Serum Levels of RBP4 Might Not Be Determined by Diabetes Mellitus but by Kidney Function and Renal Replacement Therapy  

作　　者：芦泽源 张光远 谢玉婷 李军辉 汪年松 晏春根 王锋 

机构地区：[1]Department of Nephrology,Shanghai Eighth People's Hospital [2]Department of Nephrology,Shanghai Jiaotong University Affiliated Sixth People's Hospital [3]Department of Urology,Zhongda Hospital of Southeast University [4]Department of Internal Medicine,Affiliated Hospital of Shaoxing University

出　　处：《Journal of Shanghai Jiaotong university(Science)》2016年第6期757-762,共6页上海交通大学学报（英文版）

基　　金：the National Natural Science Foundation of China(Nos.81570603,81270824 and 81670632);the New-100 Talent Plan of Shanghai Jiao Tong University School of Medicine,the Shanghai Talents Development Fund(No.201350);the Shanghai Pujiang Talent Projects(No.15PJ1406700)

摘　　要：It has been reported that retinol-binding protein 4(RBP4) is associated to adiposity,insulin resistance,and type 2 diabetes.Meanwhile,circulating RBP4 levels are also affected by renal function.The aim of the present study is to investigate whether serum levels of RBP4 are primarily associated with different stages of chronic kidney disease(CKD) or type 2 diabetes,if there is more potential relevance between RBP4 and renal replacement therapy.The serum levels of RBP4 were assessed by commercial competitive enzyme-linked immunosorbent assay(ELISA)kit in 212 patients with the CKD stages 1—5 and in 24 healthy controls,while its correlation with clinical and metabolic parameters was analyzed.The serum level of RBP4 had a strong correlation with estimated glomerular filtration rate(e GFR)(P < 0.001).Stratified by e GFR and treatment,no more differences in RBP4 serum concentration were detected between type 2 diabetic and non-diabetic subjects [CKD stages 1—5,non-dialysis(ND),hemodialysis(HD) and peritoneal dialysis(PD);P > 0.05 for all].The elevation of RBP4 become higher in HD than in PD and ND in CKD5 patients(P = 0.008 and P = 0.04,respectively),while there was no significant difference between PD and ND groups.Multivariate linear regression analysis demonstrated three independent predictors of e GFR(β =-0.676,P < 0.001),C-reactive protein(CRP)(β =-0.573,P < 0.001) and creatine(β = 0.509,P = 0.024) in the study population.The study results demonstrated that the serum level of RBP4 was negatively related to the e GFR,whether diabetes mellitus(DM) affected the blood concentration of RBP4 or not.And the serum level of RBP4 exhibited significant difference in different renal replacement therapies.It has been reported that retinol-binding protein 4 （RBP4） is associated to adiposity, insulin resistance, and type 2 diabetes. Meanwhile, circulating RBP4 levels are also affected by renal function. The aim of the present study is to investigate whether serum levels of RBP4 are primarily associated with different stages of chronic kidney disease （CKD） or type 2 diabetes, if there is more potential relevance between RBP4 and renal replacement therapy. The serum levels of RBP4 were assessed by commercial competitive enzyme-linked immunosorbent assay （ELISA） kit in 212 patients with the CKD stages 1 5 and in 24 healthy controls, while its correlation with clinical and metabolic parameters was analyzed. The serum level of RBP4 had a strong correlation with estimated glomerular filtration rate （eGFR） （P 〈 0.001）. Stratified by eGFR and treatment, no more differences in RBP4 serum concentration were detected between type 2 diabetic and non-diabetic subjects [CKD stages 1-5, non-dialysis （ND）, hemodialysis （HD） and peritoneal dialysis （PD）; P 〉 0.05 for all]. The elevation of RBP4 become higher in HD than in PD and ND in CKD5 patients （P = 0.008 and P = 0.04, respectively）, while there was no significant difference between PD and ND groups. Multivariate linear regression analysis demonstrated three independent predictors of eGFR （β = -0.676, P 〈 0.001）, C-reactive protein （CRP） （β = -0.573, P 〈 0.001） and creatine （β = 0.509, P =0.024） in the study population. The study results demonstrated that the serum level of RBP4 was negatively related to the eGFR, whether diabetes mellitus （DM） affected the blood concentration of RBP4 or not. And the serum level of RBP4 exhibited significant difference in different renal replacement therapies.

关 键 词：chronic kidney disease(CKD) retinol binding protein 4(RBP4) renal replacement therapy diabetes mellitus(DM) 

分 类 号：R692.5[医药卫生—泌尿科学]