Retinol-binding protein 4 (RBP4) has been reported involving in the occurrence and development of hypertension. However, to date, few data are available on the correlation between serum RBP4 level and blood pressure (BP) in prehypertension. Therefore, this association was investigated in prehypertensive Chinese. Overall, 160 subjects with prehypertension (Pre-HT group) and 160 subjects with normal BP (NBP group) were recruited in this study. The subjects were divided into the following four subgroups according to body mass index (BMI): obese Pre-HT subgroup; non-obese Pre-HT subgroup; obese NBP subgroup; and non-obese NBP subgroup (n=80 in each). Anthropometric parameters, systolic BP (SBP), diastolic BP (DBP) and several biochemical parameters were measured. Fasting insulin was evaluated by radioimmunoassay. Serum RBP4 level was measured by enzyme-linked immunosorbent assay. The Pre-HT group had higher levels of serum RBP4 level than did the NBP group (P<0.001). Moreover, higher RBP4 levels were identified in the obese Pre-HT subgroup relative to the non-obese Pre-HT subgroup (P=0.005). However, no difference in RBP4 level was identified between the obese and the non-obese NBP subgroups (P=0.317). RBP4 level was positively correlated with BMI (r=0.226, P=0.001), SBP (r=0.468, P<0.001) and DBP (r=0.358, P<0.001) after adjustment for age, sex, smoking status and alcohol consumption. The results of the multiple regression analyses demonstrated that RBP4 level was independently associated with SBP (β=0.427, P<0.001) and DBP (β=0.338, P<0.001). In conclusion, serum RBP4 level was significantly higher and closely associated with BP in prehypertensive Chinese.
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Blaner WS . Retinol-binding protein: the serum transport protein for vitamin A. Endocr Rev 1989; 10: 308–316.
Yang Q, Graham TE, Mody N, Preitner F, Peroni OD, Zabolotny JM et al. Serum retinol binding protein 4 contributes to insulin resistance in obesity and type 2 diabetes. Nature 2005; 436: 356–362.
Graham TE, Yang Q, Blüher M, Hammarstedt A, Ciaraldi TP, Henry RR et al. Retinol-binding protein 4 and insulin resistance in lean, obese, and diabetic subjects. N Engl J Med 2006; 354: 2552–2563.
Friebe D, Neef M, Erbs S, Dittrich K, Kratzsch J, Kovacs P et al. Retinol binding protein 4 (RBP4) is primarily associated with adipose tissue mass in children. Int J Pediatr Obes 2011; 6: e345–e352.
Lee JW, Im JA, Lee HR, Shim JY, Youn BS, Lee DC . Visceral adiposity is associated with serum retinol binding protein-4 levels in healthy women. Obesity (Silver Spring) 2007; 15: 2225–2232.
Alkharfy KM, Al-Daghri NM, Vanhoutte PM, Krishnaswamy S, Xu A . Serum retinol-binding protein 4 as a marker for cardiovascular disease in women. PLoS ONE 2012; 7: e48612.
Chen CC, Wu JY, Chang CT, Tsai FJ, Wang TY, Liu YM et al. Levels of retinol-binding protein 4 and uric acid in patients with type 2 diabetes mellitus. Metabolism 2009; 58: 1812–1816.
Cho YM, Youn BS, Lee H, Lee N, Min SS, Kwak SH et al. Plasma retinol-binding protein-4 concentrations are elevated in human subjects with impaired glucose tolerance and type 2 diabetes. Diabetes Care 2006; 29: 2457–2461.
Wang F, Han L, Hu D . Fasting insulin, insulin resistance and risk of hypertension in the general population: a meta-analysis. Clin Chim Acta 2017; 464: 57–63.
Kraus BJ, Sartoretto JL, Polak P, Hosooka T, Shiroto T, Eskurza I et al. Novel role for retinol-binding protein 4 in the regulation of blood pressure. FASEB J 2015; 29: 3133–3140.
Solini A, Santini E, Madec S, Rossi C, Muscelli E . Retinol-binding protein-4 in women with untreated essential hypertension. Am J Hypertens 2009; 22: 1001–1006.
Chiba M, Saitoh S, Ohnishi H, Akasaka H, Mitsumata K, Furukawa T et al. Associations of metabolic factors, especially serum retinol-binding protein 4 (RBP4), with blood pressure in Japanese—the Tanno and Sobetsu study. Endocr J 2010; 57: 811–817.
Deng W, Zhang Y, Zheng Y, Jiang Y, Wu Q, Liang Z et al. Serum retinol-binding protein 4 levels are elevated but do not contribute to insulin resistance in newly diagnosed Chinese hypertensive patients. Diabetol Metab Syndr 2014; 6: 72.
James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014; 311: 507–520.
Egan BM, Stevens-Fabry S . Prehypertension—prevalence, health risks, and management strategies. Nat Rev Cardiol 2015; 12: 289–300.
Xu T, Liu J, Zhu G, Liu J, Han S . Prevalence of prehypertension and associated risk factors among Chinese adults from a large-scale multi-ethnic population survey. BMC Public Health 2016; 16: 775.
Zhang H, Deng M, Xu H, Wang H, Song F, Bao C et al. Pre- and undiagnosed-hypertension in urban Chinese adults: a population-based cross-sectional study. J Hum Hypertens 2017; 31: 263–269.
Selassie A, Wagner CS, Laken ML, Ferguson ML, Ferdinand KC, Egan BM . Progression is accelerated from prehypertension to hypertension in blacks. Hypertension 2011; 58: 579–587.
Gu D, Wildman RP, Wu X, Reynolds K, Huang J, Chen CS et al. Incidence and predictors of hypertension over 8 years among Chinese men and women. J Hypertens 2007; 25: 517–523.
Wen CP, David Cheng TY, Tsai SP, Chan HT, Hsu HL, Hsu CC et al. Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians. Public Health Nutr 2009; 12: 497–506.
Inoue S, Takamoto N, Akahori Y, Masumoto A, Nakatsukasa H, Msuyama H et al. Elevated level of serum retinol-binding protein 4 in pregnancy-induced hypertension. J Obstet Gynaecol Res 2009; 35: 293–300.
Qi Q, Yu Z, Ye X, Zhao F, Huang P, Hu FB et al. Elevated retinol-binding protein 4 levels are associated with metabolic syndrome in Chinese people. J Clin Endocrinol Metab 2007; 92: 4827–4834.
Ou HY, Wu HT, Yang YC, Wu JS, Cheng JT, Chang CJ . Elevated retinol binding protein 4 contributes to insulin resistance in spontaneously hypertensive rats. Horm Metab Res 2011; 43: 312–318.
Norseen J, Hosooka T, Hammarstedt A, Yore MM, Kant S, Aryal P et al. Retinol-binding protein 4 inhibits insulin signaling in adipocytes by inducing proinflammatory cytokines in macrophages through a c-Jun N-terminal kinase- and toll-like receptor 4-dependent and retinol-independent mechanism. Mol Cell Biol 2012; 32: 2010–2019.
Qureshi AI, Suri MF, Kirmani JF, Divani AA, Mohammad Y . Is prehypertension a risk factor for cardiovascular diseases? Stroke 2005; 36: 1859–1863.
Guo X, Zhang X, Zheng L, Guo L, Li Z, Yu S et al. Prehypertension is not associated with all-cause mortality: a systematic review and meta-analysis of prospective studies. PLoS ONE 2013; 8: e61796.
Huang Y, Su L, Cai X, Mai W, Wang S, Hu Y et al. Association of all-cause and cardiovascular mortality with prehypertension: a meta-analysis. Am Heart J 2014; 167: 160–168.
Chiang PP, Lamoureux EL, Shankar A, Tai ES, Wong TY, Sabanayagam C . Cardio-metabolic risk factors and prehypertension in persons without diabetes, hypertension, and cardiovascular disease. BMC Public Health 2013; 13: 730.
We thank the National Natural Science Foundation of China (NSFC Number 81500654) and the Natural Science Foundation of Hubei Province (Number 2016CFB392) for their grant support. This study was supported by grants from the National Natural Science Foundation of China (NSFC Number 81500654) and Natural Science Foundation of Hubei Province (Number 2016CFB392).
The authors declare no conflict of interest.
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