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Retinol binding protein-4 (RBP4) levels have been associated with patients of type 2 diabetes (T2DM) including insulin resistance (IR), dyslipidemia, and cardiovascular disease (CVD). The present study examined the relationship between serum levels of RBP4 and the risk factors related to hypothyroidism (Hypo) and CVD in diabetic Egyptian patients. A total of 96 subjects were recruited and divided into 8 groups. Subjects were assessed for different biochemical parameters. In addition, serum levels of RBP4 were measured using specific immunoassays. There was a highly statistically significant difference in fasting blood glucose (FBG) and hemoglobin A1C (HbA1c) between the different patient groups and the control group. Thyroid stimulating hormone (TSH) concentration in the (T2DM+Hyp) group was considerably higher than in the other groups. There were statistically significant variations in TSH levels between all groups and controls. The mean RBP4 value in Group5 (T2DM+Hyp+CVD) was significantly higher than in the other groups. In (T2DM+Hypo+CVD) group, the receiver operating characteristic (ROC) curve revealed that RBP4 had a higher area under curve (AUC), making it a powerful discriminator of those diseases.

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Objectives: Type 2 diabetes mellitus (T2DM) is a complex disease that affects many organs. Oxidative stress plays a key role in the pathogenesis of insulin resistance and β-cell dysfunction. Thus, the present study aimed to use oxidative stress markers as early predictors for the progression of diabetic complications. Materials and Methods: The study sample included 400 individuals (300 T2DM and 100 non-diabetic controls) aged from 35 to 59 years randomly selected from the outpatient clinic of the National Institute for Diabetes and Endocrinology. T2DM patients were divided into subgroups: Subgroup (1) patients without any complications, Subgroup (2) patients with diabetic nephropathy (DN) and Subgroup (3) patients with cardiovascular disorders (CVD). Biochemical markers of fasting blood glucose, glycated haemoglobin (HbA1C), glucose-6-phosphate dehydrogenase (G6PD), lactate, arginase, heme oxygenase-1 (HO-1), haemoglobin (Hb), triglycerides (TG), cholesterol, low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), urea, creatinine, malondialdehyde (MDA), reduced glutathione (GSH), catalase (CAT) and nitric oxide (NO) were performed. Results: DM patients showed significant increases in body mass index, systolic blood pressure, diastolic blood pressure, FBS, HbA1C, cholesterol, TG, LDL-C and glomerular filtration rate, while HDL-C decreased. Significant increases were observed in HO-1, MDA and NO, while G6PD/lactate, GSH and CAT decreased in DM patients. The DN and CVD patients exhibited a significant increase in HO-1, MDA and NO; while G6PD/lactate, GSH and CAT decreased compared with DM patients. Receiver operating characteristic analysis showed that the sensitivity and specificity of oxidative stress markers were 66.67–100%. Conclusion: Hexose monophosphate (HMP)/glycolysis pathways are shifted during DM near glycolysis rather than HMP pathway to produce energy where the amount of glucose enters the cells is low, causing oxidative stress. Oxidative stress markers could be used as early predictors of diabetes complications.