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Serum Levels of Adipokine Retinol-Binding Protein-4 in Relation to Renal Function

¹ Department of Internal Medicine III, University of Leipzig, Leipzig, Germany
² Institute of Laboratory Medicine, University of Leipzig, Leipzig, Germany
³ Interdisciplinary Center for Clinical Research Leipzig, Leipzig, Germany

Address correspondence and reprint requests to Mathias Fasshauer, MD, Ph.-Rosenthal-Str. 27, 04103 Leipzig, Germany. E-mail: mathias.fasshauer{at}medizin.uni-leipzig.de

OBJECTIVE—Retinol-binding protein (RBP)-4 was recently identified as an adipokine that induces insulin resistance. In the current study, we investigated RBP-4 serum levels in diabetic and nondiabetic patients on chronic hemodialysis (CD) compared with control subjects with a glomerular filtration rate >50 ml/min. The majority of the diabetic subjects used oral hypoglycemic agents or insulin.

RESEARCH DESIGN AND METHODS—RBP-4 was determined by enzyme-linked immunosorbent assay in control subjects (n = 59) and CD patients (n = 58) and correlated with clinical and biochemical measures of renal function, glucose and lipid metabolism, and inflammation in both groups.

RESULTS—Mean serum RBP-4 levels were almost fourfold higher in CD patients (102 ± 30 mg/l) compared with control subjects (28 ± 8 mg/l). Furthermore, serum creatinine independently predicted RBP-4 concentrations in multiple regression analyses in both control subjects and CD patients. In addition, C-reactive protein and systolic blood pressure independently and negatively correlated with RBP-4 serum concentrations in CD patients but not control subjects. In contrast, markers of glucose and lipid metabolism were not independently related to serum RBP-4 in control subjects or CD patients.

CONCLUSIONS—We show that markers of renal function are independently related to serum RBP-4 levels.

Abbreviations: CD, chronic hemodialysis • CRP, C-reactive protein • FFA, free fatty acid • GFR, glomerular filtration rate • HOMA-IR, homeostasis model assessment of insulin resistance • IGT, impaired glucose tolerance • RBP, retinol-binding protein • WHR, waist-to-hip ratio

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