RBP4 increased the expression of angiotensin converting enzyme, angiotensinogen, renin/angiotensin-forming enzyme 1 and Angiotensin II Receptor 1, as well as the secretion of Ang II (P<0.05) . Treatment of TLR4 inhibitor TAK242 alleviated RBP4 overexpression-induced activation of RAS system in adipocytes (P<0.05) . Conclusions: Elevated serum RBP4 is associated with increased risk of essential hypertension. The mechanism might be related to the active effects of RBP4 on RAS system via TLR4 in adipocytes. [Keywords] retinol binding protein 4; essential hypertension; RAS system; adipocytes; Toll-like receptor 4 Disclosure K.Zhang: None. Q.Yang: None. Funding National Institutes of Health (R01DK100385 and R01DK121146)

The Role of Retinol-Binding Protein 4 in Women Infected with Toxoplasma gondii

Background: Ocular toxoplasmosis mainly affected people in the second to fifth decades, as a result of acute or reactivate congenital or postnatally acquired infection. Retinol binding protein 4 (RBP4) is a protein transporter for retinol (Vitamin A) from the liver to peripheral tissue. Because of its function in vision RBP4 has become a target for ophthalmology research. Objectives: Identification of the role of RBP4 parameter in women infected with acute toxoplasmosis. Methodology: One hundred and fifteen blood samples were collected from aborted women, who were suspected of having toxoplasmosis for the period October 2020 to March 2021; in addition, 25 samples were collected from apparently healthy women to use as a healthy control group. All sera were investigated for the presence of anti-Toxoplasma IgM, IgA and IgG antibodies, all IgG-positive samples (50 samples) were neglected. IgM and IgA-positive samples (40 serum samples) out of 115 samples were used as toxoplasmosis case group (acute toxoplasmosis), while the negative IgM, IgA, and IgG aborted women samples were used as aborted nontoxoplasmic control group (25 serum samples). The samples from healthy women that gave negative results for the three antibodies were used as the healthy control group. Results: The RBP4 serum level was reflected a significant decrease 1.84 ± 0.44 ng/ml in aborted toxoplasmic cases when compared with aborted nontoxoplasmic and healthy control groups; 2.85 ± 0.60, 3.90 ± 0.62 ng/ml, respectively. Conclusion: There was a highly significant decrease in RBP4 serum levels in acute toxoplasmosis-infected women. This decreasing may be one of the indirect effects of Toxoplasma gondii infection on their hosts. Furthermore, this level can be used as aid test for the detection for toxoplasmosis.

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 &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.

Role of Retinol-binding Protein 4 as an Early Biomarker for Diabetic Nephropathy in Type 2 Diabetic Patients

Assess the relationship and diagnostic performance of retinol-binding protein 4 (RBP-4) as a biomarker ofdiabetic nephropathy (DN) at different levels of albuminuria (normo-, micro- and macro-albuminuria). Acase-control study, that involved 185 participants, 47 were healthy control, and 138 diabetic patients (46were normoalbuminuric patients [NA], 48 patients were microalbuminuria [MiA], and 44 patients weremacroalbuminuria [MaA]). All diabetic patients were treated with antidiabetic medication (metformin and/or oral sulfonylureas), all the participants were interviewed by the researcher, and full medical (history ofliver, kidney, lung, and other diseases), and sociodemographic data taken from them and recorded in thequestionnaire. In the present study, RBP-4 was 14.08±1.82 ng/ml in the control group, 15.98±3.74 ng/mlin the normoalbuminuria (NA) group, 30.38±6.02 ng/ml in the micro-albuminuria (MiA), and 41.01±5.78ng/ml for macro-albuminuria (MaA), there was a significant difference between all their groups comparedto control (p-value <0.001), and between each other (p-value <0.001) except that no significant differencefound between control and normoalbuminuria. In conclusion, RBP4 is an excellent predictor of bothmicroalbuminuria and microalbuminuria, there was an inverse relationship between RBP4 with GFR, whichindicate it is a good predictor for the progression of diabetic kidney impairment.

Роль ретинол-связывающего белка в дифференциальной диагностике рака поджелудочной железы

Роль ретинол-связывающего белка в дифференциальной диагностике рака поджелудочной железы

The role of retinol-binding protein 4 and its relationship with sex hormones in coronary artery disease

The role of retinol-binding protein 4 (RBP4) in patients with coronary artery disease (CAD) with different sexes has not been clearly established. Sex hormones, especially testosterone (T) and estradiol (E2), have been considered to play an important role in CAD. This study aimed to investigate the role of RBP4 and the possible association between RBP4 and T and E2 in CAD. The study included 658 individuals who underwent coronary angiography (CAG); they were assigned to CAD group (n = 440) and controls (n = 218). CAD group was subdivided into three subgroups. Serum RBP4 and T were assayed by enzyme-linked immunosorbent assay. Serum E2 was measured using electrochemiluminescence immunoassay. For men, RBP4 levels were lower in CAD group, especially those with acute myocardial infarction, than in controls (P < 0.05, P < 0.01, respectively). For women, no significant difference was found in RBP4 levels between both groups. RBP4 was positively correlated with T in male patients with CAD (r = 0.124, P < 0.05). Logistic regression analysis showed that RBP4 was a protective factor for CAD (odds ratio 0.975, 95% confidence interval 0.958–0.993; P = 0.007). In conclusion, RBP4 levels were significantly decreased and positively related with T in men with CAD. Higher RBP4 levels were associated with lower risk of CAD. RBP4 may play a potential protective role for CAD among men.

Role of Retinol Binding Protein as a Biochemical Markers for Nutritional Status Assessment

Role of Retinol Binding Protein as a Biochemical Markers for Nutritional Status Assessment

Novel role for retinol-binding protein 4 in the regulation of blood pressure.

Elevated levels of serum retinol-binding protein 4 (RBP4) contribute to insulin resistance and correlate with increased prevalence of hypertension and myocardial infarction. We sought to determine whether lowering RBP4 would improve blood pressure (BP) and protect against obesity- or angiotensin (Ang)-II-induced hypertension. Systolic and diastolic BP were lower in the RBP4-knockout (RBP4-KO) mice and higher in the RBP4-overexpressing (RBP4-Tg) mice compared with BP in the wild-type (WT) littermates. Carbachol-induced vasodilatation was increased in arteries from the RBP4-KO compared with the WT mice and was impaired in the RBP4-Tg mice. Aortic eNOS(Ser1177) phosphorylation was enhanced ∼50% in the RBP4-KO mice, with no change in total eNOS protein. Feeding a high-fat diet increased BP in the RBP4-KO mice only to the level in the WT mice fed chow and had no effect on aortic eNOS(Ser1177) phosphorylation. Ang-II infusion resulted in 22 mmHg lower systolic BP in the RBP4-KO than in the WT mice, although the relative BP increase over saline infusion was ∼30% in both. Ang-II treatment decreased aortic eNOS(Ser1177) phosphorylation in the WT and RBP4-KO mice, but phosphorylation remained higher in the RBP4-KO mice. Cardiac hypertrophy with Ang-II treatment was diminished by 56% in the RBP4-KO mice. Thus, elevated serum RBP4 raises BP and lack of RBP4 reduces it, with commensurate changes in aortic eNOS(Ser1177) phosphorylation. Lowering RBP4 may reduce BP through enhanced eNOS-mediated vasodilatation and may be a novel therapeutic approach for hypertension.

Role of retinol binding protein 4 in hepatic steatosis

Using HepG2 cell, Xia et al.1 revealed that retinol binding protein 4 (RBP4) activated critical lipogenic transcription factors of sterol regulatory element-binding protein-1c (SREBP-1c) and liver X receptor through the stimulation of peroxisome proliferator-activated receptor-γ coactivator 1β (PGC-1β). The stimulatory effect of RBP4 on SREBP-1c activity associated with hepatic lipogenesis was ensured also in vivo. Xia et al. conclude that the activation of SREBP-1c by RBP4 is fully dependent on up-regulation of PGC-1β, because RBP4 did not exhibit lipogenic effect in PGC-1β-knockout mice. In the associated editorial,2 Dr. Maher raises an important question of whether RBP4 is directly linked to hepatic lipogenesis, but neither Xia et al. or Maher address the issue about the unidentified hepatic receptor of RBP4. The only known receptor for RBP4 is a receptor stimulated by retinoic acid-6 (STRA6), which is expressed in several tissues, including retina, brain, spleen, thymus, female genital tract, testis, muscle, and placental endothelial cells (and in small quantities in heart and lung), whereas STRA6 has not been identified in the liver.3 Until the discovery of the hepatic receptor of RBP4, the metabolic link between RBP4 and fat is not confirmed. Recently, Alapatt et al.4 reported that RBP4 receptor-2 (RBPR2), which is primarily expressed in the liver and intestine and induced in adipose tissue in obese mice, is likely to mediate effects of RBP4 on insulin action and glucose homeostasis in the capacity of an RBP4 receptor. To define the role of RBP4 in lipid metabolism, it would be necessary to investigate the effect of RBP4 also under the condition of knockdown of RBPR2. PGC-1β has been thought to be a coactivator of lipogenic transcription factors, leading to lipogenesis. However, a recent study suggests that PGC-1β plays dual roles in regulating hepatic fatty acid metabolism by controlling the expression of programs of genes involved in both fatty acid oxidation and de novo fatty acid synthesis, because PGC-1β-deficient mice were outwardly normal, but exhibited a significant increase in hepatic triglyceride content at 6 weeks of age.5 The lipogenic effects of RBP4 shown by Xia et al. might be time-dependent. Tetsuji Fujita, M.D. Department of Surgery Jikei University School of Medicine Tokyo, Japan

Significance of RBP4 in patients with gestational diabetes mellitus: a case-control study of Han Chinese women

The role of retinol binding protein 4 (RBP4) in insulin resistance was recently identified. Our study investigated the correlation between RBP4 levels with lipid and glucose metabolism in a case-control study of women with gestational diabetes mellitus (GDM). Between May 2008 and May 2010, 70 pregnant women (24–28 weeks gestation) were recruited, including 35 women with GDM and 35 healthy controls. Blood samples were collected prior to and after oral glucose tolerance tests (OGTT) to detect serum RBP4, insulin, glycated hemoglobin, triglyceride (TG) and total cholesterol (TC) levels; the insulin resistance index (HOMA-IR) was calculated. Serum RBP4 levels in the GDM group were significantly higher than the control group (22.9 ± 3.09 µg/ml versus 17.9 ± 3.91 µg/ml; p < 0.01). Insulin, TC and TG levels in the GDM group and the control group were all significantly higher than the control group (p < 0.05). Serum RBP4 levels in the GDM group were correlated with HOMA-IR, TG and blood glucose levels at 1 h and 2 h after glucose was administered (r = 0.49, 0.49, 0.52,0.52, respectively; p < 0.01). In conclusion, serum RBP4 levels are elevated in GDM cases than controls. In addition, RBP4 correlates with abnormalities of insulin resistance, glucose and lipid metabolism.

THU0065 Role of retinol binding protein 4 in insulin resistance of rheumatoid arthritis patients

ObjectivesThe retinol binding protein 4 (RBP4) has recently been described as a protein highly related with insulin resistance (IR) states like obesity and diabetes. The chronic inflammatory states, like in...

Role of Retinol-Binding Protein 4 in Obese Asian Indians with Metabolic Syndrome

Role of Retinol-Binding Protein 4 in Obese Asian Indians with Metabolic SyndromeRetinol-binding protein 4 is an adipocytokine separately implicated in the development of obesity-related insulin resistance and proatherogenic lipid profile, however, its role in humans is unclear. This study was carried out to assess the role of retinol-binding protein 4 as a potential marker of metabolic syndrome in obese Asian Indians (a high-risk population for diabetes). 52 obese (BMI &gt;23 kg/m2) Asian Indians were grouped into those with and without metabolic syndrome based on IDF criteria and compared with healthy controls. The anthropometric and biochemical parameters (fasting blood sugar, lipid profile, serum insulin, high-sensitivity C-reactive protein, and retinol-binding protein 4) were estimated. The obese groups had significantly altered adiposity indices, insulin resistance parameters (fasting blood sugar (only in the metabolic syndrome group), serum insulin, HOMA-IR and QUICKI), index of inflammation (C-reactive protein) and proatherogenic dyslipidemic profile (serum triglycerides, VLDL-cholesterol, and triglyceride/HDL-cholesterol ratio). Retinol-binding protein 4 levels were elevated in the obese groups, but were not significant. Retinol-binding protein 4 levels were correlated with anthro-pometric parameters and atherogenic lipids, while C-reactive protein was correlated with anthropometric and insulin resistance parameters in the entire group of subjects. Although these correlations were not observed in the obese groups, in the control group, retinol-binding protein 4 was correlated to the lipid parameters and C-reactive protein to adiposity indices. Thus, the role of retinol-binding protein 4 as a potential marker of metabolic syndrome is limited to the prediction of proatherogenic risk among Asian Indians.

The Metabolic Role of Retinol Binding Protein 4: An Update

Retinol binding protein 4 (RBP(4)) is regarded as a novel cardiometabolic risk factor, which is secreted mainly by the hepatocytes and also by the adipose tissue. RBP(4) has been shown to induce insulin resistance, and plasma RBP(4) values are increased in type 2 diabetes mellitus, obesity, metabolic syndrome, and cardiovascular disease. Moreover, it has been found that circulating RBP(4) decreases during medical interventions that result in amelioration of the metabolic profile, such as diet, exercise, oral antidiabetic drugs, and hypolipidemic agents. However, only few of the RBP(4)-related studies have investigated whether RBP(4) constitutes a causal factor of the above-mentioned metabolic conditions. Importantly, circulating RBP(4) is influenced by some nonmetabolic conditions, such as renal failure, acute illness, injury, and liver failure. Thus, further studies investigating the metabolic roles of RBP(4) should be carefully planned, taking into account the effects of nonmetabolic conditions on circulating RBP(4).

Suppression of retinol-binding protein 4 with RNA oligonucleotide prevents high-fat diet-induced metabolic syndrome and non-alcoholic fatty liver disease in mice

Conflicting data have been reported regarding the role of retinol-binding protein (RBP4) in insulin resistance, obesity, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD). In this study, we used pharmacological methods to investigate the role of RBP4. RNA oligonucleotide against RBP4 (anti-RBP4 oligo) was transfected into 3T3-L1 adipocytes. RT-PCR analysis showed that RBP4 mRNA expression decreased by 55% (p<0.01) compared with control cells. Validated RNA oligo was used in an in vivo study with high fat diet (HFD) fed — mice. 14weeks of HFD feeding increased RBP4 expression (associated with elevated serum levels measured with immunoblotting and ELISA) by 56% in adipose tissue (p<0.05) and 68% in the liver (p<0.01). Adipose RBP4 levels were significantly reduced after 4weeks treatment with anti-RBP4 oligo (25mg/kg, p<0.01) and rosiglitazone (RSG, 10mg/kg, p<0.05) compared with scrambled RNA oligo (25mg/kg) treated mice. Only anti-RBP4 oligo significantly inhibited RBP4 protein (p<0.01) and mRNA expression (p<0.01) in the liver and reduced serum RBP4 levels. Anti-RBP4 oligo and RSG showed comparable effects on impaired glucose tolerance, hyperinsulinaemia and hyperglycaemia. Anti-RBP4 oligo significantly enhanced adipose-GLUT4 expression (p<0.01) but did not increase muscle-GLUT4. Both RSG and anti-RBP4 oligo significantly reduced hepatic phosphoenolpyruvate carboxykinase expression (both p<0.05). Histological analysis revealed that anti-RBP4 oligo ameliorated hepatic steatosis and reduced lipid droplets associated with normalized liver function. Histological and pharmacological results of this study indicate that RBP4 is not only an adipocytokine, but also a hepatic cytokine leading to metabolic syndrome, NAFLD and type 2 diabetes.

The Role of Retinol Binding Protein In The Inflammatory And Metabolic Response To Severe Burn Injury

The Role of Retinol Binding Protein In The Inflammatory And Metabolic Response To Severe Burn Injury

Serum retinol-binding protein 4 in patients with nonalcoholic fatty liver disease: does it have a significant impact on pathogenesis?

Conflicting data have been reported in the literature about the role of retinol-binding protein 4 (RBP4) in insulin sensitivity, type 2 diabetes, and obesity in humans. It is of interest whether serum RBP4 is associated with various features of nonalcoholic fatty liver disease (NAFLD). Serum RBP4, adiponectin, leptin, and resistin were measured by enzyme-linked immunosorbent assay in 76 nondiabetic NAFLD patients, 55 of whom had elevated alanine aminotransferase (ALT). Thirty-four of 55 underwent a liver biopsy. Fasting insulin, liver and lipid panels were analyzed and ultrasound score, body mass index, and homeostasis model assessment for insulin resistance were recorded for each patient. Twenty-four healthy individuals served as controls. Serum RBP4 levels were not different between the steatosis group and controls as well as between the groups with high and normal ALT. Serum adiponectin was significantly lower and resistin was higher (P<0.001) in steatosis group compared with controls. RBP4 and resistin were negatively correlated, whereas leptin and resistin were correlated positively in patients with high ALT. At multivariate analysis, homeostasis model assessment for insulin resistance [odds ratio (OR): 10.71; 95% confidence interval (95% CI): 1.40-81.74], leptin (OR: 22.14; 95% CI: 2.40-204.12), resistin (OR: 6.29; 95% CI: 0.94-41.91), ALT (OR: 1.205; 95% CI: 1.05-1.39), and aspartate aminotransferase (OR: 0.846; 95% CI: 0.72-0.99) were independent variables associated with steatosis. Serum leptin, adiponectin, resistin, gamma-glutamyl transferase, and cholesterol were associated with histological activity by multivariate linear regression. Serum RBP4 is not a predictive factor in NAFLD irrespective of ALT. Low adiponectin, elevated resistin, and leptin were significantly associated with necroinflammation.