Endocrine Abstracts

Introduction: Retinol binding protein (RSP) is a member of the adipokine family associated with insulin resistance (IR). With an excess of free fatty acids, the binding of insulin by hepatocyte receptors decreases and hyperinsulinemia develops. RSP is a transport protein for retinol, synthesized in hepatocytes and adipocytes. The level of RSP increased in patients with obesity, diabetes mellitus and non-alcoholic fatty liver disease (NAFLD) correlated positively with the severity of the inflammatory process and fibrosis. RSP regulates the action of insulin in tissues, skeletal muscle and liver.

Purpose of the study: To determine the CPR in patients with NAFLD and type 2 diabetes. To compare the results of CPR with inflammatory markers of lipoprotein associated phospholipase (PLA2) and nitrogen oxide (NO), which inhibits the proliferation of collagen and regulates hepatic blood flow.

Material and methods: A total of 208 patients with NAFLD and T2DM (120zh/88m) were examined. The average age is 57.3±5.2. Of these, patients with type 2 diabetes are type 76 patients and 132 have impaired glucose tolerance (IGT). BMI over 30 kg/m² (34.85±1.79). Patients underwent clinical, biochemical, and instrumental research methods. RSP was determined in 89 patients with type 2 diabetes using the ELISA method in blood serum. The control group consisted of 15 healthy individuals. FLA was determined by ELISA. NO metabolites were determined by the express method.

The results of the study: The RSP content in the control group was 26.15±1.31 μg/L. In patients with type 2 diabetes without NAFLD (group 1), it was reduced by 12.8% and amounted to 20.34±3.8 μg/l. In 49 patients with NAFLD and type 2 diabetes (group 2), the RSP content was significantly increased by 48.9% and amounted to 38, 96±11.47 μg/l. The content of PLA2 was increased by 4.78 times compared to the control in group 2 and the level of stable metabolites of nitric oxide increased parallel to the activity of hepatic enzymes. A direct positive correlation between PLA2 and NO is noted. The correlation coefficient was r=0.625 P=0.001.

Conclusion: The level of CPR was significantly increased in patients with type 2 diabetes and NAFLD compared with controls and group 1. An increase in the content of inflammatory markers was accompanied by an inflammatory process in the liver with an increased activity of liver enzymes and severity of morphological changes.