scholarly journals Retinol-Binding Protein 4 and Its Relation to Insulin Resistance in Obese Children before and after Weight Loss

2008 ◽  
Vol 93 (6) ◽  
pp. 2287-2293 ◽  
Author(s):  
Thomas Reinehr ◽  
Birgit Stoffel-Wagner ◽  
Christian L. Roth
Keyword(s):  
Insulin Resistance ◽  
Body Mass Index ◽  
Weight Loss ◽  
Body Mass ◽  
Weight Status ◽  
Retinol Binding Protein ◽  
Homa Index ◽  
Obese Children ◽  
Retinol Binding Protein 4 ◽  
Lean Children

Abstract Context: There are limited and controversial data concerning the relationships between retinol-binding protein 4 (RBP4), weight status, and insulin resistance in obese humans and especially in children. Objective: Our objective was to study the longitudinal relationships among RBP4, insulin resistance and weight status in obese children. Design, Setting, and Patients: We conducted a 1-yr longitudinal follow-up study in a primary-care setting with 43 obese children (median age 10.8 yr) and 19 lean children of same the age and gender. Intervention: Our outpatient 1-yr intervention program was based on exercise, behavior, and nutrition therapy. Main Outcomes Measures: Changes of weight status (body mass index sd score), RBP4, molar RBP4/serum retinol (SR) ratio, insulin resistance index homeostasis model assessment (HOMA), and quantitative insulin sensitivity check index (QUICKI). Results: Obese children had significantly (P < 0.01) higher RBP4 concentrations and a higher RBP4/SR ratio compared with lean children. In multiple linear regression analyses adjusted to age, gender, and pubertal stage, RBP4 was significantly correlated to insulin and body mass index. Pubertal children demonstrated significantly decreased QUICKI and significantly increased HOMA index, insulin, and RBP4 concentrations compared with prepubertal children. Changes of RBP4 correlated significantly to changes of insulin (r = 0.29), HOMA index (r = 0.29), QUICKI (r = 0.22), and weight status (r = 0.31). Substantial weight loss in 25 children led to a significant (P < 0.001) decrease of RBP4, RBP4/SR, blood pressure, triglycerides, insulin, and HOMA index and an increase in QUICKI in contrast to the 18 children without substantial weight loss. Conclusion: RBP4 levels were related to weight status and insulin resistance in both cross-sectional and longitudinal analyses, suggesting a relationship between RBP4, obesity, and insulin resistance in children.

scholarly journals Visceral Adipose Tissue was Associated with Increased Risk of Insulin Resistance in Lean Polycystic Ovarian Syndrome, Independent with Retinol Binding Protein-4

2020 ◽  
pp. 168-173
Author(s):  
Vita Silvana ◽  
Andon Hestiantoro ◽  
Muharam Natadisastra ◽  
Kanadi Sumapraja ◽  
Budi Wiweko
Keyword(s):  
Insulin Resistance ◽  
Body Mass Index ◽  
Adipose Tissue ◽  
Body Mass ◽  
Visceral Adipose Tissue ◽  
Binding Protein ◽  
Retinol Binding Protein ◽  
Receiver Operating Curve ◽  
Retinol Binding Protein 4 ◽  
Visceral Adipose

Objective: To determine whether visceral adipose tissue or serum RBP-4 were related with the risk increment of insulin resistance in normal BMI PCOS patients. Methods: This was a cross-sectional study conducted in normal body mass index PCOS patients at Yasmin Clinic, RSCM, Jakarta from July 2014 until March 2015. Diagnosis of PCOS was established using Rotterrdam (2003) criteria. Insulin resistance was confirmed by using ratio of HOMA-IR >1.4. Results: Among 40 subjects, 20 subjects (50%) belong insulin resistance group. Serum RBP-4 level was higher in insulin resistance group (p=0.06). After ROC analysis was conducted, area under curve for of serum RBP-4 was 69.9% (CI 95% -3754.77 - (186.60-7696.14, p=0.061)). Cut-off level of serum RBP-4 was 23814.5 ng/mL yielded sensitivity and specificity to a level of 60% and 60%, respectively. After logistic regression were analyzed, visceral adipose tissue demonstrated substantial association with the risk increment of insulin resistance in normal BMI PCOS patients. Conclusions: Visceral adipose tissue demonstrated substantial association with the risk increment of insulin resistance in normal BMI PCOS patients, independent with serum RBP-4 levels. Key words: body mass index, diagnosis, insulin resistance, PCOS, retinol binding protein-4   Abstrak Tujuan: Untuk menentukan apakah jaringan adiposa viseral atau serum RBP-4 berhubungan dengan peningkatan risiko resistensi insulin pada Sindrom Ovarium Polikistik dengan indeks masa tubuh normal. Metode: Studi potong lintang dilakukan pada subjek SOPK dengan IMT normal di Klinik Yasmin, RSCM, Jakarta sejak Juli 2014 sampai dengan Maret 2015. Penegakan diagnosis SOPK dilakukan dengan kriteria Rotterdam (2003). Resistensi insulin dikonfirmasi dengan pemeriksaan rasio HOMA-IR > 1.4 Hasil: Diantara 40 subjek, sebanyak 20 subjek (50%) mengalami resistensi insulin. Kadar serum RBP-4 lebih tinggi pada kelompok resistensi insulin (p=0.06). Setelah dilakukan analisis Receiver Operating Curve (ROC), serum RBP-4 memiliki Area Under the Curve  (AUC) sebesar 69.9% (IK 95% -3754.77 - (186.60-7696.14, p=0,061)). Titik potong kadar serum RBP-4 adalah 23814.5 ng/mL dengan sensitivitas dan spesifisitas masing-masing 60% dan 60%. Setelah dilakukan analisis regresi logistik, jaringan adiposa viseral menunjukan asosiasi yang kuat dengan terjadinya resistensi insulin pada pasien SOPK dengan IMT normal. Kesimpulan: Jaringan adiposa viseral menunjukan asosiasi yang kuat dengan terjadinya resistensi insulin pada SOPK dengan IMT normal, independen terhadap kadar serum RBP-4. Kata kunci: diagnosis, indeks masa tubuh, resistensi insulin, retinol binding protein-4, SOPK

scholarly journals Subclinical left ventricular disfunction in obese children: are we late?

2020 ◽  
Author(s):  
B Riaño-Mendez ◽  
M Ruiz del Campo ◽  
P Garcia-Navas ◽  
CM Amiama-Perez de Villarreal ◽  
MY Ruiz del Prado
Keyword(s):  
Insulin Resistance ◽  
Body Mass Index ◽  
Body Mass ◽  
Systolic Function ◽  
Left Ventricular ◽  
Function Evaluation ◽  
Obese Children ◽  
Global Strain ◽  
Cardiovascular Evaluation ◽  
Control Study

ABSTRACTAimLongitudinal global strain (LGS) is reduced in obese patients with normal ejection fraction of the left ventricle. TAPSE/PAPS ratio, recently described, may be a step forward a more efficient RV function evaluation.There are still few publications in the application of these methods in pediatric patients.MethodsThis case-control study compared 104 children aged 5-18 years between October 2017 and February 2019, 52 obese children with body mass index (BMI) > +2 SD, and 52 matched controls.They were screened for other cardiovascular risk factors like insulin resistance or hypercholesterolemia. A complete echocardiography including standard and functional parameters was performed.ResultsWe found that obese children presented poor systolic function (LGS −15,90 ± 3,84 %) in comparison with non-obese children (−19,44 ± 5,75 %, p=0,001). LGS correlated positively with body mass index (BMI).Standard echocardiography also revealed cardiomegaly and hypertrophy.TAPSE/PASP ratio correlated negatively with triglycerides levels (β −0,402, p=0,014). Diastolic function was poor in those with HOMA-IR (β −0,375, p=0,016) and hypertriglyceridemia (β −0,375 p=0,024).ConclusionWe think that is necessary to perform a standarised cardiovascular evaluation in obese children for early identification of subclinical dysfunction especially in those with insulin resistance and dyslipidemia

scholarly journals Retinol-Binding Protein 4 and Lipocalin-2 in Childhood and Adolescent Obesity: When Children Are Not Just “Small Adults”

2008 ◽  
Vol 54 (7) ◽  
pp. 1176-1182 ◽  
Author(s):  
Christina Kanaka-Gantenbein ◽  
Alexandra Margeli ◽  
Panagiota Pervanidou ◽  
Sophia Sakka ◽  
George Mastorakos ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Binding Protein ◽  
Assessment Model ◽  
Retinol Binding Protein ◽  
Morbidly Obese ◽  
Homa Index ◽  
Lipocalin 2 ◽  
Obese Adults ◽  
Retinol Binding Protein 4 ◽  
Hs Crp

Abstract Background: Although there is much evidence regarding the physiologic and pathogenic roles of the newly described adipokines retinol-binding protein 4 (RBP4) and lipocalin-2 as potential promoters of insulin resistance in obese adults, relatively little information exists regarding their roles in obese children. Methods: We investigated the circulating concentrations of RBP4 and lipocalin-2 in 80 obese girls (ages 9– 15 years) and their relationships with high-sensitivity C-reactive protein (hs-CRP) and the adipokines leptin and adiponectin. We divided participants by their body mass index standard deviation scores (BMI SDSs) into 4 groups of 20 girls each: overweight [mean BMI SDS (SD), 1.8 (0.4)], obese [2.2 (0.4)], morbidly obese [3.6 (0.4)], and lean controls [−0.11 (0.4)]. We measured plasma-soluble RBP4, the RBP4-binding protein transthyretin, lipocalin-2, hs-CRP, leptin, and adiponectin and calculated the homeostatic assessment model (HOMA) index from fasting glucose and insulin concentrations. Results: Unexpectedly, plasma RBP4 and lipocalin-2 concentrations were correlated negatively with BMI SDS values (P = 0.005, and P < 0.03, respectively). These results were different from those of adults and were not correlated with the HOMA index. In contrast, hs-CRP and leptin concentrations were positively correlated with BMI SDS values (P < 0.0001, and P < 0.00001, respectively), as expected, whereas the adiponectin concentration was negatively correlated (P = 0.008). Conclusions: Although the correlations of leptin, adiponectin, and hs-CRP concentrations with BMI in children are similar to those of adults, the correlations of RBP4 and lipocalin-2 with BMI in children are the inverse of those observed in adults. Thus, although systemic inflammation and mild insulin resistance are present in childhood obesity, RBP4 and lipocalin-2 concentrations are not increased in children as they are in obese adults with long-standing severe insulin resistance and type 2 diabetes.

scholarly journals Serum Retinol-Binding Protein 4 Is Reduced after Weight Loss in Morbidly Obese Subjects

2007 ◽  
Vol 92 (3) ◽  
pp. 1168-1171 ◽  
Author(s):  
Dominik G. Haider ◽  
Karin Schindler ◽  
Gerhard Prager ◽  
Arthur Bohdjalian ◽  
Anton Luger ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Weight Loss ◽  
Gastric Banding ◽  
Binding Protein ◽  
Retinol Binding Protein ◽  
Morbidly Obese ◽  
Model Assessment ◽  
Serum Concentrations ◽  
Retinol Binding Protein 4 ◽  
Obese Subjects

Abstract Context: Administration of retinol-binding protein 4 (RBP-4) impairs insulin sensitivity in animals, and elevated serum concentrations have been associated with insulin resistance in humans. Objective: We have studied whether weight loss influences RBP-4. Patients and Methods: Fasting serum concentrations of RBP-4 were measured before and 6 months after gastric banding surgery in 33 morbidly obese patients aged 40 ± 11 yr with a body mass index (BMI) of 46 ± 5 kg/m2. Fourteen healthy subjects aged 29 ± 5 yr with a BMI less than 25 kg/m2 served as controls. To characterize the association of weight loss with central and peripheral appetite regulation, the signaling protein agouti-related protein (AGRP), the orexigenic hormone ghrelin, and its recently identified antagonist obestatin were determined. Results: At baseline, RBP-4 levels were markedly higher in obese than in lean subjects (2.7 ± 0.5 vs. 0.9 ± 0.5 μg/ml; P < 0.001). In contrast, AGRP and obestatin were lower in obese subjects compared with lean controls (all P < 0.001). Six months after gastric banding, BMI was reduced to 40 ± 5 kg/m2, RBP-4 was reduced to 2.0 ± 0.7 μg/ml, AGRP increased from 1.8 ± 1.1 to 3.4 ± 1.1 ng/ml, ghrelin increased from 93 ± 58 to 131 ± 70 pg/ml, and obestatin increased from 131 ± 52 to 173 ± 35 pg/ml (all P < 0.05). Individual changes of RBP-4 were associated with changes of BMI (r = 0.72), the homeostasis model assessment insulin resistance-index (r = 0.53), and total cholesterol (r = 0.42, for all P < 0.05). Conclusion: Reductions in circulating RBP-4 may contribute to improved insulin resistance in morbidly obese subjects after weight loss. This is accompanied by favorable changes in appetite-regulating hormones, which might support the sustained weight loss after obesity surgery.

scholarly journals Fetuin-A and Its Relation to Metabolic Syndrome and Fatty Liver Disease in Obese Children Before and After Weight Loss

2008 ◽  
Vol 93 (11) ◽  
pp. 4479-4485 ◽  
Author(s):  
Thomas Reinehr ◽  
Christian L. Roth
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Weight Loss ◽  
Fatty Liver Disease ◽  
Weight Status ◽  
Resistance Index ◽  
Obese Children ◽  
Fetuin A ◽  
Insulin Resistance Index

Context: There are very limited data available concerning the relationships between fetuin-A, weight status, nonalcoholic fatty liver disease (NAFLD), and features of the metabolic syndrome (MetS) in obese humans, and especially in children. Objective: Our objective was to study the longitudinal relationships between fetuin-A, NAFLD, and MetS in obese children. Design: This was a 1-yr longitudinal follow-up study. Setting: This study was performed in primary care. Patients: A total of 36 obese and 14 lean children was included in the study. Intervention: An outpatient 1-yr intervention program based on exercise, behavior, and nutrition therapy was performed. Main Outcome Measures: Changes of weight status (sd score-body mass index), waist circumference, fetuin-A, blood pressure, lipids, transaminases, insulin resistance index homeostasis model assessment (HOMA), and prevalence of NAFLD (defined by liver ultrasound) were calculated. Results: The 12 obese children with NAFLD had significantly higher fetuin-A levels (0.35 ± 0.07 g/liter) than the 24 obese children without NAFLD (0.29 ± 0.06 g/liter) and the 14 normal weight children (0.29 ± 0.05 g/liter). Fetuin-A levels were independent of age, pubertal stage, and gender. Fetuin-A correlated significantly to systolic (r = 0.50) and diastolic blood pressure (r = 0.41), insulin resistance index HOMA (r = 0.28), and high-density lipoprotein-cholesterol (r = −0.31). Changes of fetuin-A correlated significantly to changes of insulin resistance index HOMA (r = 0.34), systolic (r = 0.31) and diastolic blood pressure (r = 0.37), and waist circumferences (r = 0.36). Substantial weight loss in 21 children led to a significant decrease of fetuin-A and the prevalence of NAFLD in contrast to the 15 children without substantial weight loss. Conclusions: Fetuin-A levels were higher in children with NAFLD, and were related to insulin resistance and to features of the MetS in both cross-sectional and longitudinal analyses. Therefore, fetuin-A might be a new promising link between obesity and its comorbidities.

scholarly journals Insulin Resistance Is Unrelated to Circulating Retinol Binding Protein and Protein C Inhibitor

2007 ◽  
Vol 92 (11) ◽  
pp. 4306-4312 ◽  
Author(s):  
Miriam Promintzer ◽  
Michael Krebs ◽  
Jelena Todoric ◽  
Anton Luger ◽  
Martin Georg Bischof ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Mass Index ◽  
Insulin Sensitivity ◽  
Body Mass ◽  
Protein C ◽  
Binding Protein ◽  
Retinol Binding Protein ◽  
Insulin Resistant ◽  
Protein C Inhibitor ◽  
Active Antigen

Abstract Context: Recent data suggest that circulating retinol-binding protein (RBP) might be involved in the pathogenesis of insulin resistance. Moreover, protein C inhibitor (PCI), which specifically binds retinoic acid, was found to be increased in myocardial infarction survivors who are also insulin resistant. Objective: The objective of this study was to investigate the association of insulin resistance with RBP factors and PCI active antigen. Design and Setting: This was a clinical study. Patients: Nondiabetic humans with high (IS; n = 20, 14 females, six males, aged 47.2 ± 1.9 yr, body mass index 26 ± 1 kg/m2) and low (IR; n = 20, 14 females, six males, aged 45.5 ± 1.7 yr, body mass index 28 ± 1 kg/m2) insulin-stimulated glucose-disposal (M) participated in this study. Main Outcome Measures: M was measured by 2-h hyperinsulinemic (40 mU·min−1·m−2)-isoglycemic clamp tests. Measurements of RBP were performed using a nephelometric method and validated using quantitative Western blotting. Results: M (80–120 min) was higher in IS (10.9 ± 0.6 mg·min−1·kg−1) than IR (4.0 ± 0.2; P < 10−12). Fasting plasma RBP concentrations were comparable between IS and IR measured by both nephelometry (IS: 4.4 ± 0.3; IR: 4.6 ± 0.3 mg/dl, P = 0.6) and quantitative Western blot (IS 7.9 ± 0.5, IR 8.3 ± 0.6 mg/dl; P = 0.6). Fasting plasma PCI active antigen was similar in both groups. Plasma RBP and PCI were not significantly related to M. RBP was positively correlated with uric acid (r = 0.488, P = 0.003), triglycerides (r = 0.592, P < 0.001), prealbumin (r = 0.63, P < 0.0001), and vitamin A (r = 0.75, P < 10−6). Conclusions: Our data demonstrate that healthy, insulin-resistant humans do not show altered plasma retinol binding factors, such as RBP and PCI. Both do not significantly correlate with insulin sensitivity. Thus, our findings do not support the hypothesis of insulin sensitivity modulation by proteins involved in retinol transport.

scholarly journals Obesity, insulin resistance and their interaction on liver enzymes

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249299
Author(s):  
Chenbing Liu ◽  
Min Shao ◽  
Ling Lu ◽  
Chenzhao Zhao ◽  
Lihong Qiu ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Mass Index ◽  
Body Mass ◽  
Weight Status ◽  
Liver Enzymes ◽  
Linear Regression Analysis ◽  
Fasting Blood Glucose ◽  
Normal Weight ◽  
Chinese Adults ◽  
Glutamyl Transferase

Introduction To investigate weight status, insulin resistance assessed by HOMA-IR, and their interaction on liver function in non-diabetic Chinese adults. Methods and results A total of 7066 subjects were included, and divided into normal weight (n = 3447), overweight (n = 2801), and obese (n = 818) groups. Data including weight, height, waist circumference, fasting blood glucose, fasting insulin, total cholesterol, triglycerides, y-glutamyl transferase (GGT), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were acquired. In multi-linear regression analysis for liver enzymes as dependent variables, insulin resistance emerged as a determinant of ALT (β = 0.165, P<0.001), AST (β = 0.040, P<0.001) and GGT (β = 0.170, P<0.001) after adjusting for age, sex, body mass index, triglyceride, and cholesterol. Interactions between insulin resistance and weight status by body mass index were observed in ALT (P<0.001), AST (P<0.001) and GGT (P = 0.0418). Conclusion Insulin resistance had significant associations with greater risk of elevated ALT, AST and GGT level in non-diabetic Chinese adults, especially among those who were overweight/ obese.

scholarly journals Correlation between Body Mass Index and Homa Index in Bariatric Patients

2019 ◽  
Vol 26 (1) ◽  
pp. 31-38
Author(s):  
Paula Dejeu ◽  
Viorel Dejeu ◽  
Dănuț Dejeu ◽  
Bembea Marius
Keyword(s):  
Insulin Resistance ◽  
Bariatric Surgery ◽  
Body Mass Index ◽  
Body Mass ◽  
The Body ◽  
Model Assessment ◽  
Homa Index ◽  
Homeostasis Model Assessment ◽  
Bariatric Patients ◽  
Gastric By Pass

Abstract Background and aims: Overweight and obese individuals are prone to an insulin resistance status assessed in the present study by the HOMA index ("Homeostasis model assessment"). This prospective study assessed the body mass index (BMI) and the insulin resistance status (HOMA index) in obese patients after bariatric surgery (gastric sleeve, gastric by-pass). Material and Methods: The study included 48 patients who were assessed before the bariatric surgery and at 6 months thereafter. The assessment included the body mass index (BMI) and the HOMA index before meal. Results: There was a significant positive correlation between BMI and HOMA index, mostly between weight loss and improvement in insulin resistance status (rho = 0.308, p = 0.0335). Conclusions: BMI decreases significantly after bariatric surgery, which correlates positively with an improvement in insulin resistance status.

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