Study Of The Relationship Between Serum Retinol Binding Protein4and Lower Extremity Arterial Disease In Type2Diabetes

Objective:Retinol binding protein4(RBP-4) is a new adipocytokine. It was mainly secreted by the liver and adipose tissue. RBP-4is a21kDa plasma protein. It plays an irreplaceable role in physiological functions of retinol. The main function of RBP-4is to transport the retinol (vitaminA) in the blood circulation. Lower extremity arterial disease(LEAD), a part of peripheral arterial disease and one of complications of T2DM,manifests stenosis or block of peripheral arterial.In addition,the Pathological mechanism of LEAD is atherosclerosis.This study was designed to investigate the relationship between RBP4and type2diabetes with the LEADMethods:90cases hospitalized type2diabetic patients were divided into two groups,45cases with LEAD and45cases without LEAD. The clinical data including age,gender,height, weight, duration of disease were collected. Fasting blood was taked to detect fasting plasma glucose (FPG), fasting serum insulin (FINS), fasting serum C-peptide, triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), Glycosylated hemoglobin (HbA1c), retinol binding protein4(RBP4). Insulin resistance index was calculated by the model HOMA-IR (HOMA-IR=FPG (mmol/L)×FINS (mU/L)/22.5). The lower extremity artery of femoral artery, popliteal artery, anterior tibial artery, posterior tibial artery and dorsalis pedis artery were detected with color Doppler ultrasound by trained professionals. Visceral-abdominal fat area (VA) and subcutaneous fat area (SA) were measured by computed tomography(CT). Statistical analysis was performed using SPSS version13.0. Measurement data meeting normal distribution were describled by mean±SD, while non-normally distributed variables were summarized by median (interquartile range). Independent-Samples t test was used for comparison between the two groups. Pearson's or Spearman's correlation analysis was used to analysis the correlation between RBP4and other variables. Logistic regression analysis was applied to predict whether RBP4and other variables were risk factors of LEAD in type2diabetes or not. P<0.05(two-sided test) was considered to be statistically significant.Result:1Comparison between two groups showed that RBP4, FPG, TC,TG in the LEAD group were significantly higher than the other group, while HDL-C lower than the other group.(P<0.05)2Correlation analysis showed that serum RBP4positively correlated with age, HbA1c, TC, TG, FPG, FINS, Ln(HOMA-IR) significantly.(r values were0.313,0.244,0.322,0.863,0.251,0.290,0.315,0.399,0.992,0.988, respectively.P <0.05).3Logistic multiple stepwise regression analysis,made by the dependant variable group, demonstrated that duration of diabetes,RBP4and TG were risk factors of LEAD in Type2diabetes mellitus patientsConclusion:1Serum RBP4,FPG,TG,TC,VA, SA and high-density lipoprotein may contribute to the progression of lower limb arterial lesions.2RBP4and duration of diabetes were independent risk factors of Type2diabetes mellitus patients with the lower extremity arterial disease.