High Plasma Retinol-Binding Protein 4 Levels as Risk Factor of Type 2 Diabetes Mellitus in Abdominal Obesity

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Anak Agung Gede Budhitresna
Ketut Suastika
Anak Agung Gede Budhiarta
Anwar Santoso


Background. Abdominal obesity is a risk factor for cardiovascular disease and type 2 diabetes mellitus (T2DM). Plasma retinol-binding protein 4 (RBP4) levels have been reported to increase in the abdominally obese subjects and it has been hypothesized that high plasma protein levels were considered to play an important role in the occurrence of T2DM.


Objective. We assessed the value of high plasma RBP4 levels as risk factor of T2DM in abdominally obese subjects.


Methodology. A case-control study, nested within a cross-sectional study, on 81 abdominally obese subjects was performed. We studied 33 patients with T2DM, compared with 33 matched controls. The plasma RBP4 levels were measured by ELISA. Insulin resistance (IR) status of the patients were determined using HOMA-IR; β-cell function was determined using HOMA-B. Analysis of variance (ANOVA) was used to test the equality of continuous variables. Forward conditional logistic regression analyses were performed to examine the odds ratios (OR) between high plasma RBP4 levels and consequent T2DM. Path analyses models were performed to assess the influence of risk factors on occurrence of T2DM.


Result. Plasma RBP4 levels were significantly increased, while HOMA-B was significantly lower in cases with respect to controls. In analyses adjusted for multiple T2DM risk factors, we observed positive association with high plasma RBP4 levels 9.74 (CI 95%; 2.03 – 46.67) (p = 0.004). It has been proven that high RBP4 level was a dominant risk factor (66.9%, p = < 0.001) influencing incidence of T2DM in the abdominally obese subjects.


Conclusion. The present study confirmed that high plasma RBP4 level is associated with increased incident T2DM in the abdominally obese subjects, and suggested that RBP4 has a major effect in the development of T2DM.


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Gede Budhitresna, A. A., Suastika, K., Gede Budhiarta, A. A., & Santoso, A. (2014). High Plasma Retinol-Binding Protein 4 Levels as Risk Factor of Type 2 Diabetes Mellitus in Abdominal Obesity. Journal of the ASEAN Federation of Endocrine Societies, 28(2), 129. Retrieved from https://asean-endocrinejournal.org/index.php/JAFES/article/view/66
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