Childhood retinol-binding protein 4 (RBP4) levels predicting the 10-year risk of insulin resistance and metabolic syndrome: the BCAMS study

Abstract

BackgroundElevated retinol-binding protein 4 (RBP4) levels may contribute to the development of metabolic abnormalities, but prospective studies evaluating the association between childhood RBP4 levels and metabolic syndrome (MS) in adulthood are lacking. We investigated whether RBP4 levels during childhood predict cardiometabolic risk at 10-year follow-up.MethodsThe relationships between RBP4 levels, the established adipokines (leptin and adiponectin) and the components of MS were examined in 3445 school-aged children recruited in 2004 for the Beijing Child and Adolescent Metabolic Syndrome study. In 2015, 352 of these individuals completed an in-depth follow-up examination.ResultsParticipants with higher childhood RBP4 levels had adverse cardiometabolic profiles at follow-up. Those with incident or persistent MS had higher baseline RBP4 levels than those who never exhibited the elements of MS. Moreover, baseline RBP4 predicted hyperglycemia (OR per SD increase = 1.48, P = 0.009), elevated triglyceride (OR = 1.54, P < 0.001), elevated blood pressures (OR = 1.46, P = 0.015), MS (OR = 1.68, P = 0.002) and insulin resistance (OR = 1.44, P = 0.015) in the 10-year follow-up phase, independent of baseline BMI. Significant improvements were seen for the net reclassification improvement and integrated discrimination index after adding childhood RBP4 levels into the risk models using conventional cardiometabolic risk factors in predicting MS at follow-up (P < 0.05). Leptin and adiponectin demonstrated the expected associations with metabolic disorders.ConclusionsChildhood RBP4 serves as a risk factor for subsequent development of MS and its components, independent of pediatric obesity. Incorporating childhood RBP4 into conventional cardiometabolic risk assessment models significantly improves the prediction of MS.Electronic supplementary materialThe online version of this article (10.1186/s12933-018-0707-y) contains supplementary material, which is available to authorized users.

Elevated RBP4 plasma levels were associated with diabetic retinopathy in type 2 diabetes

“…Interestingly, oxidative stress had been suggested to play a role in the pathogenesis of DR [ 36 ]. Second, a previous study suggested that baseline RBP4 predicted insulin resistance (OR = 1.44, P =0.015) in the 10-year follow-up phase in Beijing Child and Adolescent Metabolic Syndrome study [ 37 ]. In fact, insulin resistance was an independent specific marker of proliferative retinopathy [ 38 ].…”

“…It was reported that the level of circulating RBP4 is often elevated in obese mice and humans and that, under these circumstances, the protein induces insulin resistance [ 7 ]. Previous studies had suggested that circulating RBP4 levels were associated with insulin resistance [ 8 ], metabolic syndrome [ 9 ], impaired glucose tolerance [ 10 ], and type 2 diabetes [ 11 ].…”

Insulin resistance, beta-cell function, adipokine profiles and cardiometabolic risk factors among Chinese youth with isolated impaired fasting glucose versus impaired glucose tolerance: the BCAMS study

“…The interassay CVs were <7.0%, <9.3% and <8.5%, respectively. FGF21 and RBP4 were measured using a commercial ELISA Kit (R&D Systems, Minnesota, USA) with interassay CVs of <7.4% and <10%, respectively 28 29. All samples were analyzed in duplicate.…”

Adipose Tissue Mediates Associations of Birth Weight with Glucose Metabolism Disorders in Children

“…Pubertal development was assessed by trained examiners according to Tanner . Customized questionnaires , retrospectively completed by both parents and child participants, were used to collect information on family history, term of gestation, socioeconomic status, lifestyle, and physical activity (frequency of vigorous exercise including cycling, hiking, running, or swimming of at least 30 minutes in duration). Diet was scored by the consumption frequency of breakfast, beans, seafood, milk, vegetables, fruits, red meat, snacks, fast food, fried food, and soft drinks.…”

“…The intra‐assay coefficients of variation (CVs) for insulin, leptin, and adiponectin were < 4.1%, < 7.4%, and < 5.4%, and the interassay CVs were < 7.0%, < 9.3%, and < 8.5%, respectively. Resistin (Phoenix Pharmaceuticals, Burlingame, California) and RBP4 (R&D Systems, Minneapolis, Minnesota) were measured using commercial ELISA kits . The intra‐ and interassay CVs were < 5.2% and < 10.1% for resistin and <6.2% and <8.5% for RBP4, respectively.…”