Serum retinol‐binding protein 4 as a predictor of cardiovascular events in elderly patients with chronic heart failure

Abstract

Aims RBP4 is an adipokine with adverse effects on cardiovascular system. Increased circulating retinol-binding protein 4 (RBP4) has been linked to chronic heart failure (CHF). However, whether elevated RBP4 is correlated with a poor prognosis in elderly patients with CHF remains unclear. The aim of this study was to evaluate the prognostic value of serum RBP4 in elderly patients with CHF. Methods and results We enrolled 934 consecutive elderly patients (aged 60 years and older) with CHF and 138 age-matched and sex-matched control subjects in a prospective cohort study and explored the association of serum RBP4 levels with the clinical outcomes using multivariate Cox regression analyses. Serum RBP4 levels were elevated in CHF patients when compared with controls (46.66 ± 12.38 μg/mL vs. 40.71 ± 7.2 μg/mL, P < 0.001). Patients with the highest RBP4 concentrations had higher N terminal pro brain natriuretic peptide (NT-proBNP) levels but lower left ventricular eject fraction (LVEF) and estimated glomerular filtration rate (P < 0.001). Serum RBP4 levels were increased as the New York Heart Association functional class increased and LVEF decreased (P < 0.001) and were negatively correlated with LVEF (r = À0.154, P < 0.001) but positively correlated with NT-proBNP levels (r = 0.074, P = 0.023). Multivariate Cox regression analysis suggested that log RBP4 was an independent predictor for major adverse cardiac event(s) [hazard ratio (HR) = 2.61, 95% confidence interval (CI) = 1.19-5.70], together with age, male, LVEF, log NT-proBNP, and estimated glomerular filtration rate. Moreover, log RBP4 was also an independent predictor for cardiovascular mortality (HR = 2.24, 95% CI = 1. 35-5.39) and CHF rehospitalization (HR = 2.54, 95% CI = 1.09-5.60) even after adjustment for the established adverse prognostic factors for CHF. The Kaplan-Meier survival curves showed that high concentration of RBP4 was a prognostic indicator of major adverse cardiac event(s) in patients with CHF. Conclusions Our findings demonstrate for the first time that elevated serum RBP4 is correlated with worse outcome in elderly patients with CHF.

Low Levels of Serum Fetuin-A and Retinol-Binding Protein 4 Correlate with Lipoprotein Subfractions in Morbid Obese and Lean Non-Diabetic Subjects

“…Additionally, RBP4 levels are related to large VLDL and small-dense LDL subfractions in subjects with and without diabetes [32]; mean LDL size in morbid obese patients was noticed as well [33]. However, other studies did not confirm these results [34,35]. In this study, we did not observe correlations between RBP4 and total cholesterol, triglyceride, LDL-C levels, and mean LDL size, but there was a positive correlation between RBP4 and VLDL subfraction levels in obese and lean non-diabetic subjects.…”

Retinol-Binding Protein-4—A Predictor of Insulin Resistance and the Severity of Coronary Artery Disease in Type 2 Diabetes Patients with Coronary Artery Disease

“…At the same time, elevated serum RBP-4 was associated with metabolic syndrome components [ 41 ]. Previous research found a significant positive correlation between RBP-4 levels and CAD severity [ 23 , 42 , 43 , 44 ]. All of these studies support the present study’s outcomes.…”

Novel insights into potential therapeutic targets and biomarkers using integrated multi-omicsapproaches for dilated and ischemic cardiomyopathies

“…10). Moreover, cardiomyocytes are not a homogenous group of cells as can be seen in bulk and single cell RNA-seq, this is also true on the protein level where a small subset of proteins show variability between cardiomyocytes in a mosaic pattern and can likely be further altered under pathological conditions 96,97,123 .…”

“…Reverse was true for some of the genes that are reported to be involved in heart failure Kininogen 1 (KNG1) 94,95 , Retinol Binding Protein 4 (RBP4) 96 , Apolipoprotein B (APOB) 97 (Supplementary Table 7&8; Supplementary Fig. 10).…”