Serum retinol-binding protein 4 linked adolescent cardiometabolic risk components to metabolic syndrome and insulin resistance

Background: Cardiometabolic risk factors can be exhibited by children and may persist into adulthood. RBP4 has been related to sugar-sweetened beverage consumption, and proposed to be a vital mediator connecting obesity and insulin resistance (IR).

Objectives: This study investigated the role of RBP4 in the adolescent by evaluating the association of its serum levels with cardiometabolic risk components and outcomes.

Methods: A total of 272 representative adolescents were randomly selected from a large-scale cross-sectional study. Data were analyzed using principal component analysis and multivariate regression models adjusted for covariates. 

Results: Three principal components were extracted from 12 cardiometabolic risk factors and the first principal component (PC1) explained 38.7% of the total variance. RBP4 levels were positively correlated to body-weight-related parameters, triglyceride, systolic blood pressure and uric acid in both sexes and to metabolic syndrome (MetS) and IR. Significant multivariate-adjusted differences at RBP4 levels (1.999 ng/dl in boys and 2.377 ng/dl in girls) for a one-unit increase in PC1 scores were found among adolescents with hyperuricemia, but not among those without. Circulating RBP4 levels were notably capable at discriminating the presence of MetS and IR. A one-standard deviation increment of RBP4 was associated with a 2.5- and 1.9-fold risk of contracting MetS and IR, respectively, and explained 5.5% and 13.7% of the excess risk of PC1 on these two metabolic disorders.

Conclusions: Circulating RBP4 levels are associated with combined-cardiometabolic risk components and adolescent MetS and IR. Hyperuricemia demonstrates clinical implications on the positive correlation between continuous cardiometabolic risk-scores and RBP4 levels.