Retinol-binding protein 4 in obese and obese-diabetic postmenopausal women in Montenegro

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Abstract

Introduction:

Menopause is associated with an increase in visceral fat and obesity is the leading risk factor for insulin resistance (IR) and type 2 diabetes mellitus (T2DM). Recent evidence suggests that retinol-binding protein 4 (RBP4) is not an independent determinant of IR and its role in human glucose metabolism is not well clarified. We examined RBP4 and its association with IR, cardiometabolic and kidney parameters in obese postmenopausal women with and without T2DM.

Methods:

Basic anthropometric, biochemical parameters, and blood pressure (BP) were determined in 50 obese diabetic and 50 obese non-diabetic sedentary postmenopausal women, and compared with 50 healthy normal weight controls.

Results:

Higher levels of RBP4 were observed in obese individuals, as compared with normal weight group (p=0.033). However, we did not find significant difference between obese non-diabetic and obese-diabetic individuals (p=0.583). Serum RBP4 did not correlate with anthropometric measurements or any indicator of glucose metabolism in diabetic group, whereas RBP4 correlated with creatinine (r=0.416, p=0.003), eGFR (r= -0.304, p=0.032) and triglycerides (r=0.484, p<0.001). In obese non-diabetic group, correlations were observed with fasting glucose (r=0.346, p=0.014), insulin (r=0.292, p=0.038), HOMA-IR (r=0.329 p=0.020), HbA1c (r=0.326, p=0.021), creatinine (r=0.399, p=0.004), eGFR (r= -0.389, p=0.005), HDL-c (r= -0.316, p=0.025), triglycerides (r=0.461, p<0.001), and systolic BP (r=0.286, p=0.044). In multiple regression analysis, triglycerides (Beta=0.302, p<0.001) and eGFR (Beta= -0.188, p=0.015) were independent predictors of RBP4.

Conclusions:

Serum RBP4 is not increased in obese type 2 diabetic postmenopausal women, but is associated with triglycerides and eGFR independently of diabetes.

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Most cited references 29

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A new equation to estimate glomerular filtration rate.

Andrew Levey, Lesley Stevens, Christopher H Schmid … (2009)

Equations to estimate glomerular filtration rate (GFR) are routinely used to assess kidney function. Current equations have limited precision and systematically underestimate measured GFR at higher values. To develop a new estimating equation for GFR: the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Cross-sectional analysis with separate pooled data sets for equation development and validation and a representative sample of the U.S. population for prevalence estimates. Research studies and clinical populations ("studies") with measured GFR and NHANES (National Health and Nutrition Examination Survey), 1999 to 2006. 8254 participants in 10 studies (equation development data set) and 3896 participants in 16 studies (validation data set). Prevalence estimates were based on 16,032 participants in NHANES. GFR, measured as the clearance of exogenous filtration markers (iothalamate in the development data set; iothalamate and other markers in the validation data set), and linear regression to estimate the logarithm of measured GFR from standardized creatinine levels, sex, race, and age. In the validation data set, the CKD-EPI equation performed better than the Modification of Diet in Renal Disease Study equation, especially at higher GFR (P < 0.001 for all subsequent comparisons), with less bias (median difference between measured and estimated GFR, 2.5 vs. 5.5 mL/min per 1.73 m(2)), improved precision (interquartile range [IQR] of the differences, 16.6 vs. 18.3 mL/min per 1.73 m(2)), and greater accuracy (percentage of estimated GFR within 30% of measured GFR, 84.1% vs. 80.6%). In NHANES, the median estimated GFR was 94.5 mL/min per 1.73 m(2) (IQR, 79.7 to 108.1) vs. 85.0 (IQR, 72.9 to 98.5) mL/min per 1.73 m(2), and the prevalence of chronic kidney disease was 11.5% (95% CI, 10.6% to 12.4%) versus 13.1% (CI, 12.1% to 14.0%). The sample contained a limited number of elderly people and racial and ethnic minorities with measured GFR. The CKD-EPI creatinine equation is more accurate than the Modification of Diet in Renal Disease Study equation and could replace it for routine clinical use. National Institute of Diabetes and Digestive and Kidney Diseases.

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Increased visceral fat and decreased energy expenditure during the menopausal transition.

J C Lovejoy, C Champagne, L. de Jonge … (2008)

This study assessed longitudinal changes in body composition, fat distribution and energy balance in perimenopausal women. We hypothesized that total fat and abdominal body fat would increase at menopause due to decreased energy expenditure (EE) and declining estrogen, respectively. Observational, longitudinal study with annual measurements for 4 years. Healthy women (103 Caucasian; 53 African-American), initially premenopausal. During follow-up, lack of menstruation for 1 year and follicle-stimulating hormone >30 mIU ml(-1) defined a subject as postmenopausal. Fat and lean mass (dual-energy X-ray absorptiometry), visceral (VAT) and subcutaneous abdominal fat (SAT) (computed tomography), dietary intake (4-day food record), serum sex hormones and physical activity (tri-axial accelerometry). Twenty-four hour EE was measured by whole-room calorimeter in a subset of 34 women at baseline and at year 4. Body fat and weight increased significantly over time only in those women who became postmenopausal by year 4 (n=51). All women gained SAT over time; however, only those who became postmenopausal had a significant increase in VAT. The postmenopausal group also exhibited a significant decrease in serum estradiol. Physical activity decreased significantly 2 years before menopause and remained low. Dietary energy, protein, carbohydrate and fiber intake were significantly higher 3-4 years before the onset of menopause compared with menopause onset. Twenty-four hour EE and sleeping EE decreased significantly with age; however, the decrease in sleeping EE was 1.5-fold greater in women who became postmenopausal compared with premenopausal controls (-7.9 vs -5.3%). Fat oxidation decreased by 32% in women who became postmenopausal (P<0.05), but did not change in those who remained premenopausal. Middle-aged women gained SAT with age, whereas menopause per se was associated with an increase in total body fat and VAT. Menopause onset is associated with decreased EE and fat oxidation that can predispose to obesity if lifestyle changes are not made.

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Effect of menopausal status on body composition and abdominal fat distribution.

MJ Toth, A Tchernof, CK Sites … (2000)

Preliminary studies suggest that the menopause transition is associated with deleterious changes in body composition and abdominal fat distribution. Limitations of the methodology used in these studies, however, render their conclusions controversial. Thus, the present study used radiologic imaging techniques to examine the effect of menopausal status on body composition and abdominal fat distribution. Cross-sectional. Fifty-three healthy, middle-aged, premenopausal women (mean+/-SD; 47+/-3 y) and 28 early-postmenopausal women (51+/-4 y). Total and regional body composition by dual energy X-ray absorptiometry and abdominal fat distribution by computed tomography. No differences in total body fat-free mass or appendicular skeletal muscle mass were noted between groups. In contrast, total body fat mass was 28% higher (23+/-7 vs 18+/-7 kg) and percentage fat 17% higher (35+/-6 vs 30+/-9%; both P<0.01) in postmenopausal women compared with premenopausal women. Postmenopausal women had a 49% greater intra-abdominal (88+/-32 vs 59+/-32 cm2; P<0.01) and a 22% greater abdominal subcutaneous fat area (277+/-93 vs 227+/-108 cm2; P<0.05) compared to premenopausal women. The menopause-related difference in intra-abdominal fat persisted (P<0.05) after statistical adjustment for age and total body fat mass, whereas no difference in abdominal subcutaneous fat was noted. A similar pattern of differences in total and abdominal adiposity was noted in sub-samples of pre- and postmenopausal women matched for age or fat mass. Our data suggest that early-postmenopausal status is associated with a preferential increase in intra-abdominal fat that is independent of age and total body fat mass. International Journal of Obesity (2000) 24, 226-231

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Author and article information

Journal

Journal ID (publisher-id): JHS

Title: Journal of Health Sciences

Publisher: University of Sarajevo Faculty of Health Studies (Bosnia )

ISSN (Print): 2232-7576

ISSN (Electronic): 1986-8049

Publication date (Print): 2015

Volume: 5

Issue: 3

Pages: 78-84

Affiliations

[1 ]Primary Health Care Center, Podgorica, Montenegro

[2 ]Laboratory of Medical Biochemistry, Ibn Rochd University Hospital, College of Medicine, Annaba, Algeria

[3 ]Clinical Center of Montenegro, Podgorica, Montenegro

Author notes

[* ]Corresponding Author: Aleksandra Klisic, Center of Laboratory Diagnostics, Primary Health Care Center, Trg Nikole Kovacevica 6, 81000 Podgorica, Montenegro, Phone and Fax: +382 20 481 999, E-mail: aleksandranklisic@ 123456gmail.com

Article

Publisher ID: JHS-5-78

DOI: 10.17532/jhsci.2016.290

SO-VID: fef5e628-98e3-4cc7-9774-776231cd5ed8

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Retinol-binding protein 4 in obese and obese-diabetic postmenopausal women in Montenegro

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Abstract

Introduction:

Methods:

Results:

Conclusions:

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Journal of Health Sciences

Most cited references 29

A new equation to estimate glomerular filtration rate.

Increased visceral fat and decreased energy expenditure during the menopausal transition.

Effect of menopausal status on body composition and abdominal fat distribution.

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