Retinol binding protein 4, obesity, and insulin resistance in adolescents

  • Ronaldi Noor Departmen of Child Health, Andalas University Medical School, Padang, West Sumatera
  • Eka Agustria Rini Departmen of Child Health, Andalas University Medical School, Padang, West Sumatera
  • Eti Yerizel Departmen of Child Health, Andalas University Medical School, Padang, West Sumatera
Keywords: obesity, retinol binding protein 4, RBP4, insulin resistance, HOMA-IR

Abstract

Background Obesity is a global problem. Even in poor and developing countries, obesity has reached alarming levels. In childhood, obesity may lead to insulin resistance. Retinol binding protein (RBP4), secreted primarily by liver and adipose tissues, was recently proposed as a link between obesity and insulin resistance. The role of RBP4 in pediatric obesity and its relationship with insulin resistance have not been well elucidated.

Objective To compare RBP4 levels in obese and lean adolescents and to assess for a relationship between RBP4 levels and insulin resistance.

Method This cross-sectional study was conducted in three senior high schools in Padang, West Sumatera, Indonesia. Subjects were adolescents aged 14-18 years, who were obese or normal weight (n=56). We measured subjects’ body mass index (BMI) and serum RBP4 concentrations. Insulin resistance was assessed using the homeostasis model assessment of insulin resistance (HOMA-IR) index.

Results Similar RBP4 levels were found in the obese and normoweight groups (P>0.05). Higher RBP4 levels were found in the insulin resistant compared to the non-insulin resistant group, but the difference was not significant (P > 0.05).

Conclusion There is no significant difference in mean RBP4 levels in obese adolescents compared to normoweight adolescents. Nor are mean RBP4 levels significantly different between obese adolescents with and without insulin resistance. 

 

References

WHO Global Strategy on Diet, Physical Activity & Health. Childhood overweight and obesity. 2013. [cited 2014, September 12]. Available from: http://www.who.int/dietphysicalactivity/childhood/en/.

Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics. 2012 Update. Circulation. 2012;125:e2-220. https://doi.org/10.1161/CIR.0b013e31823ac046

Lailani D, Hakimi. Pertumbuhan fisik anak obesitas. Sari Pediatri. 2003;5:99-102. https://doi.org/10.14238/sp5.3.2003.99-102

Aycan Z. Obesity in childhood: definition and epidemiology. J Clin Res Ped Endo. 2009;1:44-53. https://doi.org/10.4008/jcrpe.v1i1.25

Lloyd LJ, Langley-Evans SC, McMullen S. Childhood obesity and risk of the adult metabolic syndrome: a systematic review. Int J Obes. 2012;36:1-11. https://doi.org/10.1038/ijo.2011.186

Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public-health crisis, common sense cure. Lancet. 2002;360:473-82. https://doi.org/10.1016/S0140-6736(02)09678-2

Choi SH, Hong ES, Lim S. Clinical implications of adipocytokines and newly emerging metabolic factors with relation to insulin resistance and cardiovascular health. Front Endocrinol. 2013;4:97. https://doi.org/10.3389/fendo.2013.00097

Kotnik P, Fischer-Posovsky P, Wabitsch M. RBP4: a controversial adipokine. Eur J Endocrinol. 2011;165:703-11. https://doi.org/10.1530/EJE-11-0431

Keskin M, Kurtoglu S, Kendirci M, Atabek ME, Yazici C. Homeostasis Model Assessment Is More Reliable Than the Fasting Glucose/Insulin Ratio and Quantitative Insulin Sensitivity Check Index for Assessing Insulin Resistance Among Obese Children and Adolescents. Pediatrics 2005;115:500-3. https://doi.org/10.1542/peds.2004-1921

Steinberger J, Daniels SR. Obesity, insulin resistance, diabetes, and cardiovascular risk in children: an American Heart Association scientific statement from the Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and the Diabetes Committee 9Council on Nutrition, Physical Activity, and Metabolism). Circulation. 2003;107:1448-53. https://doi.org/10.1161/01.CIR.0000060923.07573.F2

Ziegelmeier M, Bachmann A, Seeger J, Lossner U, Kratzsch J, Bluher M, et al. Serum levels of adipokine retinol-binding protein-4 in relation to renal function. Diabetes Care. 2007;30:2588–92. https://doi.org/10.2337/dc07-0275

Marcovecchio LM, Mohn A, Chiarelli F. Obesity and insulin resistance in children. J Pediatr Gastroenterol Nutr. 2010;51:149-50. https://doi.org/10.1097/MPG.0b013e3181f853f9

Graham TE, Yang Q, Bluher M, Hammarstedt A, Ciarldi TP, Henry RR, et al. Retinol-binding protein 4 and insulin resistance in lean, obese, and diabetic subjects. New Engl J Med. 2006;354:2552-63. https://doi.org/10.1056/NEJMoa054862

Aeberli I, Biebinger R, Lehmann R, L'allemand D, Spinas GA, Zimmermann MB. Serum retinol-binding protein 4 concentration and its ratio to serum retinol are associated with obesity and metabolic syndrome components in children. J Clin Endocrinol Metab. 2007:92:4359–65. https://doi.org/10.1210/jc.2007-0468

Reinehr T, Stoffel-Wagner B, Roth CL. Retinol-binding protein 4 and its relation to insulin resistance in obese children before and after weight loss. J Clin Endocrinol Metab. 2008;93:2287-93. https://doi.org/10.1210/jc.2007-2745

Kanaka-Gantenbein C, Margeli A, Pervanidou P, Sakka S, Mastorakos G, Chrousos GP et al. Retinol-binding protein 4 and lipocalin-2 in childhood and adolescent obesity: when children are not just "small adults". Clini Chem. 2008;54:1176-82. https://doi.org/10.1373/clinchem.2007.099002

Janke J, Engeli S, Boschmann M, Adams F, Bohnke J, Luft FC, et al. Retinol-binding protein 4 in human obesity. Diabetes. 2006;55:2805-10. https://doi.org/10.2337/db06-0616

Tanumihardjo SA. Biomarkers of vitamin A status: what do they mean? In: World Health Organization. Report: Priorities in the assessment of vitamin A and iron status in populations; 2010 September 15–17; Panama City, Panama. Geneva: World Health Organization; 2012.

Fernandez-Real, JM, Moreno JM, Ricart W. Circulating retinol-binding protein-4 concentration might reflect insulin resistance–associated iron overload. Diabetes. 2008;57:1918-25. https://doi.org/10.2337/db08-0041

Published
2017-02-28
How to Cite
1.
Noor R, Rini E, Yerizel E. Retinol binding protein 4, obesity, and insulin resistance in adolescents. PI [Internet]. 28Feb.2017 [cited 24Nov.2024];57(1):1-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/702
Section
Articles
Received 2016-09-26
Accepted 2017-01-18
Published 2017-02-28