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Submitted on June 13, 2006
Accepted on April 5, 2007
Department of Internal Medicine, Koshigaya Hospital, Dokkyo University School of Medicine, Koshigaya, Japan
* To whom correspondence should be addressed. E-mail: takeb{at}gmail.plala.or.jp.
Context: Retinol binding protein (RBP)-4 is a recently identified adipocytokine that is associated with insulin resistance.
Objective: The study was designed to investigate the association between RBP4 and various markers related to insulin resistance, and diabetic complications in type 2 diabetic patients. The effect on RBP4 of addition of pioglitazone to other diabetic medications was also examined.
Design, setting, patients, intervention and main outcome measures: RBP4 levels were measured in 101 hospitalized patients with type 2 diabetes and in 22 non-hospitalized control subjects. Endothelial function was evaluated using flow-mediated vasodilatation (FMD). In a further 22 non-hospitalized type 2 diabetic patients, pioglitazone (30 mg/day) was administered for 12 weeks while other medications for diabetes were continued.
Results: There was a significant elevation of RBP4 levels in diabetic patients compared with healthy subjects. RBP4 showed significant positive correlations with triglyceride, systolic-blood pressure and log urinary albumin excretion (UAE), and significant negative correlations with high-density lipoprotein cholesterol and FMD. In stepwise regression analysis, log UAE, triglyceride and gender showed a significant association with RBP4. RBP4 was significantly elevated in patients with proliferative-diabetic retinopathy compared with non-diabetic retinopathy and simple-diabetic retinopathy patients. Addition of pioglitazone for 12 weeks to other diabetic medications the patients were already taking did not affect the serum RBP4 concentration.
Conclusions: The current study shows that RBP4 is associated with variables related to insulin resistance and diabetic complications. Addition of pioglitazone for 12 weeks to other diabetic medications the patients were already taking did not affect serum RBP4 levels.
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