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This version published online on August 28, 2007
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2006-2522
A more recent version of this article appeared on November 1, 2007
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Right arrow Diabetes and Insulin

Insulin Resistance is Unrelated to Circulating Retinol Binding Protein and Protein C Inhibitor

Miriam PROMINTZER, Michael KREBS*, Jelena TODORIC, Anton LUGER, Martin Georg BISCHOF, Peter NOWOTNY, Oswald WAGNER, Harald ESTERBAUER, and Christian ANDERWALD

Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Austria, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University Vienna, Vienna, Austria, Department of Clinical Pharmacology, Medical University of Vienna, Austria

* To whom correspondence should be addressed. E-mail: michael.krebs{at}meduniwien.ac.at.

Context: Recent data suggest that circulating retinol binding protein (RBP) might be involved in the pathogenesis of insulin resistance. Moreover, protein C inhibitor (PCI) which specifically binds retinoic acid was found to be increased in myocardial infarction survivors who are also insulin-resistant.

Objective: The objective of this study was to investigate the association of insulin resistance with plasma retinol binding factors (RBP) and PCI active antigen.

Design and Setting: This was a clinical study.

Patients: Nondiabetic humans with high (IS; n = 20, f/m = 14/6, age: 47.2 ± 1.9 years, BMI: 26 ± 1 kg/m2) and low (IR; n = 20, f/m = 14/6, age: 45.5 ± 1.7 years, BMI: 28 ± 1 kg/m2) insulin-stimulated glucose-disposal (M) participated in this study.

Main Outcome Measures: M was measured by 2-h hyperinsulinemic-(40 mU|b1min-1|b1m-2)-isoglycemic clamp-tests. Measurements of RBP were performed using a nephelometric method and validated using quantitative Western blotting.

Results: M (80–120 min) was higher in IS (10.9 ± 0.6 mg|b1min-1|b1kg-1) than in IR (4.0 ± 0.2; P < 10-12). Fasting plasma RBP concentrations were comparable between IS and IR measured by both, nephelometry (IS: 4.4 ± 0.3; IR: 4.6 ± 0.3 mg/dl, P = 0.6) and quantitative Western blot (IS 7.9±0.5, IR 8.3±0.6 mg/dl; P = 0.6). Fasting plasma PCI active antigen was similar in both groups. Plasma RBP and PCI were not significantly related to M. RBP was positively correlated with uric acid (r = 0.488, P = 0.003), triglycerides (r = 0.592, P < 0.001), prealbumin (r = 0.63, P < 0.0001) and vitamin A (r = 0.75, P < 10-6).

Conclusions: Our data demonstrate that healthy, insulin-resistant humans do not show altered plasma retinol binding factors, such as RBP and PCI. Both do not significantly correlate with insulin sensitivity. Thus, our findings do not support the hypothesis of insulin sensitivity modulation by proteins involved in retinol transport.


Key words: Insulin Resistance • Retinol Binding Protein • Protein C Inhibitor




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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]




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