Retinol-Binding Protein 4 and Insulin Resistance in Lean, Obese, and Diabetic Subjects

• Published in: The New England journal of medicine Vol. 354; no. 24; pp. 2552 - 2563
• Main Authors: Graham, Timothy E, Yang, Qin, Blüher, Matthias, Hammarstedt, Ann, Ciaraldi, Theodore P, Henry, Robert R, Wason, Christopher J, Oberbach, Andreas, Jansson, Per-Anders, Smith, Ulf, Kahn, Barbara B
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 15.06.2006
• Subjects: Adipocytes - metabolism; Adult; Biological and medical sciences; Blood Glucose - metabolism; Cross-Sectional Studies; Diabetes; Diabetes Mellitus; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - genetics; Diabetes Mellitus, Type 2 - metabolism; Exercise - physiology; Female; General aspects; Glucose; Glucose Metabolism Disorders - blood; Glucose Metabolism Disorders - metabolism; Glucose Metabolism Disorders/blood/metabolism; Glucose Transporter Type 4 - metabolism; Humans; Insulin; Insulin resistance; Insulin Resistance - physiology; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Metabolic diseases; Metabolic Syndrome - blood; Metabolic Syndrome X/blood; Middle Aged; Obesity; Obesity - blood; Obesity - metabolism; Obesity/blood/metabolism; Retinol-Binding Proteins - metabolism; Retinol-Binding Proteins, Plasma; Rodents; Thinness - blood; Thinness - metabolism; Thinness/blood/metabolism; Type 2/blood/genetics/metabolism; Endocrinopathy; Human; Medicine; Obesity; Binding protein; Target tissue resistance; Diabetes mellitus; Nutrition disorder; Insulin resistance; Insulin; Nutritional status; Retinol
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa054862

In this study, serum levels of retinol-binding protein 4, a molecule secreted by adipocytes, correlated with the magnitude of insulin resistance in subjects with obesity, impaired glucose tolerance, or type 2 diabetes and in nonobese, nondiabetic subjects with a strong family history of type 2 diabetes. Levels of this molecule appear to be elevated in serum before the development of frank diabetes and might be used to identify insulin resistance and associated cardiovascular risk factors. Levels of retinol-binding protein 4 appear to be elevated in serum before the development of frank diabetes and might be used to identify insulin resistance and associated cardiovascular risk factors. Type 2 diabetes is caused by resistance to insulin action in multiple tissues, accompanied by failure of the pancreatic beta cells to compensate sufficiently by increased insulin secretion. 1 Measurement of insulin resistance provides an early and strong predictor of type 2 diabetes. 2 Even in the absence of hyperglycemia or diabetes, insulin resistance constitutes an important risk factor for cardiovascular disease and early death. 3 Obesity, which has reached epidemic proportions worldwide, is a major cause of insulin resistance. 4 However, insulin resistance does not develop in all obese persons, and genetic background contributes strongly to insulin resistance, even in nonobese persons. 5 In . . .