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This version published online on April 1, 2008
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2007-2536
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Submitted on November 15, 2007

Retinol Binding Protein-4 Elevation Is Associated with Serum TSH Level Independently of Obesity in Elderly Subjects with Normal Glucose Tolerance

Sung Hee Choi, You Jin Lee, Young Joo Park, Ki Woong Kim, Eun Jung Lee, Soo Lim, Do Joon Park, Sang Eun Kim, Kyong Soo Park, Hak C. Jang*, and Bo Youn Cho

Department of Internal Medicine (S.H.C.,Y.J.L., Y.J.P., E.J.L., D.J.P., K.S.P., H.C.J., B.Y.C.), Seoul National University College of Medicine, Seoul, Korea; Department of Internal Medicine (S.H.C., Y.J.P., S.L., H.C.J.), Neuropsychiatry (K.W.K.), and Nuclear Medicine (S.E.K.), Seoul National University Bundang Hospital, Seongnam, Korea

* To whom correspondence should be addressed. E-mail: janghak{at}snu.ac.kr.

Context: Elevated levels of retinol binding protein 4 (RBP4) are positively correlated with insulin resistance, obesity, diabetes mellitus, and cardiovascular disease (CVD). Subclinical hypothyroidism (SCH) has also been associated with CVD, however, the factors linking SCH to CVD are not clear.

Objective: To evaluate risk factors for CVD in elderly patients grouped according to thyroid function.

Design: 217 subjects (≥ 65 years old) were randomly selected from a population and allocated to a euthyroid group (177) and an SCH group (40) on the basis of plasma concentrations of thyroid-stimulating hormone (TSH) and free thyroxine (fT4). We included subjects with normal glucose tolerance by a 75 g oral glucose tolerance test and subjects with impaired fasting glucose. We measured anthropometric parameters, levels of fasting glucose and insulin, hemoglobin A1c, adiponectin, and RBP4, lipid profiles, total body fat content, and the area of subcutaneous and visceral fat.

Results: The SCH group had higher RBP4 levels than the euthyroid group, irrespective of BMI and fat content. Subcutaneous and visceral fat areas and total body fat percentage did not differ between groups and were not correlated with RBP4 level. Other CVD risk factors did not differ between groups. RBP4 level was positively correlated with TSH level (r = 0.241, P = 0.001) after adjustment for age, sex, and BMI.

Conclusions: Plasma RBP4 levels were associated with subclinical hypothyroidism independent of obesity in elderly subjects with normal glucose tolerance, indicating that RBP4 level could be used as an index of CVD risk in SCH.
Key words: RBP4 • TSH • subclinical hypothyroidism • cardiovascular disease • normal glucose tolerance • elderly • obesity






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