Serum retinol binding protein 4 is negatively related to estrogen in Chinese women with obesity: a cross-sectional study

Elevated Serum Retinol Binding Protein 4 is Associated with the Risk of Diabetic Cardiomyopathy

Background

Retinol binding protein 4 (RBP4), a biomarker for insulin resistance in type 2 diabetes (DM), is increased in heart failure. This case-control study aims to determine the association between serum RBP4 levels and diabetic cardiomyopathy (DCM).

Methods

Demographic and clinical data were obtained from 245 DM patients and 102 non-diabetic controls. RBP4 levels were measured using ELISA. The association between RBP4 and DCM was evaluated using multivariate logistic regression and restricted cubic splines (RCS) in DM patients.

Results

We showed that serum RBP4 levels were higher in DCM patients than in DM patients without DCM or the controls. Multivariate analysis adjusted by age, gender, body mass index, diabetes duration, left ventricular ejection fraction, insulin treatment, triglycerides, low-density lipoprotein cholesterol, estimated glomerular filtration rate, diabetic retinopathy, diabetic nephropathy, diabetic neuropathy and log N-terminal proBNP showed a significant association between RBP4 and DCM (highest vs. lowest tertile OR 16.87, 95% CI: 6.58, 43.23, p < 0.001). RCS displayed a positive linear correlation between RBP4 levels and the risk of DCM in diabetes (p = 0.004). Adding RBP4 to a basic risk model for DCM improved the reclassification (Net reclassification index: 87.86%, 95% CI: 64.4%, 111.32%, p < 0.001).

Conclusions

The positive association between serum RBP4 and DCM suggested the role of RBP4 as a potential diagnostic biomarker for distinguishing DCM in patients with DM.

Sexual Dimorphism in the Association of Serum Retinol-Binding Protein-4 With Long-Term Dynamic Metabolic Profiles in Non-Diabetes

OBJECTIVES

We aimed to investigate the association of circulating retinol-binding protein-4 (RBP4) levels with long-term cardiometabolic risk profiles and whether sex disparity mattered.

METHODS

We included 784 non-diabetic participants aged 40 years and above from a well-defined community-based cohort at baseline in 2005 and they were invited to attend the on-site follow-up examination for two consecutive times with 3-year intervals in 2008 and 2011, respectively. Serum RBP4 was measured at baseline, and the anthropometry and biochemical measurements were performed at each visit. Generalized estimating equation models were used to assess the association of serum RBP4 levels with the dynamic changes in adiposity and glucolipid profile.

RESULTS

Based on all the baseline and the 3- and 6-year follow-up data, baseline serum RBP4 levels (each 1-unit of log₁₀RBP4) were significantly associated with waist circumference [β=3.12, 95% confidence interval (CI) (0.77, 5.47), P=0.01], fasting, and 2-h post-loading glucose [β=0.26 (0.05, 0.47), P=0.02, and 1.70 (1.29, 2.12), P< 0.0001], serum triglycerides [β=0.75, 95% CI (0.54, 0.96), P< 0.0001], total cholesterol [β=0.47, 95% CI [0.23 0.70], P<0.0001), and marginally with body mass index (β=0.97, 95% CI (0.02, 1.93), P=0.046], in total participants, after adjusting potential confounders. The association of RBP4 with 2-h post-loading glucose was stronger in women than that in men [β=1.99, 95% CI (1.49, 2.50) vs. 0.61 (-0.14, 1.36), P for interaction=0.001]. The analysis of change in Z-score of cardiometabolic profiles corresponding to each 1-unit increment in log₁₀RBP4 showed consistent results.

CONCLUSIONS

Higher RBP4 levels are associated with longitudinal increase in adiposity and deteriorated glucolipid profile defined by repeated measurements. The associations differ in sex regarding to the 2-h post-loading glucose.

Sex Differences in Nonalcoholic Fatty Liver Disease: Estrogen Influence on the Liver-Adipose Tissue Crosstalk

Significance: Nonalcoholic fatty liver disease (NAFLD) is a hepatic and systemic disorder with a complex multifactorial pathogenesis. Owing to the rising incidence of obesity and diabetes mellitus, the prevalence of NAFLD and its impact on global health care are expected to increase in the future. Differences in NAFLD exist between males and females, and among females depending on their reproductive status. Clinical and preclinical data show that females in the fertile age are more protected against NAFLD, and studies in postmenopausal women and ovariectomized animal models support a protective role for estrogens. Recent Advances: An efficient crosstalk between the liver and adipose tissue is necessary to regulate lipid and glucose metabolism, protecting the liver from steatosis and insulin resistance contributing to NALFD. New advances in the knowledge of sexual dimorphism in liver and adipose tissue are providing interesting clues about the sex differences in NAFLD pathogenesis that could inspire new therapeutic strategies. Critical Issues: Sex hormones influence key master regulators of lipid metabolism and oxidative stress in liver and adipose tissue. All these sex-biased metabolic adjustments shape the crosstalk between liver and adipose tissue, contributing to the higher protection of females to NAFLD. Future Directions: The development of novel drugs based on the protective action of estrogens, but without its feminizing or undesired side effects, might provide new therapeutic strategies for the management of NAFLD. Antioxid. Redox Signal. 35, 753-774.

The Effect of RBP4 on microRNA Expression Profiles in Porcine Granulosa Cells

Simple Summary

Retinol binding protein 4 (RBP4), mainly secreted by the liver and adipocytes, is a transporter of vitamin A. RBP4 has been shown to be involved in several pathophysiological processes, such as polycystic ovary syndrome (PCOS), obesity, insulin resistance, and cardiovascular risk. However, the role of RBP4 in mammalian follicular granulosa cells (GCs) remains largely unknown. To characterize the molecular pathways associated with the effects of RBP4 on GCs, we used sRNA deep sequencing to detect differential microRNA (miRNA) expression in GCs overexpressing RBP4. A total of 17 miRNAs were significantly different between the experimental and control groups. Our results support the notion that several miRNAs are involved in important biological processes associated with folliculogenesis and pathogenesis. These results will be useful for further studies investigating the role of RBP4 in porcine GCs.

Abstract

Retinol binding protein 4 (RBP4) is a transporter of vitamin A that is secreted mainly by hepatocytes and adipocytes. It affects diverse pathophysiological processes, such as obesity, insulin resistance, and cardiovascular diseases. MicroRNAs (miRNAs) have been reported to play indispensable roles in regulating various developmental processes via the post-transcriptional repression of target genes in mammals. However, the functional link between RBP4 and changes in miRNA expression in porcine granulosa cells (GCs) remains to be investigated. To examine how increased expression of RBP4 affects miRNA expression, porcine GCs were infected with RBP4-targeted lentivirus for 72 h, and whole-genome miRNA profiling (miRNA sequencing) was performed. The sequencing data were validated using real-time quantitative polymerase chain reaction (RT-qPCR) analysis. As a result, we obtained 2783 known and 776 novel miRNAs. In the experimental group, 10 and seven miRNAs were significantly downregulated and upregulated, respectively, compared with the control group. Ontology analysis of the biological processes of these miRNAs indicated their involvement in a variety of biological functions. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses indicated that these miRNAs were involved mainly in the chemokine signaling pathway, peroxisome proliferators-activated receptors (PPAR) signaling pathway, insulin resistance pathway, nuclear factor-kappa B(NF-kappa B) signaling pathway, and steroid hormone biosynthesis. Our results indicate that RBP4 can regulate the expression of miRNAs in porcine GCs, with consequent physiological effects. In summary, this study profiling miRNA expression in RBP4-overexpressing porcine GCs provides an important reference point for future studies on the regulatory roles of miRNAs in the porcine reproductive system.

Retinol-binding protein 4 is associated with arterial stiffness in early postmenopausal women

OBJECTIVE

Recent evidence in postmenopausal women suggested lack of association between serum levels of retinol-binding protein 4 (RBP4) and subclinical atherosclerosis; however, associations with arterial stiffness in this population remain unexplored. We evaluated the association among RBP4 and cardiovascular risk factors, including homocysteine, a marker involved in retinoic acid synthesis, and indices of arterial stiffness, in a sample of apparently healthy postmenopausal women.

METHODS

This cross-sectional study included 123 healthy postmenopausal women, not on hormone therapy, antihypertensive, or hypolipidemic treatment and with a menopausal age 10 years or less. We performed biochemical/hormonal assessment and sonographic evaluation, including carotid-femoral pulse wave velocity (PWV) and carotid artery stiffness index (SI).

RESULTS

Univariate analysis showed that RBP4 values correlated with age, low-density lipoprotein-cholesterol and estradiol levels. There was a trend of association of SI and PWV with homocysteine and triglycerides. RBP4 differed according to PWV, using the median PWV value as cut-off (RBP4, PWV ≤8.1 vs >8.1 m/s: 10.09 ± 2.05 vs 10.85 ± 1.91 ng/mL, analysis of covariance P value 0.014 adjusted for age, menopausal age, estradiol, pulse pressure). Linear regression analysis showed that PWV was independently associated with RBP4, age, and pulse pressure, whereas SI was independently associated with RBP4. An increase of one standard deviation in RBP4 levels (2.54 ng/mL) was associated with an increase of 0.577 m/s in PWV.

CONCLUSIONS

RBP4 serum levels are associated with arterial stiffness, in a sample of healthy postmenopausal women. If this association is causative, serum RBP4 levels could serve as a marker of arterial stiffness. Prospective studies are required to investigate the significance of our findings. : Video Summary:http://links.lww.com/MENO/A621.

Retinol binding protein 4 and risk of type 2 diabetes in Singapore Chinese men and women: a nested case-control study

Background

Although retinol binding protein 4 (RBP4) has been implicated in insulin resistance in experimental studies, the association between RBP4 and risk of type 2 diabetes remains unclear. We assessed this association in a Chinese population, and pooled our results with those from two prior studies.

Methods

Plasma RBP4 levels were measured among 571 incident type 2 diabetes cases and 571 controls nested within the Singapore Chinese Health Study. All participants were free of diabetes, cancer and cardiovascular disease at blood collection (1999–2004). Incident cases of physician-diagnosed diabetes were self-reported at subsequent interviews (2006–2010).

Results

Plasma RBP4 levels were significantly higher in men than women, and the respective median values were 30 (interquartile range: 24–35) μg/mL and 25 (interquartile range: 21–31) μg/mL, respectively. With adjustment for diabetes risk factors, compared to the lowest quartile, the odds ratio (OR) and confidence interval (CI) for risk of type 2 diabetes associated with the highest quartile of RBP4 levels were 1.23 (0.73–2.07; P-trend = 0.14) in all subjects, 0.63 (0.27–1.45; P-trend = 0.65) in men, and 2.29 (1.05–5.00; P-trend = 0.018) in women. The difference in the risk estimates between men and women was statistically significant (P-interaction = 0.032). When we pooled our results with two prior studies, ORs (95% CIs) comparing high versus low category of RBP4 was 1.01 (0.70–1.46; I² = 8.2%; P-heterogeneity = 0.34) in men, and 1.73 (1.28–2.33; I² = 0%; P-heterogeneity = 0.80) in women.

Conclusions

Increased plasma RBP4 levels were associated with higher risk of type 2 diabetes in women but not in men.

Electronic supplementary material

The online version of this article (10.1186/s12986-018-0329-0) contains supplementary material, which is available to authorized users.

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.