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Published in: European Journal of Nutrition 2/2014

01-03-2014 | Original Contribution

Retinol-binding protein 4 and insulin resistance are related to body fat in primary and secondary schoolchildren: the Ouro Preto study

Authors: Ana Paula Pereira Castro, Ana Paula Carlos Cândido, Roney Luiz de Carvalho Nicolato, Ivo Santana Caldas, George Luiz Lins Machado-Coelho

Published in: European Journal of Nutrition | Issue 2/2014

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Abstract

Purpose

Evidence suggests that plasma retinol-binding protein 4 (RBP4) and insulin resistance are related to body fat (BF). We aimed to assess the relationship between RBP4 and insulin resistance with obesity in a mixed (skin color) cohort of the Brazilian population.

Methods

A nested case–control study was conducted in 227 schoolchildren aged 7–14 years. Schoolchildren with a high BF percentage (% BF, ≥ 30 for girls and ≥ 25 for boys) were identified as the obese group (n = 137), and those with lower values were identified as the non-obese group (n = 90). Percentage of body fat (% BF) was determined by tetrapolar bioimpedance (Quantum II, RJL System), RBP4 by enzyme-linked immunosorbent assay (Immunology Consultants Laboratory), plasma fasting insulin by chemiluminescent immunoassay (Access® Immunoassay System) and insulin resistance by the homeostasis model insulin resistance (IRHOMA) index. Serum lipid profile and arterial blood pressure were evaluated.

Results

The significant independent risk factors associated with obesity were as follows: male sex, increased serum LDL-C, RBP4 and IRHOMA. Among children with higher RBP4, the association with obesity increased significantly (from 3.1 to 8.5) in the presence of insulin resistance, when compared to higher RBP4 and non-insulin resistance.

Conclusion

IRHOMA and RBP4 showed significant associations with obesity and traditional CVD risk factors. They might therefore be used as a marker for CVD risk and have clinical implications in the development of comorbidities associated with obesity.
Literature
1.
go back to reference Daniels SR, Jacobson MS, McCrindle BW et al (2000) American heart association childhood obesity research summit: executive summary. Circulation 119:2114–2123CrossRef Daniels SR, Jacobson MS, McCrindle BW et al (2000) American heart association childhood obesity research summit: executive summary. Circulation 119:2114–2123CrossRef
2.
go back to reference World Health Organization (2000) Obesity: preventing and managing the global epidemic, report of a WHO consultation on obesity, Geneva, 1997 June 3–5 World Health Organization (2000) Obesity: preventing and managing the global epidemic, report of a WHO consultation on obesity, Geneva, 1997 June 3–5
3.
go back to reference Instituto Brasileiro de Geografia e Estatística. Indicadores sociodemográficos e de saúde no Brasil. Rio de Janeiro: Instituto Brasileiro de Geografia e Estatística (2009). (Estudos e Pesquisas: Informação Demográfica e Socioeconômica, 25) Instituto Brasileiro de Geografia e Estatística. Indicadores sociodemográficos e de saúde no Brasil. Rio de Janeiro: Instituto Brasileiro de Geografia e Estatística (2009). (Estudos e Pesquisas: Informação Demográfica e Socioeconômica, 25)
4.
go back to reference Weiss R, Kaufman FR (2008) Metabolic complications of childhood obesity: identifying and mitigating the risk. Diabetes Care 31(2):310–316CrossRef Weiss R, Kaufman FR (2008) Metabolic complications of childhood obesity: identifying and mitigating the risk. Diabetes Care 31(2):310–316CrossRef
5.
go back to reference Kolotkin RL, Crosby RD, Williams GR et al (2001) The relationship between health-related quality of life and weight loss. Obes Res 9:564–571CrossRef Kolotkin RL, Crosby RD, Williams GR et al (2001) The relationship between health-related quality of life and weight loss. Obes Res 9:564–571CrossRef
6.
go back to reference Cândido APC, Benedetto R, Castro APP et al (2009) Cardiovascular risk factors in children and adolescents living in an urban area of Southwest of Brazil: Ouro Preto study. Eur J Pediatr 168:1373–1382CrossRef Cândido APC, Benedetto R, Castro APP et al (2009) Cardiovascular risk factors in children and adolescents living in an urban area of Southwest of Brazil: Ouro Preto study. Eur J Pediatr 168:1373–1382CrossRef
7.
go back to reference Freitas SN, Caiaffa WT, César CC et al (2007) A comparative study of methods for diagnosis of obesity in urban mixed-race population in Minas Gerais. Public Health Nutr 10:883–890CrossRef Freitas SN, Caiaffa WT, César CC et al (2007) A comparative study of methods for diagnosis of obesity in urban mixed-race population in Minas Gerais. Public Health Nutr 10:883–890CrossRef
8.
go back to reference Cândido APC, Ferreira S, Lima AA et al (2007) Lipoprotein (a) as a risk factor associated with ischemic heart disease: Ouro Preto study. Atherosclerosis 191:454–459CrossRef Cândido APC, Ferreira S, Lima AA et al (2007) Lipoprotein (a) as a risk factor associated with ischemic heart disease: Ouro Preto study. Atherosclerosis 191:454–459CrossRef
9.
go back to reference Lee D-C, Lee J-W, Im J-A (2007) Association of serum retinol binding protein 4 and insulin resistance in apparently healthy adolescents. Metab, Clin Exp 3:327–331CrossRef Lee D-C, Lee J-W, Im J-A (2007) Association of serum retinol binding protein 4 and insulin resistance in apparently healthy adolescents. Metab, Clin Exp 3:327–331CrossRef
10.
go back to reference Pala L, Monami M, Ciani S et al (2012) Adipokines as possible new predictors of cardiovascular diseases: a case control study. J Nutr Metab. doi:10.1155/2012/253428 Pala L, Monami M, Ciani S et al (2012) Adipokines as possible new predictors of cardiovascular diseases: a case control study. J Nutr Metab. doi:10.​1155/​2012/​253428
11.
go back to reference Conroy R, Espinal Y, Fennoy L et al (2011) Retinol binding protein 4 is associated with adiposity-related co-morbidity risk factors in children. J Pediatr Endocrinol Metab 24:913–919 Conroy R, Espinal Y, Fennoy L et al (2011) Retinol binding protein 4 is associated with adiposity-related co-morbidity risk factors in children. J Pediatr Endocrinol Metab 24:913–919
12.
go back to reference Santoro N, Perrone L, Cirillo G et al (2009) Variations of retinol binding protein 4 levels are not associated with changes in insulin resistance during puberty. J Endocrinol Invest 32:411–414 Santoro N, Perrone L, Cirillo G et al (2009) Variations of retinol binding protein 4 levels are not associated with changes in insulin resistance during puberty. J Endocrinol Invest 32:411–414
13.
go back to reference Kanaka-Gantenbein C, Margeli A, Pervanidou P et al (2008) Retinol- binding protein 4 and lipocalin-2 in childhood and adolescent obesity: when children are not just “Small Adults”. Clin Chem 7:1176–1182CrossRef Kanaka-Gantenbein C, Margeli A, Pervanidou P et al (2008) Retinol- binding protein 4 and lipocalin-2 in childhood and adolescent obesity: when children are not just “Small Adults”. Clin Chem 7:1176–1182CrossRef
14.
go back to reference Deurenberg P, Kusters CS, Smit HE (1990) Assessment of body composition by bioelectrical impedance in children and young adults is strongly age-dependent. Eur J Clin Nutr 44:261–268 Deurenberg P, Kusters CS, Smit HE (1990) Assessment of body composition by bioelectrical impedance in children and young adults is strongly age-dependent. Eur J Clin Nutr 44:261–268
15.
go back to reference Willams DP, Going SB, Lohman TG et al (1992) Body fatness and risk for elevated blood pressure, total cholesterol, and serum lipoprotein ratios in children and adolescents. Am J Public Health 82:358–363CrossRef Willams DP, Going SB, Lohman TG et al (1992) Body fatness and risk for elevated blood pressure, total cholesterol, and serum lipoprotein ratios in children and adolescents. Am J Public Health 82:358–363CrossRef
16.
go back to reference Giuliano ICB, Caramelli B, Pellanda L et al. (2005) Diretriz de prevenção da aterosclerose na infância e adolescência. Arq Bras Cardiol 85:1–36CrossRef Giuliano ICB, Caramelli B, Pellanda L et al. (2005) Diretriz de prevenção da aterosclerose na infância e adolescência. Arq Bras Cardiol 85:1–36CrossRef
17.
go back to reference Madeira IR, Carvalho CN, Gazolla FM et al (2008) Ponto de corte do índice Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) avaliado pela curva receiver operating characteristc (ROC) na detecção da síndrome metabólica em crianças pré-púberes com excesso de peso. Arq Bras Endocrinol Metabol 52(9):1466–1473CrossRef Madeira IR, Carvalho CN, Gazolla FM et al (2008) Ponto de corte do índice Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) avaliado pela curva receiver operating characteristc (ROC) na detecção da síndrome metabólica em crianças pré-púberes com excesso de peso. Arq Bras Endocrinol Metabol 52(9):1466–1473CrossRef
18.
go back to reference Keskin M, Kurtoglu S, Kendirci M et al (2005) Homeostasis model assessment is more reliable than fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics 115(4):500–503CrossRef Keskin M, Kurtoglu S, Kendirci M et al (2005) Homeostasis model assessment is more reliable than fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics 115(4):500–503CrossRef
19.
go back to reference Burrows AR, Leiva BL, Burqueño AM et al (2006) Sensibilidad insulínica en niños de 6 a 15 años: associación con estado nutricional y pubertad. Revista Médica de Chile 134:1417–1426CrossRef Burrows AR, Leiva BL, Burqueño AM et al (2006) Sensibilidad insulínica en niños de 6 a 15 años: associación con estado nutricional y pubertad. Revista Médica de Chile 134:1417–1426CrossRef
20.
go back to reference Copeland K, Pankratz K, Cathey V et al (2006) Acanthosis nigricans, insulin resistance (HOMA) and dyslipidemia among native American children. J Okla State Med Assoc 99:19–24 Copeland K, Pankratz K, Cathey V et al (2006) Acanthosis nigricans, insulin resistance (HOMA) and dyslipidemia among native American children. J Okla State Med Assoc 99:19–24
21.
go back to reference Mion Júnior D, Junior OK, Gomes MAM et al (2006) V Diretrizes Brasileiras de Hipertensão Arterial. São Paulo, Sociedade Brasileira de Hipertensão, Sociedade Brasileira de Cardiologia, Sociedade Brasileira de Nefrologia Mion Júnior D, Junior OK, Gomes MAM et al (2006) V Diretrizes Brasileiras de Hipertensão Arterial. São Paulo, Sociedade Brasileira de Hipertensão, Sociedade Brasileira de Cardiologia, Sociedade Brasileira de Nefrologia
22.
go back to reference Tanner JM (1962) Growth at adolescence, 2nd edn. Blackwell Scientific Publications, Oxford, p 326 Tanner JM (1962) Growth at adolescence, 2nd edn. Blackwell Scientific Publications, Oxford, p 326
23.
go back to reference Rhie JY, Choi BM, Eun SH et al (2011) Association of serum retinol binding protein 4 with adiposity and pubertal development in Korean children and adolescents. Korean Acad Med Sci 26:797–802CrossRef Rhie JY, Choi BM, Eun SH et al (2011) Association of serum retinol binding protein 4 with adiposity and pubertal development in Korean children and adolescents. Korean Acad Med Sci 26:797–802CrossRef
24.
go back to reference Matthews DR, Hosker JP, Rudenski AS et al (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419CrossRef Matthews DR, Hosker JP, Rudenski AS et al (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419CrossRef
25.
go back to reference Gungor N, Saad R, Janosky J et al (2004) Validation of surrogate estimates of insulin sensitivity and insulin secretion in children and adolescents. J Pediatr 144:47–55CrossRef Gungor N, Saad R, Janosky J et al (2004) Validation of surrogate estimates of insulin sensitivity and insulin secretion in children and adolescents. J Pediatr 144:47–55CrossRef
26.
go back to reference Del Prato S, Riccio A, Kreutzenberg VS et al (1995) Basal plasma insulin levels exert a qualitative but not a quantitative effect on glucose-mediated glucose uptake. Am J Physiol 268:1089–1095 Del Prato S, Riccio A, Kreutzenberg VS et al (1995) Basal plasma insulin levels exert a qualitative but not a quantitative effect on glucose-mediated glucose uptake. Am J Physiol 268:1089–1095
27.
go back to reference Araujo CL, Dumith SC, Menezes AMB et al (2010) Nutritional status of adolescents: the 11- year follow-up of the 1993 Pelotas (Brazil) birth cohort study. Cadernos de Saúde Pública 26(10):1895–1903CrossRef Araujo CL, Dumith SC, Menezes AMB et al (2010) Nutritional status of adolescents: the 11- year follow-up of the 1993 Pelotas (Brazil) birth cohort study. Cadernos de Saúde Pública 26(10):1895–1903CrossRef
28.
go back to reference Wang Y (2002) Is obesity associated with early sexual maturation? A comparison of the association in American boys versus girls. Pediatrics 110:903–910CrossRef Wang Y (2002) Is obesity associated with early sexual maturation? A comparison of the association in American boys versus girls. Pediatrics 110:903–910CrossRef
29.
go back to reference Van Lenthe FJ, Kemper CG, van Mechelen W (1996) Rapid maturation in adolescence results in greater obesity in adulthood: the Amsterdam Growth and Health Study. Am J Clin Nutr 64:18–24 Van Lenthe FJ, Kemper CG, van Mechelen W (1996) Rapid maturation in adolescence results in greater obesity in adulthood: the Amsterdam Growth and Health Study. Am J Clin Nutr 64:18–24
30.
go back to reference Novaes JF, Lamounier JA, Franceschini SC et al (2009) Fatores ambientais associados ao sobrepeso infantil. Revista de Nutrição (Campinas) 22:661–673CrossRef Novaes JF, Lamounier JA, Franceschini SC et al (2009) Fatores ambientais associados ao sobrepeso infantil. Revista de Nutrição (Campinas) 22:661–673CrossRef
31.
go back to reference Barbosa Filho VC, Campos W, Bozza R et al (2012) The prevalence and correlates of behavioral risk factors for cardiovascular health among Southern Brazil adolescents: a cross section study. BMC Pediatr. doi:10.1186/1471-2431-12-130 Barbosa Filho VC, Campos W, Bozza R et al (2012) The prevalence and correlates of behavioral risk factors for cardiovascular health among Southern Brazil adolescents: a cross section study. BMC Pediatr. doi:10.​1186/​1471-2431-12-130
32.
go back to reference Coelho LG, Cândido AP, Machado-Coelho GL et al (2012) Association between nutritional status, food habits and physical activity level in schoolchildren. J Pediatr 88(5):406–412 Coelho LG, Cândido AP, Machado-Coelho GL et al (2012) Association between nutritional status, food habits and physical activity level in schoolchildren. J Pediatr 88(5):406–412
33.
go back to reference Rutters F, Nieuwenhuizen AG, Verhoef SP et al (2009) The relationship between leptin, gonadotropic hormones, and body composition during puberty in a Dutch children cohort. Eur J Endocrinol 160:973–978CrossRef Rutters F, Nieuwenhuizen AG, Verhoef SP et al (2009) The relationship between leptin, gonadotropic hormones, and body composition during puberty in a Dutch children cohort. Eur J Endocrinol 160:973–978CrossRef
34.
go back to reference Lin CJ, Chu NF, Hung YJ et al (2012) The association of retinol binding protein 4 with metabolic syndrome and obesity in adolescents: the effects of gender and sex hormones. Clin Pediatr 52(1):16–23 Lin CJ, Chu NF, Hung YJ et al (2012) The association of retinol binding protein 4 with metabolic syndrome and obesity in adolescents: the effects of gender and sex hormones. Clin Pediatr 52(1):16–23
35.
go back to reference Horlick MB, Rosenbaum M, Nicolson M et al (2000) Effect of puberty on the relationship between circulating leptin and body composition. J Clin Endocrinol Metabol 85:2509–2518 Horlick MB, Rosenbaum M, Nicolson M et al (2000) Effect of puberty on the relationship between circulating leptin and body composition. J Clin Endocrinol Metabol 85:2509–2518
36.
go back to reference Kos K, Wong S, Tan BK et al (2011) Human RBP4 adipose tissue expression in gender specific and influenced by leptin. Clin Endocinol 74:197–205CrossRef Kos K, Wong S, Tan BK et al (2011) Human RBP4 adipose tissue expression in gender specific and influenced by leptin. Clin Endocinol 74:197–205CrossRef
37.
go back to reference Dai S, Fulton JE, Harrist RB et al (2009) Blood lipids in children: age- related patterns and association with body-fat indices. Am J Prev Med 32(2):556–564 Dai S, Fulton JE, Harrist RB et al (2009) Blood lipids in children: age- related patterns and association with body-fat indices. Am J Prev Med 32(2):556–564
38.
go back to reference Monti LD, Brambilla P, Stefani I et al (1995) Insulin regulation of glucose turnover and lipid levels in obese children with fasting normo insulinemia. Diabetologia 38:739–747CrossRef Monti LD, Brambilla P, Stefani I et al (1995) Insulin regulation of glucose turnover and lipid levels in obese children with fasting normo insulinemia. Diabetologia 38:739–747CrossRef
39.
go back to reference Kannel WB, D’ Agostino RB, Belanger AJ (1995) Concept of bridging the gap from youth to adulthood. Am J Med Sci 310:2569–2575CrossRef Kannel WB, D’ Agostino RB, Belanger AJ (1995) Concept of bridging the gap from youth to adulthood. Am J Med Sci 310:2569–2575CrossRef
40.
go back to reference Balagopal P, Graham TE, Kahn BB et al (2007) Reduction of elevated serum retinol binding protein (RBP4) in obese children by lifestyle intervention: association with subclinical inflammation. J Clin Endocrinol Metab 92:1971–1974CrossRef Balagopal P, Graham TE, Kahn BB et al (2007) Reduction of elevated serum retinol binding protein (RBP4) in obese children by lifestyle intervention: association with subclinical inflammation. J Clin Endocrinol Metab 92:1971–1974CrossRef
41.
go back to reference Kim LY, Kim TK, Cheong ES et al (2012) Relation of absolut or relative adiposity to insulin resistance, retinol binding protein-4, leptin, and adiponectin in type 2 diabetes. Diabetes Metab J 36:415–421CrossRef Kim LY, Kim TK, Cheong ES et al (2012) Relation of absolut or relative adiposity to insulin resistance, retinol binding protein-4, leptin, and adiponectin in type 2 diabetes. Diabetes Metab J 36:415–421CrossRef
42.
go back to reference Friebe D, Neef M, Erbs S et al (2010) Retinol binding protein 4 (RBP4) is primarily associated with adipose tissue mass in children. Int J Pediatr Obes 6(2–2):345–352 Friebe D, Neef M, Erbs S et al (2010) Retinol binding protein 4 (RBP4) is primarily associated with adipose tissue mass in children. Int J Pediatr Obes 6(2–2):345–352
43.
go back to reference Foy CG, Foley KL, D’Agostino RB et al (2006) Physical activity, insulin sensitivity, and hypertension among US adults: findings from Insulin Resistance Atherosclerosis Study. Am J Epidemiol 163:921–928CrossRef Foy CG, Foley KL, D’Agostino RB et al (2006) Physical activity, insulin sensitivity, and hypertension among US adults: findings from Insulin Resistance Atherosclerosis Study. Am J Epidemiol 163:921–928CrossRef
44.
go back to reference Atebek ME, Pirgon O, Kurtoglu S (2007) Assessment of abnormal glucose homeostasis and insulin resistance in Turkish obese children and adolescents. Diabetes Obes Metab 9:304–310CrossRef Atebek ME, Pirgon O, Kurtoglu S (2007) Assessment of abnormal glucose homeostasis and insulin resistance in Turkish obese children and adolescents. Diabetes Obes Metab 9:304–310CrossRef
45.
go back to reference Hotamisligil GS, Arner P, Caro JF et al (1995) Increased adipose tissue expression of tumor necrosis factor- alpha in human obesity and insulin resistance. J Clin Investig 95:2409–2415CrossRef Hotamisligil GS, Arner P, Caro JF et al (1995) Increased adipose tissue expression of tumor necrosis factor- alpha in human obesity and insulin resistance. J Clin Investig 95:2409–2415CrossRef
46.
go back to reference Blanner WS (1989) Retinol binding protein- the serum transport protein for vitamin A. Endocr Rev 10:308–316CrossRef Blanner WS (1989) Retinol binding protein- the serum transport protein for vitamin A. Endocr Rev 10:308–316CrossRef
Metadata
Title
Retinol-binding protein 4 and insulin resistance are related to body fat in primary and secondary schoolchildren: the Ouro Preto study
Authors
Ana Paula Pereira Castro
Ana Paula Carlos Cândido
Roney Luiz de Carvalho Nicolato
Ivo Santana Caldas
George Luiz Lins Machado-Coelho
Publication date
01-03-2014
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nutrition / Issue 2/2014
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI
https://doi.org/10.1007/s00394-013-0543-5

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