The correlation of retinol-binding protein-4 and lipoprotein combine index with the prevalence and diagnosis of acute coronary syndrome

Abstract

Retinol-binding protein-4 (RBP-4) along with the lipid profile plays crucial roles in Acute coronary syndrome (ACS). The study aimed to investigate the correlation of RBP-4, lipoprotein combine index (LCI), and RBP-4 + LCI with ACS. 163 ACS and 77 non-CAD in patients were consecutively enrolled in this study. The serum level of RBP-4 was measured via enzyme-linked immunosorbent assay. LCI was calculated using the formula: total cholesterol × triglyceride × low-density lipoprotein cholesterol/high-density lipoprotein cholesterol. RBP-4 ≥4 ng/ml, LCI ≥16 and LCI ≥16 + RBP-4 ≥4 ng/ml were new independent risk factors of ACS, and OR value of LCI ≥16 + RBP-4 ≥4 ng/ml was higher than that of RBP-4 and LCI combined (all p < 0.05). The AUC for LCI + RBP-4 was higher than that for LCI and RBP-4 individually. The risk of high LCI in 1 lesion vessel was greater than those of 2 or ≥3 lesion vessels (all p < 0.05). In 1 lesion vessel or ≥3 lesion vessels group, the risk associated with LCI and RBP-4 combined was higher than the risk of LCI or RBP-4 alone (all p < 0.05). The risk of hypertension, diabetes mellitus, smoking and history of MI increased with numbers of vessels lesion (all p < 0.05). Increase in RBP-4 and LCI values were found to be independent risk factors for ACS, and the risk of the combined rise in LCI and RBP-4 values was higher than LCI or RBP-4 alone. The combined tests of LCI and RBP-4 might be a potential diagnostic marker for ACS.

Circulating retinol binding protein 4 levels in coronary artery disease: a systematic review and meta-analysis

“…Twenty-three articles were subsequently excluded at the full-text review phase, of which 2 articles did not include a control group, 6 articles did not measure RBP4 levels, 14 articles were related to other diseases and 1 article published results from fewer than 10 patients (Supplementary Table 3 ). Therefore, 15 articles that met the inclusion criteria were pooled in the analysis [ 7 – 15 , 31 – 36 ].

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“…The selected articles were published between 2007 and 2020, including 3471 patients with CAD and 3640 controls. These studies included a prospective cohort study [ 8 ], 12 case–control studies [ 7 , 9 – 15 , 31 , 32 , 34 , 36 ] and two nested case–control studies [ 33 , 35 ]. Studies were conducted in Asia [ 8 – 11 , 13 – 15 , 32 , 34 , 36 ], Europe [ 7 , 12 , 31 , 35 ] and the USA [ 33 ].…”

“…These studies included a prospective cohort study [ 8 ], 12 case–control studies [ 7 , 9 – 15 , 31 , 32 , 34 , 36 ] and two nested case–control studies [ 33 , 35 ]. Studies were conducted in Asia [ 8 – 11 , 13 – 15 , 32 , 34 , 36 ], Europe [ 7 , 12 , 31 , 35 ] and the USA [ 33 ]. Patients with CAD were aged 55.2 to 64.7 years, and the BMI covered a range of 23.0 to 32.7 kg/m 2 across studies.…”

“…Levels of RBP4 were determined using an ELISA in all of the studies. Most studies enrolled both female and male participants [ 7 , 9 – 11 , 13 – 15 , 32 , 34 – 36 ], while two studies recruited only males [ 12 , 31 ] and two studies involved solely females [ 8 , 33 ]. The comparative data between CAD and control group was provided as follows: 11 studies, CAD ( n = 3169) vs controls ( n = 3369); two studies, CAD with complications group ( n = 177) vs controls ( n = 141); and two studies, CAD alone and CAD with complications group ( n = 125) vs controls ( n = 130).…”

“…The risks of bias due to departures from intended exposures, bias due to missing data, bias in measurement of outcomes and bias in selection of the reported result were considered low in all the studies. Regarding the bias in selection of participants into the study, three studies [ 8 , 33 , 35 ] were considered to be at low risk, and twelve studies [ 7 , 9 – 15 , 31 , 32 , 34 , 36 ] were considered to be at moderate risk. In relation to the bias in classification of exposures, two articles [ 35 , 36 ] were categorized as having a moderate risk of bias and thirteen articles [ 7 – 15 , 31 – 34 ] were at low risk.…”