Retinol-binding protein 4 is associated with impaired glucose regulation and microalbuminuria in a Chinese population

Aims/hypothesis  Increased retinol-binding protein 4 (RBP4) has been reported in association with insulin resistance and type 2 diabetes. We aimed to investigate the association of serum RBP4 with impaired glucose regulation and microalbuminuria in Chinese adults aged 40 years or older. Methods  Serum RBP4 was measured in 763 individuals with normal glucose regulation, 508 with impaired glucose regulation and 524 newly diagnosed diabetic patients. Serum RBP4 was measured using ELISA and urine albumin/creatinine ratio was used to determine the urinary albumin excretion. Results  Serum RBP4 concentrations were significantly higher in participants with isolated impaired fasting glucose, isolated impaired glucose tolerance, combined impaired fasting glucose/impaired glucose tolerance and diabetes than in those with normal glucose regulation, whereas serum RBP4 levels were not different in the four groups with dysregulation of glucose metabolism. RBP4 was associated with a higher risk for impaired glucose regulation (OR 1.011 for each 1 μg/ml increase in RBP4, 95% CI 1.000–1.022, p = 0.04) after adjustment for sex, age, BMI, current smoking and alcohol intake, family history of diabetes, insulin resistance, triacylglycerol, total cholesterol, and HDL- and LDL-cholesterol; the corresponding OR of combined impaired glucose regulation and type 2 diabetes was 1.022 (95% CI 1.009–1.035, p = 0.0009). RBP4 was associated with the risk of microalbuminuria (OR 1.023, 95% CI 1.004–1.042, p = 0.01) after adjustment for sex, age, smoking habit and alcohol intake, BMI, waist/hip ratio, homeostasis model assessment of insulin resistance, GFR, triacylglycerol, total cholesterol, and HDL- and LDL-cholesterol. Conclusions/interpretation  Serum RBP4 level is closely associated with impaired glucose regulation and is an independent risk factor for microalbuminuria. M. Xu and X. Y. Li contributed equally to this study.