Background: Retinol-binding protein 4 (RBP4) is known as an acute phase inflammatory reactant, associated with insulin resistance. Increased levels of this novel adipokine is observed in obesity, type 2 diabetes mellitus, metabolic syndrome (MetS) and cardiovascular diseases, as well as in nonalcoholic fatty liver disease (NAFLD), but some of these data remain controversial. The aim of this study was to evaluate the relationship between RBP4 and prediabetes in obese patients with NAFLD.
Subjects and methods: A total of 79 obese patients with ultrasound based diagnosis of NAFLD were included. All subjects were divided into 2 groups: 1) without carbohydrate disturbances (n=41), and 2) with prediabetes (n=38). Serum RBP4 was measured using ELISA method.
Results: The obese NAFLD patients with prediabetes had significantly higher levels of RBP4 compared to those patients without carbohydrate disturbances (78.55±35.74 vs. 65.30±32.25 μg/ml, P=0.041), as well as patients with MetS than patients with less than 3 MetS components (P=0.019), and patients with dyslipidemia compared to patients without lipid abnormalities (P=0.013). There was weak to moderate positive correlation between RBP4 levels and visceral adiposity index, glucose, insulin and HOMA-IR, and moderate negative correlation with Quicki index (P<0.050.001). RBP4≥61 μg/ml compared to those with lower values, have about 3.5-fold higher risk of prediabetes (OR 3.544, 95% CI 1.3859.072, P=0.008 and OR 3.522, 95% CI 1.2939.596, P=0.014, individually and in the group plan respectively). RBP4≥55 μg/ml in creased the risk for MetS approximately 3.1 times (OR 3.148, 95% CI 1.1788.414, P=0.022). In the group plan, the regression equation kept thisvalue, lost statistical significance but retaining the risk predictive value (OR 2.988, 95% CI 0.49917.882, P=0.230).
Conclusions: RBP4 is associated with increased risk for prediabetes and MetS in obese patients with NAFLD.
Keywords: Retinol-binding protein 4, nonalcoholic fatty liver disease, prediabetes, obesity, metabolic syndrome
18 - 21 May 2019
European Society of Endocrinology