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Abstract
Diabetes mellitus is a group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels.T2DM, which was previously referred to as non insulin dependent diabetes mellitus, or adult onset diabetes mellitus, accounts for 90–95%of diabetic patients.IGT is an important risk factor for development of type 2 diabetes.However, prospective and long-term studies report different predictive values for the development of type 2 diabetes in different populations.RBP4 is the major carrier of retinol in the circulation in a complex with transthyretin. It’s predominantly synthesized in the liver with a lesser amount derived from adipocytes. This has led to the recent suggestion that RBP4 may be a newly discovered adipocytokine with a potential link between cardiovascular risk and insulin resistance.High plasma RBP4 levels are associated with insulin resistance states suggesting that RBP4 plays a key role in the pathogenesis of insulin resistance in humans and reflects the magnitude of insulin resistance in subjects with obesity, T2DM and non obese subjects with family history of T2DM.RBP4 is encoded by RBP4 gene which maps to chromosomer 10q23-q24 a region that has been linked to increased risk for type 2DM in different populations.Adipose tissue RBP4 mRNA expression has been shown to be increased in insulin resistance state in many studies either done on animals or human.The current study was carried out at the Medical Biochemistry and General Surgery departments, faculty of medicine, Menofiya University.The aim of this work is to study the expression of retinol binding protein 4 mRNA in fat depots of human subjects with type 2 diabetes mellitus.This study involved 48 individuals, 18 subjects with T2DM, 15subjects with IGT and 15 non diabetic subjects served as controls. All subjects were undergoing abdominal surgery (cholecystectomy and hernia).Full history and clinical examination were made to every subject.Anthropometric measurements were taken include; weight, height and waist circumference. Calculation of waist to hip ratio and BMI were done. Laboratory investigations were also carried out to all individuals including: oral glucose tolerance test (OGTT), Lipid profile (total cholesterol, triglycerides, high density lipoprotein cholesterol, HDLc and low density lipoprotein cholesterol, LDLc), glycated hemoglobin (HbA1c), fasting insulin and plasma RBP4. Determination of insulin resistance by HOMA-IR and determination of mRNA expression of RBP4 in subcutaneous adipose tissue were also carried out.The results of the present study can be summarized as follows:• Waist circumference and waist to hip ratio are significantly higher in T2DM and IGT groups than the control group.• Fasting, 2 hours post prandial blood glucose and HbA1c are significantly higher in both IGT and T2DM groups compared with thecontrol group.• Total cholesterol, triacylglycerol and LDLc are significantly higher in T2DM and IGT groups compared with the control group. whereas, serum HDLc is significantly lower.• Fasting serum insulin, HOMA-IR, mRNA expression of RBP4 and plasma RBP4 concentrations are significantly higher in IGT and T2DM compared with the control group.• There is non significant positive correlation between plasma RBP4 and each of BMI, total cholesterol, triacylglycerol and LDLc and mRNA expression of RBP4 in all studied groups.• There is non significant negative correlation between plasma RBP4 and HDLc in all studied groups.• There is significant positive correlation between plasma RBP4 and both waist circumference and waist to hip ratio in T2DM group.• There is significant positive correlation between plasma RBP4 and fasting serum insulin and HOMA-IR in all studied groups.• The proportion of IGT and T2DM is increased on increasing RBP4 concentration according to the quartiles analysis.