This Article Full Text Full Text (PDF) All Versions of this Article: 92/3/1168    most recent Author Manuscript (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Haider, D. G. Articles by Ludvik, B. Search for Related Content PubMed PubMed Citation Articles by Haider, D. G. Articles by Ludvik, B. Related Collections Diabetes and Insulin Obesity

Serum Retinol-Binding Protein 4 Is Reduced after Weight Loss in Morbidly Obese Subjects

Departments of Clinical Pharmacology (D.G.H., M.W.) and Surgery (G.P., A.B.), and Division of Endocrinology and Metabolism, Department of Internal Medicine (K.S., A.L., M.W., B.L.), Medical University of Vienna, 1090 Vienna, Austria

Address all correspondence and requests for reprints to: Bernhard Ludvik, M.D., Medical University of Vienna, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Allgemeines Krankenhaus Wien, Währinger Gürtel 18-20, 1090 Vienna, Austria. E-mail: bernhard.ludvik{at}meduniwien.ac.at.

Context: Administration of retinol-binding protein 4 (RBP-4) impairs insulin sensitivity in animals, and elevated serum concentrations have been associated with insulin resistance in humans.

Objective: We have studied whether weight loss influences RBP-4.

Patients and Methods: Fasting serum concentrations of RBP-4 were measured before and 6 months after gastric banding surgery in 33 morbidly obese patients aged 40 ± 11 yr with a body mass index (BMI) of 46 ± 5 kg/m². Fourteen healthy subjects aged 29 ± 5 yr with a BMI less than 25 kg/m² served as controls. To characterize the association of weight loss with central and peripheral appetite regulation, the signaling protein agouti-related protein (AGRP), the orexigenic hormone ghrelin, and its recently identified antagonist obestatin were determined.

Results: At baseline, RBP-4 levels were markedly higher in obese than in lean subjects (2.7 ± 0.5 vs. 0.9 ± 0.5 µg/ml; P < 0.001). In contrast, AGRP and obestatin were lower in obese subjects compared with lean controls (all P < 0.001). Six months after gastric banding, BMI was reduced to 40 ± 5 kg/m², RBP-4 was reduced to 2.0 ± 0.7 µg/ml, AGRP increased from 1.8 ± 1.1 to 3.4 ± 1.1 ng/ml, ghrelin increased from 93 ± 58 to 131 ± 70 pg/ml, and obestatin increased from 131 ± 52 to 173 ± 35 pg/ml (all P < 0.05). Individual changes of RBP-4 were associated with changes of BMI (r = 0.72), the homeostasis model assessment insulin resistance-index (r = 0.53), and total cholesterol (r = 0.42, for all P < 0.05).

Conclusion: Reductions in circulating RBP-4 may contribute to improved insulin resistance in morbidly obese subjects after weight loss. This is accompanied by favorable changes in appetite-regulating hormones, which might support the sustained weight loss after obesity surgery.

This article has been cited by other articles:

				J. P. Mills, H. C. Furr, and S. A. Tanumihardjo Retinol to Retinol-Binding Protein (RBP) Is Low in Obese Adults due to Elevated apo-RBP Experimental Biology and Medicine, October 1, 2008; 233(10): 1255 - 1261. [Abstract] [Full Text] [PDF]

				R. L. Bradley, J. Y. Jeon, F.-F. Liu, and E. Maratos-Flier Voluntary exercise improves insulin sensitivity and adipose tissue inflammation in diet-induced obese mice Am J Physiol Endocrinol Metab, September 1, 2008; 295(3): E586 - E594. [Abstract] [Full Text] [PDF]

				S. K. Hutchison, C. Harrison, N. Stepto, C. Meyer, and H. J. Teede Retinol-Binding Protein 4 and Insulin Resistance in Polycystic Ovary Syndrome Diabetes Care, July 1, 2008; 31(7): 1427 - 1432. [Abstract] [Full Text] [PDF]

				S. H. Choi, Y. J. Lee, Y. J. Park, K. W. Kim, E. J. Lee, S. Lim, D. J. Park, S. E. Kim, K. S. Park, H. C. Jang, et al. Retinol Binding Protein-4 Elevation Is Associated with Serum Thyroid-Stimulating Hormone Level Independently of Obesity in Elderly Subjects with Normal Glucose Tolerance J. Clin. Endocrinol. Metab., June 1, 2008; 93(6): 2313 - 2318. [Abstract] [Full Text] [PDF]

				T. Reinehr, B. Stoffel-Wagner, and C. L. Roth Retinol-Binding Protein 4 and Its Relation to Insulin Resistance in Obese Children before and after Weight Loss J. Clin. Endocrinol. Metab., June 1, 2008; 93(6): 2287 - 2293. [Abstract] [Full Text] [PDF]

				Q. Qi, Z. Yu, X. Ye, F. Zhao, P. Huang, F. B. Hu, O. H. Franco, J. Wang, H. Li, Y. Liu, et al. Elevated Retinol-Binding Protein 4 Levels Are Associated with Metabolic Syndrome in Chinese People J. Clin. Endocrinol. Metab., December 1, 2007; 92(12): 4827 - 4834. [Abstract] [Full Text] [PDF]

				G. Perseghin, G. Lattuada, F. De Cobelli, A. Esposito, E. Belloni, T. Canu, F. Ragogna, P. Scifo, A. Del Maschio, and L. Luzi Serum Retinol-Binding Protein-4, Leptin, and Adiponectin Concentrations Are Related to Ectopic Fat Accumulation J. Clin. Endocrinol. Metab., December 1, 2007; 92(12): 4883 - 4888. [Abstract] [Full Text] [PDF]

				I. Aeberli, R. Biebinger, R. Lehmann, D. l'Allemand, G. A. Spinas, and M. B. Zimmermann Serum Retinol-Binding Protein 4 Concentration and Its Ratio to Serum Retinol Are Associated with Obesity and Metabolic Syndrome Components in Children J. Clin. Endocrinol. Metab., November 1, 2007; 92(11): 4359 - 4365. [Abstract] [Full Text] [PDF]

				T. W.K. Ng, G. F. Watts, P. H. R. Barrett, K.-A. Rye, and D. C. Chan Effect of Weight Loss on LDL and HDL Kinetics in the Metabolic Syndrome: Associations with changes in plasma retinol-binding protein-4 and adiponectin levels Diabetes Care, November 1, 2007; 30(11): 2945 - 2950. [Abstract] [Full Text] [PDF]

				M. Anderwald-Stadler, M. Krebs, M. Promintzer, M. Mandl, M. G. Bischof, P. Nowotny, T. Kastenbauer, A. Luger, R. Prager, and C. Anderwald Plasma obestatin is lower at fasting and not suppressed by insulin in insulin-resistant humans Am J Physiol Endocrinol Metab, November 1, 2007; 293(5): E1393 - E1398. [Abstract] [Full Text] [PDF]

				M. Ziegelmeier, A. Bachmann, J. Seeger, U. Lossner, J. Kratzsch, M. Bluher, M. Stumvoll, and M. Fasshauer Serum Levels of Adipokine Retinol-Binding Protein-4 in Relation to Renal Function Diabetes Care, October 1, 2007; 30(10): 2588 - 2592. [Abstract] [Full Text] [PDF]

				V. Vicennati, S. Genghini, R. De Iasio, F. Pasqui, U. Pagotto, and R. Pasquali Circulating obestatin levels and the ghrelin/obestatin ratio in obese women Eur. J. Endocrinol., September 1, 2007; 157(3): 295 - 301. [Abstract] [Full Text] [PDF]

				A. Garg The Ongoing Saga of Obestatin: Is It a Hormone? J. Clin. Endocrinol. Metab., September 1, 2007; 92(9): 3396 - 3398. [Full Text] [PDF]

				Z.-F. Guo, X. Zheng, Y.-W. Qin, J.-Q. Hu, S.-P. Chen, and Z. Zhang Circulating Preprandial Ghrelin to Obestatin Ratio Is Increased in Human Obesity J. Clin. Endocrinol. Metab., May 1, 2007; 92(5): 1875 - 1880. [Abstract] [Full Text] [PDF]

				P. Balagopal, T. E. Graham, B. B. Kahn, A. Altomare, V. Funanage, and D. George Reduction of Elevated Serum Retinol Binding Protein in Obese Children by Lifestyle Intervention: Association with Subclinical Inflammation J. Clin. Endocrinol. Metab., May 1, 2007; 92(5): 1971 - 1974. [Abstract] [Full Text] [PDF]