Endocrine Abstracts

Retinol binding protein (RBP) is an adipokine, related to insulin resistance (IR). Excess free fat acid reduces the binding of insulin by hepatocyte receptors and leads to hyperinsulinemia. RBP transport protein synthesized in hepatocytes and adipocytes. The level of RBP increases in patients with obesity, diabetes and non-alcoholic fatty liver disease (NAFLD). It is positively correlated with the degree of severity of the inflammatory process and fibrosis. The RBP regulates the activity of insulin in tissues, skeletal muscles, and the liver.

Purpose of research: Determine RBP in patients with NAFLD and type 2 diabetes. Compare the results of RBP with markers of lipoprotein-associated inflammation phospholipase (FLA2) and nitrogen oxide (NO), which inhibits the proliferation of collagen and regulates hepatic blood flow.

Material and Methods: 208 patients with NAFLD and type 2 diabetes were examined. The average age is 57.3 ± 5.2. There were 76 patients with type 2 diabetes and 132 with impaired glucose tolerance (NTG). BMI more than 30 kg/m² (34.85 ± 1.79).

Clinical, biochemical, and instrumental research methods were performed. RBP was determined in 89 patients with type 2 diabetes using the immunoassay method in blood serum. The control group consisted of 15 practically healthy person. FLA was determined by immunoenzyme method. NO metabolites were determined by Express method.

Research result: The RBP content in the control group was 26.15 ± 1.31 mg/l. The RBP content in patients with type 2 diabetes without NAFLD (group 1) was reduced by 12.8% and amounted to 20.34 ± 3.8 mg/l. The RBP content in 49 patients with NAFLD and2 diabetes (group 2) was significantly increased by 48.9% and amounted to 38.96 ± 11.47 mg/l. The FLA2 content was increased by 4.78 times in relation to the control in group 2. The content level stable nitric oxide metabolites was increased in parallel with liver activity enzymes. There is a direct positive correlation between FLA2 and NO. The correlation coefficient was r = 0.625 P = 0.001.

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