Increased plasma RBP4 concentration in older hypertensives is related to the decreased kidney function and the number of antihypertensive drugs—results from the PolSenior substudy

Majerczyk, Marcin; Choręża, Piotr; Bożentowicz-Wikarek, Maria; Brzozowska, Aniceta; Arabzada, Habibullah; Owczarek, Aleksander; Mossakowska, Małgorzata; Grodzicki, Tomasz; Zdrojewski, Tomasz; Wiȩcek, Andrzej; Olszanecka-Glinianowicz, Magdalena; Chudek, Jerzy

doi:10.1016/j.jash.2016.11.009

Cited by 14 publications

(13 citation statements)

References 48 publications

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“…However, our study reported that both of those biomarkers had excellent clinical accuracy for eGFR decline prediction. Several previous studies also reported elevated serum RBP4 levels in kidney disease[ 12 13 23 24 ] but did not make a comparison between those two biomarkers.…”

Section: Discussionmentioning

confidence: 99%

Retinol-binding protein 4 versus albuminuria as predictors of estimated glomerular filtration rate decline in patients with type 2 diabetes

2018

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Background:Since the increase in some tubular damage biomarkers can be observed at the early stage of diabetic nephropathy, even in the absence of albuminuria, we aimed to investigate if urinary albumin is superior than tubular damage marker, such as serum retinol-binding protein 4 (RBP4), in predicting renal function decline (defined as estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2) in the cohort of patients with type 2 diabetes mellitus (T2D).Materials and Methods:A total of 106 sedentary T2D patients (mean [± standard deviation] age 64.9 [±6.6] years) were included in this cross-sectional study. Anthropometric and biochemical parameters (fasting glucose, glycated hemoglobin [HbA1c], lipid parameters, creatinine, RBP4, high sensitivity C-reactive protein [hsCRP], urinary albumin excretion [UAE]), as well as blood pressure were obtained.Results:HsCRP (odds ratio [OR] =0.754, 95% confidence interval [CI] (0.603–0.942), P = 0.013) and RBP4 (OR = 0.873, 95% CI [0.824–0.926], P < 0.001) were independent predictors of eGFR decline. Moreover, although RBP4 and UAE as single diagnostic parameters of renal impairment showed excellent clinical accuracy (area under the curve [AUC] = 0.900 and AUC = 0.940, respectively), the Model which included body mass index, HbA1c, triglycerides, hsCRP, and RBP4 showed statistically same accuracy as UAE, when UAE was used as a single parameter (AUC = 0.932 vs. AUC = 0.940, respectively; P for AUC difference = 0.759). As well, the Model had higher sensitivity and specificity (92% and 90%, respectively) than single predictors, RBP4, and UAE.Conclusion:Although serum RBP4 showed excellent clinical accuracy, just like UAE, a combination of markers of tubular damage, inflammation, and traditional markers has the higher sensitivity and specificity than UAE alone for prediction renal impairment in patients with T2D.

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Section: Discussionmentioning

confidence: 99%

Retinol-binding protein 4 versus albuminuria as predictors of estimated glomerular filtration rate decline in patients with type 2 diabetes

2018

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“…Plasma RBP4 levels (Immundiagnostik AG, Bensheim, Germany, sensitivity 0.9 pg/mL) were measured by ELISA, with mean intra-assay and inter-assay coefficients of variability < 5% and < 9.8%, respectively, as described previously [11].…”

Section: Biochemical Measurementsmentioning

confidence: 99%

“…Elevated plasma retinol-binding protein 4 (RBP4) level has recently emerged as a potential new risk factor for atherosclerosis [9] and cardiovascular diseases, including HT [10,11], and CAD [12] development, the leading causes of HF in older populations [13,14]. RBP4 is an adipokine secreted by tissues storing retinoids such as liver or adipose tissue [15].…”

Section: Introductionmentioning

confidence: 99%

Plasma Level of Retinol-Binding Protein 4, N-Terminal proBNP and Renal Function in Older Patients Hospitalized for Heart Failure

et al. 2018

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Background/Aim: Elevated plasma concentration of retinol-binding protein 4 (RBP4) has recently emerged as a potential new risk factor for cardiovascular diseases, including hypertension (HT) and coronary artery disease (CAD). Limited data suggest that RBP4 promotes inflammatory damage to cardiomyocytes and participates in the development of heart failure (HF). This study aimed to analyze the relationship between concentrations of plasma RBP4 and serum N-terminal proBNP (NT-proBNP), a powerful biomarker of left ventricle dysfunction, in the older Polish population. Methods: The study sample consisted of 2,826 (1,487 men) participants of the PolSenior study, aged 65 years and older, including a subgroup hospitalized for HF (n = 282). In all subjects, plasma concentrations of RBP4, interleukin-6 (IL-6), serum level of NT-proBNP, and hs-CRP were measured. Additionally, BMI, estimated glomerular filtration rate (eGFR), and HOMA-IR were calculated. The prevalence of HT, CAD, atrial fibrillation (AF), and medication were considered as potential confounders. Results: Similar RBP4 levels were found in subjects with NT-proBNP < 125 and ≥125 ng/mL, with and without AF, and in the subgroups hospitalized for HF with and without AF. Regression analysis revealed no association between log₁₀(NT-proBNP) and log₁₀(RBP4). Plasma levels of RBP4 were increased by HT occurrence and diuretic therapy, while diminished with regard to female gender, age, eGFR values, AF, and IL-6 levels. Conclusion: Our results show that RBP4 is affected by GFR but cannot be considered as an independent biomarker of heart muscle dysfunction.

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“…The primary sources of RBP4 in vivo are hepatocytes and adipocytes [ 12 ]. Higher plasma RBP4 levels were reported in insulin-resistant humans and mice [ 11 , 13 ] as well as patients with type 2 diabetes [ 11 , 14 ], hypertriglyceridemia [ 15 ], atherogenic dyslipidaemia [ 16 , 17 ], and hypertension [ 18 – 20 ].…”

Section: Introductionmentioning

confidence: 99%

Components of metabolic syndrome in relation to plasma levels of retinol binding protein 4 (RBP4) in a cohort of people aged 65 years and older

Majerczyk

Kocełak

Choręża

et al. 2018

J Endocrinol Invest

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PurposeElevated plasma concentration of retinol binding protein 4 (RBP4) has recently emerged as a potential risk factor as a component of developing metabolic syndrome (MS). Therefore, this study aimed to analyse the relationship between components of MS and concentrations of plasma RBP4 in a population of subjects 65 years and older.MethodsThe study sample consisted of 3038 (1591 male) participants of the PolSenior study, aged 65 years and older. Serum lipid profile, concentrations of RBP4, glucose, insulin, C-reactive protein, IL-6, and activity of aminotransferases were measured. Nutritional status (BMI/waist circumference) and treatment with statins and fibrates were evaluated. Glomerular filtration rate (eGFR), de Ritis ratio, and fatty liver index (FLI), as well as HOMA-IR were calculated.ResultsOur study revealed a strong relationship between components of MS and RBP4 in both sexes: plasma RBP4 levels were increased in men by at least 3×, and in women by at least 4×. Hypertriglyceridemia was most strongly associated with elevated plasma RBP4 levels. Multivariate, sex-adjusted regression analysis demonstrated that chronic kidney disease [OR 1.86 (95% CI 1.78–1.94)], hypertriglyceridemia [OR 1.52 (1.24–1.87)], hypertension [OR 1.15 (1.12–1.19)], low serum HDL cholesterol [OR 0.94 (0.92–0.97)], and age > 80 years [OR 0.86 (0.81–0.90)] were each independently associated with RBP4 concentration (all p < 0.001).ConclusionsIn Caucasians 65 years and older, RBP4 serum levels are associated with a number of components of MS, independent of sex and kidney function. Hypertriglyceridemia as a component of MS is most significantly related to RBP4 concentration.

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Increased plasma RBP4 concentration in older hypertensives is related to the decreased kidney function and the number of antihypertensive drugs—results from the PolSenior substudy

Cited by 14 publications

References 48 publications

Retinol-binding protein 4 versus albuminuria as predictors of estimated glomerular filtration rate decline in patients with type 2 diabetes

Retinol-binding protein 4 versus albuminuria as predictors of estimated glomerular filtration rate decline in patients with type 2 diabetes

Plasma Level of Retinol-Binding Protein 4, N-Terminal proBNP and Renal Function in Older Patients Hospitalized for Heart Failure

Components of metabolic syndrome in relation to plasma levels of retinol binding protein 4 (RBP4) in a cohort of people aged 65 years and older

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