Journal of the Formosan Medical Association
Volume 109, Issue 6 , Pages 422-429, June 2010

Decreased Retinol Binding Protein 4 Concentrations are Associated With Cholesterol Gallstone Disease

  • Shen-Nien Wang

      Affiliations

    • Department of Surgery, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
    • Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Shen-Nien Wang and Yao-Tsung Yeh contributed equally to this work.
    • ,
  • Yao-Tsung Yeh

      Affiliations

    • Department of Medical Technology, Fooyin University, Kaohsiung, Taiwan
    • Shen-Nien Wang and Yao-Tsung Yeh contributed equally to this work.
    • ,
  • Sen-Teh Wang

      Affiliations

    • Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
    • ,
  • Yi-Ling Chen

      Affiliations

    • Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • ,
  • Shih-Chang Chuang

      Affiliations

    • Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Chen-Guo Ker

      Affiliations

    • Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • King-Teh Lee

      Affiliations

    • Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr King-Teh Lee, Department of Surgery, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, Kaohsiung, 807 Taiwan

Received 2 January 2009; received in revised form 6 July 2009; accepted 17 September 2009.

Article Outline

Background/Purpose

Circulating retinol binding protein 4 (RBP4) is associated with a variety of obesity-related diseases. This study investigated whether there were aberrant concentrations of RBP4 in cholesterol gallstone disease.

Methods

Serum RBP4 levels of 100 cholesterol gallstone patients and 147 healthy controls were measured by enzyme-linked immunosorbent assay and further correlated with clinical and biochemical characteristics, including insulin resistance and renal function. Gallstone specimens were obtained during laparoscopic cholecystectomy and analyzed for their chemical composition using Fourier transform infrared spectroscopy

Results

Significantly lower serum RBP4 levels were found in patients with cholesterol gallstones in comparison with controls (30.57 ± 13.64 mg/L vs. 41.52 ± 20.25 mg/L, p<0.001). Lower serum RBP4 levels were also associated with gallstone occurrence (odds ratio = 0.93; 95% confidence interval = 0.88–0.96; p = 0.004). Serum RBP4 levels of all subjects were positively correlated with total cholesterol, triglyceride, creatinine, insulin resistance and albumin, and inversely correlated with aspartate aminotransferase and alanine aminotransferase. In multivariate analysis, cholesterol gallstone formation was significantly associated with a lower serum RBP4 level (odds ratio = 4.2; 95% confidence interval= 1.40–12.57; p = 0.010). RBP4 levels were significantly decreased regardless of renal function in patients with gallstones, but levels increased proportionate to renal dysfunction in people without gallstones.

Conclusion

Circulating RBP4 decreases in cholesterol gallstone disease independent of renal function. Further studies are needed to investigate the relationship between liver function and RBP4 levels in these patients.

Key Words:  adipokine , cholesterol gallstone , insulin resistance , renal function , retinol binding protein 4

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PII: S0929-6646(10)60073-3

doi:10.1016/S0929-6646(10)60073-3

Journal of the Formosan Medical Association
Volume 109, Issue 6 , Pages 422-429, June 2010

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