The Relationship of Fetuin-A, Adiponectin, Retinol Binding Protein-4 (RBP-4) and High Sensitivity C-Reactive Protein (hsCRP) with Insulin Resistance (HOMA-IR) in Obese Non Diabetic Men

Imelda Novianti, Andi Wijaya, Marsetio Donosepoetro

Abstract


BACKGROUND: Central obesity is the accumulation of visceral (intra-abdominal) fat and is strongly known to be associated with insulin resistance and type 2 diabetes mellitus (T2DM). Obesity can cause adipocyte hypertrophy that results in dysregulation of adipokine expression. The abnormal function of adipocytes may play an important role in the development of a chronic low-grade proinflammatory state associated with obesity. Adiponectin, retinol binding protein (RBP)-4 and fetuin-A play a role in the pathophysiology of insulin resistance. Expression of fetuin-A is increased due to fat accumulation in the liver. Elevated concentration of fetuin-A in the circulation can impair insulin signaling in muscle and liver as well as suppress adiponectin secretion, although its molecular mechanism is still unclear. The aim of this study was to identify the relationship of fetuin-A, adiponectin, RBP-4 and hsCRP with insulin resistance in obese non diabetic men.

METHODS: This was an observational study with a cross-sectional design. The study subjects were 64 men with non diabetic abdominal obesity, characterized by waist circumference of 98.47 ± 5.88 cm and fasting blood glucose of 85.75±8.36 mg/dL.

RESULTS: This study showed that fetuin-A was positively correlated with HOMA-IR in obese non diabetic men with insulin resistance (r = 0.128; p = 0.570), although not significant. Fetuin-A was found to be correlated with adiponectin, RBP-4 and hsCRP (r=0.150; p=0.233; r=0.050; p=0.711; r=-0.04; p=0.445), although not significant.

CONCLUSIONS: The concentration of fetuin-A showed a tendency to be positively correlated with HOMA-IR and with RBP-4 in obese non diabetic men, although statistically not significant. The concentration of fetuin-A showed a tendency to be negatively correlated with adiponectin and hsCRP although statistically not significant. There was no interrelationship between fetuin-A, adiponectin, RBP-4, hsCRP and HOMA-IR. Elevated concentrations of fetuin-A were noted in obese subjects, which in turn might impair insulin signaling. This finding might suggest that fetuin-A may represent a new target for the prevention of insulin resistance. Further studies might be needed on obese population with fatty liver.

KEYWORDS: fetuin-A, adiponectin, RBP-4, hsCRP, insulin resistance


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References


Ferranti dS, Mozzafarian D. The perfect storm: Obesity, adipocyte dysfunction, and metabolic consequences. Clin Chem. 2008; 54: 945-55, CrossRef.

Kim J, WeiY, Sowers JR. Role of mithochondrial dysfunction in insulin resistance. Circ Res. 2008; 102: 401-14, CrossRef.

Després JP, Lemieux I. Abdominal obesity and metabolic syndrome. Nature. 2006; 444: 881-7, CrossRef.

Tilg H, Moschen AR. Role of adiponectin and PBEF/visfatin as regulators of inflammation: involvement in obesity-associated diseases. Clin Sci. 2008; 114: 275-88, CrossRef.

Matsuzawa Y, Funahashi T, Kihara S, Shimomura I. Adiponectin and metabolic syndrome. Arterioscler Thromb Vasc Biol. 2004; 24: 29-33, CrossRef.

Takebayashi K, Suetsugu M, Wakabayashi S, Aso Y, lnukai T. Retinol binding protein-4 concentrations and clinical features of type 2 diabetes patients. J Clin Endocrinol Metab. 2007; 92: 2712-9, CrossRef.

Hennige AM, Staiger H, Wicke C, Machicao F, Fritsche A, Haring HU, et al. Fetuin-A induces cytokine expression and suppresses adiponectin production. PloS ONE. 2008; 3: e1765, CrossRef.

Sobngwi E, Effoe V, Boudou P, Njamen D, Gautier JF, Mbanya JC. Waist circumference does not predict circulating adiponectine concentrations in Sub-Saharan women. Cardiovasc Diabetol. 2007; 6: 31, CrossRef.

Wahrenberg H, Hertel K, Leijonhufvud BM, Persson LG, Toft E, Arner P. Use of waist circumference to predict insulin resistance: Retrospective study. BMJ. 2005; 330: 1363-4, CrossRef.

Gavi S, Stuart LM, Kelly P, Melendez MM,Mynarcik DC, Gelato MC, et al. Retinol binding protein 4 ls associated with insulin resistance and body fat distribution in non obese subjects without type 2 diabetes. J Clin Endocrinol Metab. 2007; 92: 1886-90, CrossRef.

Koska J, Stefan N, Permana PA, Weyer C, Sonoda M, Bogardus C, et al. Increase fat accumulation in liver may link insulin resistance with subcutaneus abdominal adipocyte enlargement, visceral adiposity, and hypoadiponectinemia in obese individuals. Am J Clin Nutr. 2008; 87: 295-302, PMID.

Stefan N, Kantartzis K, Haring HU. Cause and metabolic consequences of fatty liver. Endocr Rev. 2008; 29: 939-60, CrossRef.

Kalabay L, Graf L, Vortis K, Jakab L, Benko Z, Telegdy L, et al. Human serum fetuin A/alpha2HS-glycoprotein concentration is associated with long-term survival in patients with alcoholic liver cirrhosis, comparison with the child-pugh and MELD scores. BMC Gastroenterology. 2007; 7: 15, CrossRef.

Stefan N, Hennige AM, Staiger H, Machann J, Schick F, Krtiber SM, et al. Alpha2-heremans schmid glycoproteinl fetuin-A is associated with insulin resistance and fat accumulation in the liver in humans. Diabetes Care. 2006; 29: 853-7, CrossRef.

Esteve E, Ricart W, Fernandez JS. Adipocytokines and insulin resistance. Diabetes Care. 2009; 32: S362-7, CrossRef.

Shea J, RandelI E, Vasdev S, Wang PP, Roebothan B, Sun G. Serum retinol-binding protein 4 concentrations in response to short-term overfeeding in normal weight, overweight, and obese men. Am J Clin Nutr. 2007; 86: 1310-5, PMID.

Broch M, Vendrell J, Ricart W, Richart C, Fernandez-Real JM. Circulating retinol binding protein-4, insulin sensitivity, insulin secretion, and insulin disposition index in obese and nonobese subjects. Diabetes Care. 2007; 30: 1802-6, CrossRef.

Mills JP, Furr HC, Tanumihardjo SA. Retinol to retinol binding protein (RBP) is low in obese adults due to elevated apo-RBP. Exp Biol Med. 2008; 233: 1255-61, CrossRef.

Graham TE, Yang Q, BIuher M, Hammarstedt A, Ciaraldi TP, Henry RR, et al. Retinol-binding protein 4 and insulin resistance in lean, obese and diabetic subjects. N Engl J Med. 2006; 354: 2552-63, CrossRef.

Song A, Xu M, Bi Y, Xu Y, Huang Y, Li M, et al. Serum fetuin-A associates with type 2 diabetes and insulin resistance in Chinese adults. PLoS ONE. 2011; 6: e19228, CrossRef.




DOI: https://doi.org/10.18585/inabj.v4i1.157

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