Retinol binding protein 4 and incident diabetes
					– the Atherosclerosis Risk in Communities Study (ARIC
					Study)

Luft, Vivian C.; Pereira, Mark; Pankow, James S.; Ballantyne, Christie; Couper, David; Heiss, Gerardo; Duncan, Bruce B.

doi:10.1590/S1415-790X2013000200014

Acessibilidade / Reportar erro

Brasil

Revista Brasileira de Epidemiologia

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Artigos Originais • Rev. bras. epidemiol. 16 (2) • June 2013 • https://doi.org/10.1590/S1415-790X2013000200014 copy

Retinol binding protein 4 and incident diabetes – the Atherosclerosis Risk in Communities Study (ARIC Study)

Proteína carreadora de retinol 4 e diabetes incidente – Atherosclerosis Risk in Communities Study (ARIC Study)

Authorship SCIMAGO INSTITUTIONS RANKINGS

Background:

Retinol binding protein 4 (RBP4) has been described as a link between impaired glucose uptake in adipocytes and systemic insulin sensitivity.

Objective:

To determine whether RBP4 fasting levels predict the development of type 2 diabetes.

Methods:

Using a case-cohort design, we followed 543 middle-aged individuals who developed diabetes and 537 who did not over ~9 years within the population-based Atherosclerosis Risk in Communities Study. Weighted Cox proportional hazards analyses permitted statistical inference of the RBP4 – incident diabetes associations to the entire cohort.

Results:

Women in the highest tertile of RBP4 presented greater risk of developing diabetes (HR = 1.74; 95%CI 1.03 – 2.94) in analyses adjusted for age, ethnicity, study center, parental history of diabetes, hypertension, glomerular filtration rate, body mass index, waist-hip ratio, nonesterified fatty acids, adiponectin, leptin, triglycerides and HDL-C. When additionally adjusted for fasting insulin, this association’s significance became borderline (HR = 1.68; 95%CI 1.00 – 2.82). No association between RBP4 levels and incident diabetes was found in men.

Conclusion:

These findings suggest that RBP4 levels may be directly involved in the pathogenesis of type 2 diabetes in women.

Diabetes; Retinol-Binding Proteins; RBP4 protein, human; Epidemiologic Studies

Associação Brasileira de Saúde Coletiva Av. Dr. Arnaldo, 715 - 2º andar - sl. 3 - Cerqueira César, 01246-904 São Paulo SP Brasil , Tel./FAX: +55 11 3085-5411 - São Paulo - SP - Brazil
E-mail: revbrepi@usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author: Vivian C. Luft. Programa de Pós-graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2.400, 90035-003 Porto Alegre, RS, Brazil. E-mail: vivi_luft@yahoo.com.br

	Overall	White Women (n=206 )	African-American Women (n=208)	White Men (n=131)	African-American Men (n=85)
	r	R	r	r	r
Possible confounders
Age (years)	0.20	0.34	0.19	-0.01	0.06
Usual ethanol intake (g/wk)	0.16	0.00	0.05	0.12	0.38
N cigarettes per day * N years of smoking	0.15	0.08	0.16	-0.04	0.09
Body mass index (kg/m 22. World Health Organization. Preventing chronic diseases: a vital investment . Geneva; 2005. )	0.05	0.10	0.05	-0.05	-0.13
Waist (cm)	0.14	0.14	0.09	0.05	-0.08
Waist-to-hip ratio	0.26	0.21	0.12	0.07	0.19
Creatinine (mg/dL)	0.34	0.20	0.37	0.23	0.07
GFR (mL/min per 1.73m 22. World Health Organization. Preventing chronic diseases: a vital investment . Geneva; 2005. )	-0.21	-0.26	-0.38	-0.21	-0.12
Inflammation markers and adipokines
C-reactive protein (mg/mL)	-0.03	0.13	0.03	-0.26	-0.10
IL-6 (pg/mL)	-0.09	-0.01	-0.07	-0.27	-0.10
Fibrinogen (μmol/L)	-0.05	0.04	0.06	-0.12	-0.07
Orosomucoid (mg/dL)	0.13	0.13	0.25	0.09	0.28
Sialic acid (mg/dL)	0.15	0.21	0.11	0.18	-0.08
White blood count (10 99. Duncan BB, Schmidt MI, Pankow J, Bang H, Couper D, Ballantyne CM et al. Adiponectin and the developmen.t of type 2 diabetes - the ARIC Study. Diabetes 2004; 53: 2473-8. /L)	0.09	0.05	0.12	0.03	0.12
Complement component 3 (mg/dL)	0.08	0.20	0.17	0.01	-0.01
Adiponectin (ug/mL)	-0.15	-0.05	-0.04	-0.10	-0.20
Leptin (ng/mL)	-0.13	0.17	0.00	0.06	0.00
Other metabolic variables
Non-esterified fatty acids (mEq/L)	0.10	0.24	0.05	0.12	0.25
Triglycerides (mmol/L)	0.37	0.34	0.32	0.34	0.25
HDL-cholesterol (mg/dL)	-0.08	0.09	-0.04	-0.04	0.11
Systolic blood pressure (mmHg)	0.13	0.18	0.00	0.06	0.17
Diastolic blood pressure (mmHg)	0.08	0.07	-0.02	0.00	0.29
Fasting insulin (μU/mL)	0.08	0.18	0.08	0.03	-0.07
HOMA-IR	0.09	0.19	0.10	0.04	-0.05
Fasting glucose (mg/dL)	0.12	0.11	0.13	0.04	0.09

		Minimal adjustment		Full adjustment
		Mean (95%CI), g/mL	p value	Mean (95%CI), g/mL	p value
Gender	Female	27.8 (27.0 – 28.7)	<0.01	27.8 (27.1 – 28.6)	<0.01
	Male	32.3 (31.2 – 33.3)		32.3 (31.2 – 33.5)
Ethnicity	African-American	29.2 (28.1 – 30.3)	0.73	30.9 (29.5 – 32.2)	0.03
	White	29.5 (28.7 – 30.2)		29.1 (28.5 – 29.8)
Age	45–54 years	26.7 (24.7 – 28.7)	<0.01	29.9 (28.1 – 31.7)	0.58
	55–64 years	28.7 (27.9 – 29.5)		29.6 (28.9 – 30.3)
Ethanol (4^th quartile)^a	Yes	31.2 (29.7 – 32.8)	<0.01	30.6 (29.2 – 31.9)	0.06
	No	28.9 (28.1 – 29.6)		29.1 (28.5 – 29.7)
GFR (1^st quartile)^b	Yes	31.9 (30.5 – 33.4)	<0.01	32.1 (30.9 – 33.3)	<0.01
	No	28.6 (27.9 – 29.3)		28.6 (28.0 – 29.2)
Smoking	Current	29.7 (28.1 – 31.3)	<0.01	29.6 (28.2 – 31.0)	0.12
	Former	31.3 (30.0 – 32.5)		30.2 (29.2 – 31.2)
	Never	28.1 (27.2 – 29.1)		28.9 (28.1 – 29.7)
Inflammation score 88. Duncan BB, Schmidt MI, Pankow JS, Ballantyne CM, Couper D, Vigo A et al. Atherosclerosis Risk in Communities Study. Low-grade systemic inflammation and the development of type 2 diabetes: the atherosclerosis risk in communities study. Diabetes 2003; 52: 1799-805.	High	29.5 (28.5 – 30.6)	0.77	28.9 (28.1 – 29.7)	0.11
	Low	29.3 (28.5 – 30.1)		29.8 (29.1 – 30.4)
Body mass index	Normal	29.3 (28.1 – 30.4)	0.86	30.1 (28.9 – 31.2)	0.30
	Overweight	29.4 (28.6 – 30.2)		29.0 (28.3 – 29.7)
	Obese	29.8 (28.3 – 31.2)		29.3 (27.8 – 30.7)
WHR^c
Men	Yes	33.1 (31.5 – 34.8)	0.26	33.2 (31.9 – 34.6)	0.15
	No	31.9 (30.6 – 33.3)		31.9 (30.7 – 33.0)
Women	Yes	28.5 (27.3 – 29.7)	0.08	27.9 (26.9 – 28.9)	0.61
	No	27.0 (25.9 – 28.1)		27.5 (26.7 – 28.4)
Fasting insulin^d	< P25	28.3 (26.7 – 29.9)	0.30	28.5 (27.1 – 29.9)	0.06
	P25 – P75	29.7 (28.8 – 30.5)		30.0 (29.3 – 30.6)
	> P75	29.7 (28.5 – 31.0)		28.8 (27.5 – 30.1)

	Men			Women
	2^nd tertile	3^rd tertile	Linear trend	2^nd tertile	3^rd tertile	Linear trend
	HR (95%CI)	HR (95%CI)	p value	HR (95%CI)	HR (95%CI)	p value
Model 1	0.96 (0.59–1.57)	1.07 (0.66–1.73)	0.77	1.48 (1.01–2.16)	1.92 (1.32–2.79)	<0.01
Model 2	1.02 (0.62–1.69)	1.12 (0.67–1.85)	0.67	1.49 (1.01–2.18)	1.94 (1.33–2.83)	<0.01
Model 3	0.89 (0.51–1.56)	1.00 (0.58–1.71)	0.93	1.26 (0.82–1.92)	1.70 (1.11–2.59)	0.01
Model 4	0.89 (0.51–1.56)	1.03 (0.60–1.77)	0.90	1.27 (0.83 – 1.94)	1.83 (1.19 – 2.82)	0.01
Model 5	0.98 (0.54–1.76)	0.94 (0.51–1.73)	0.83	1.27 (0.79– 2.03)	1.74 (1.03–2.94)	0.04
Model 6	1.01 (0.57–1.80)	0.93 (0.51–1.71)	0.83	1.28 (0.81–2.04)	1.68 (1.00–2.82)	0.05
Model 7	1.04 (0.56–1.92)	0.83 (0.44–1.57)	0.57	1.12 (0.67–1.85)	1.24 (0.70–2.19)	0.47