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Type 2 Diabetes – Elevated levels of RBP4 early indication of Insulin Resistance

June 15th, 2006

Type 2 Diabetes – Elevated levels of RBP4 early indication of Insulin Resistance

Exercise can help lower RBP4 levels

A recent study found that increased levels of retinol binding protein 4 (RBP4) molecule helps predict the early stage of insulin resistance which is the one of the major reasons why most people develop type 2 diabetes and cardiovascular disease.  This study led by researchers from Beth Israel Deaconess Medical Center (BIDMC) was first reported in the June 15th issue of The New England Journal of Medicine (NEJM).

It may become possible to develop anti-diabetic therapies that lower RBP4 levels.  By measuring for elevated levels of RBP4, this could be used as a diagnostic tool to assess people’s risk for developing diabetes before the disease becomes onset.

 

"Type 2 diabetes is a rapidly increasing epidemic in the Western world," said senior author Barbara Kahn, MD., who is Chief of the Division of Diabetes, Endocrinology and Metabolism at BIDMC and is also Professor of Medicine at Harvard Medical School. "Since it is now occurring even in childhood, predictions indicate that it could shorten lifespan in the U.S. for the first time in more than a century."

Insulin is a hormone that is needed to allow the body to use up sugar from the blood and change it into to energy.  Muscles, fat, and liver cells become unable to react to insulin when insulin resistance occurs.  The excess unconverted sugar, in the form of glucose, resides and stays in the bloodstream.  That is why blood glucose levels rise up considerably in diabetes.

"Insulin resistance not only predisposes individuals to type 2 diabetes, it is also a major risk factor for cardiovascular disease," said the co-lead author, Timothy Graham, MD., from the Kahn laboratory. "Unfortunately, in the clinical setting, it is often difficult to distinguish individuals with and without insulin resistance."

 

Researchers at Kahn’s laboratory last year, discovered that RBP4 causes insulin resistance.  RBP4 is a protein which is released from fat. Before this discovery, RBP4 was only understood to participate in the delivery of vitamin A.

From this previous research, Graham along with co-lead author Qin Yang, MD., PhD., wanted to measure blood serum levels of RBP4 and at the same time determine if there was any changes in insulin resistance.

Participants in this study were either obese, had impaired glucose tolerance with pre-diabetes, or had type 2 diabetes.  They also had participants that were non-obese and healthy to compare against the glucose impaired individuals.  The results showed that those that had the highest level of insulin resistance also had the highest levels of RBP4 in all cases.  The researchers also noticed that high levels of RBP4 also correlated to the metabolic syndrome that includes high triglyceride levels, obesity with excess abdominal weight, high blood pressure, and decreased levels of the “good” HDL cholesterol.

 

Further testing was completed with participants that were of normal body weight and normal blood glucose levels, but had a genetic risk because type 2 diabetes was prevalent in their families.  The researchers discovered that there were elevated RBP4 levels in this group too.

The researchers wanted to see if exercise would help lower the RBP4 levels and at the same time improve insulin responsiveness.  Approximately two-thirds of the participants that exercised not only improved their insulin sensitivity but the also decreased the level of RBP4 at the same time.  The other one-third participants did not improve the insulin sensitivity and the RBP4 levels remained the same.

"Collectively, these findings tell us that RBP4 is a useful marker for therapeutic improvement and that this protein could play a causal role in insulin resistance in humans, just as our lab previously showed in mice," said Kahn.

"Being able to determine diabetes risk well before the onset of symptoms could provide an important opportunity for patients to take preventive measures," she adds. "For those who are overweight or sedentary, this could mean making changes to their diet and fitness routines. For those who are lean and fit, but have a family history of type 2 diabetes, this could mean taking anti-diabetic medication. Either way, these findings could help clinicians to better manage this growing epidemic."

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Nicole Wilson
Best Syndication

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Important:  The material on Best Syndication is for informational purposes only and is not a substitute for medical advice or treatment for any medical conditions. You should promptly seek professional medical care if you have any concern about your health, and you should always consult your physician before starting a fitness program.
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Copyright 2005 Best Syndication                   Last Updated Saturday, July 10, 2010 09:47 PM