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. 2009 Jan;154(1):67-73.e1.
doi: 10.1016/j.jpeds.2008.07.018. Epub 2008 Sep 10.

The relationship of retinol binding protein 4 to changes in insulin resistance and cardiometabolic risk in overweight black adolescents

Elizabeth Goodman  1 , Timothy E Graham, Lawrence M Dolan, Stephen R Daniels, Eric R Goodman, Barbara B Kahn
Affiliations

The relationship of retinol binding protein 4 to changes in insulin resistance and cardiometabolic risk in overweight black adolescents

Elizabeth Goodman et al. J Pediatr. 2009 Jan.

Abstract

Objective: To assess, among overweight non-hispanic black adolescents the relationship of changes in plasma retinol binding protein 4 (RBP4) over 3 years to changes in insulin resistance (IR) and 4 associated cardiometabolic risks.

Study design: Nested, retrospective study of 51 overweight, post-pubertal non-Hispanic black participants in the Princeton School District Study. Participants were in the top (worsening IR) or bottom (improved IR) quartile for 3-year change in IR. RBP4 was measured by quantitative Western blot with frozen plasma. Regression analyses adjusted for age, sex, and adiposity (baseline and change). Three measures of adiposity were assessed (waist circumference, body mass index, and weight) in separate regression models.

Results: RBP4 increased in one third (n = 17). In logistic regression analyses, increased RBP4 was associated with significantly higher odds of worsening as opposed to improved IR independent of age, sex, or adiposity. Odds ratios were 5.6 (weight, P = .024), 6.0 (BMI, P = .025) and 7.4 (waist circumference, P = .015). Initial RBP4 (beta = 0.81, P = .005) and change in RBP4 (beta = 0.56, P = .046) also predicted change in triglycerides, but not change in high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, or fibrinogen.

Conclusion: This retrospective cohort study provides evidence that RBP4 may be a mechanism through which obesity influences insulin resistance and hypertriglyceridemia in overweight postpubertal black youth and suggests utility of RBP4 as a biomarker of risk.

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Figures

Figure 1
Figure 1
Influence of change in RBP4 on change in HOMA-IR is dependent on initial RBP4 level in overweight black youth. Panel A=Relationship of change in RBP4 to change in HOMA-IR without adjusting for the influence of initial RBP4 level. Panel B= Relationship of change in RBP4 to change in HOMA-IR adjusting for the influence of initial RBP4 concentration by stratification into initial RBP4 tertiles. Grey line, open circle= High baseline RBP4 (top tertile initial RBP4 concentration). Black line, closed circle = Lower initial RBP4 (bottom two tertiles of initial RBP4 concentration
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