Elevated serum retinol-binding protein 4 concentrations are associated with renal dysfunction and uric acid in type 2 diabetic patients
Elevated serum retinol-binding protein 4 concentrations are associated with renal dysfunction and uric acid in type 2 diabetic patients
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DOI：
10.1002/dmrr.894
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发表时间：
2008-11-01
影响因子：
8
通讯作者：
Shin, Shyi-Jang
中科院分区：
文献类型：
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作者：
Chang, Yu-Hung;Lin, Kun-Der;Shin, Shyi-Jang
背景虽然一些研究报道视黄醇结合蛋白4（RBP 4）可能诱导胰岛素抵抗，但其他研究表明，糖尿病患者的白蛋白尿和尿酸升高与胰岛素抵抗有关。因此，本研究试图进一步探讨血清RBP 4、血尿酸与糖尿病患者尿蛋白严重程度的关系。方法95例2型糖尿病患者和16例健康体检者参加本研究。根据尿白蛋白/肌酐比值（ACR）将糖尿病患者分为正常白蛋白尿组、微量白蛋白尿组和大量白蛋白尿组。结果正常白蛋白尿的2型糖尿病患者血清RBP 4水平明显升高（43.4 ± 14.9 μ g/mL），微量白蛋白尿（57.3 +/- 24.2 μ g/mL）和大量白蛋白尿（64.7 +/- 27.6 μ g/mL）与对照组患者（32.6 +/- 10.0 μ g/mL）相比。与正常白蛋白尿组相比，2型糖尿病伴微量白蛋白尿或大量白蛋白尿患者的血清RBP 4也显著升高。糖尿病受试者血清RBP 4与甘油三酯、尿酸和ACR呈正相关，与低密度脂蛋白胆固醇和估计肾小球滤过率（eGFR;在每个参数中调整年龄和性别）呈负相关。多元逐步线性回归分析显示，尿酸和eGFR与血清RBP 4仍有显著相关性。结论eGFR和尿酸均是血清RBP 4的重要决定因素，提示早期糖尿病肾病肾清除功能受损影响RBP 4，间接支持代谢综合征、尿酸和胰岛素抵抗之间的联系。(C)版权所有2008年约翰威利父子有限公司。
Background While some studies have reported that retinol-binding protein 4 (RBP4) might induce insulin resistance, other studies have demonstrated that the presence of albuminuria in diabetic patients and increased uric acid are related to insulin resistance. Therefore, this study attempted to further investigate the relationship among serum RBP4, serum uric acid, and the severity of alburninuria in diabetic patients.Methods A total of 95 type 2 diabetic patients and 16 healthy subjects participated in this study. Diabetic patients were classified into normalbuminuria, microalbuminuria and macroalbumiuria groups according to their urine albumin-to-creatinine ratio (ACR). Serum RBP4 was measured by an enzyme-linked immunosorbent assay (ELISA).Results Serum RBP4 was significantly elevated in type 2 diabetic patients with normoalbuminuria (43.4 +/- 14.9 mu g/mL), microalbuminuria (57.3 +/- 24.2 mu g/mL) and macroalburninuria (64.7 +/- 27.6 mu g/mL) as compared with control patients (32.6 +/- 10.0 mu g/mL). Serum RBP4 was also significantly elevated in type 2 diabetic patients with microalbuminuria or macroalburninuria as compared with the normoalbuminuric group. Serum RBP4 in diabetic subjects was positively correlated with triglycerides, uric acid and ACR, and negatively correlated with low-density lipoprotein choiesterol and estimated glomerular filtration rate (eGFR; with age and gender adjustment in each parameter). Multiple stepwise linear regression analysis showed that uric acid and eGFR remained significantly associated with serum RBP4.Conclusions Both eGFR and uric acid are significant determinants of serum RBP4, suggesting that the impaired renal clearance of early diabetic nephropathy affects RBP4 and indirectly supporting the hypothesized link among metabolic syndrome, uric acid and insulin resistance. (C) Copyright 2008 John Wiley & Sons, Ltd.