Serum retinol binding protein 4 in individuals with essential hypertension and type 2 diabetes: A cross-sectional study

Abstract

ABSTRACT Background: Cardiometabolic disorders, notably primary hypertension and type 2 diabetes, present substantial global health challenges. The intricate interplay between metabolic and cardiovascular pathways has prompted extensive research into molecular mechanisms linking these conditions. The adipokine Retinol Binding Protein 4 (RBP4), initially recognized for retinol transport, has emerged as a potential biomarker in the network of metabolic and cardiovascular dysfunction. Recent studies implicate RBP4 in insulin resistance and its complications, including hypertension. This study explores RBP4 dynamics in patients with primary hypertension and type 2 diabetes, aiming to contribute valuable insights into diagnostic and therapeutic advancements in managing these interconnected disorders. Methods: This cross-sectional study, conducted over 2 years in a tertiary healthcare centre of North India, aimed to investigate the serum concentration of Retinol Binding Protein 4 (RBP4) in 119 participants diagnosed with primary hypertension and type 2 diabetes. Ethical guidelines were strictly followed, and comprehensive clinical assessments, including blood pressure measurements, were performed. RBP4 levels were quantified using an ELISA kit, alongside markers of insulin resistance. Statistical analyses, involving t-tests and correlation assessments, sought to unravel potential associations between RBP4, insulin resistance, and blood pressure parameters using SPSS 20.0. Results: The study comprised 61 healthy control (HC) participants and 58 individuals diagnosed with both essential hypertension and type 2 diabetes (EH+T2D). EH+T2D participants were on average older (45.71 ± 9.29 years vs. 40.34 ± 9.47 years, P = 0.002). Dyslipidemia prevalence was markedly higher in EH+T2D (72.4% vs. 11.4%, P < 0.0001), accompanied by disrupted lipid profiles. Serum RBP4 concentration was significantly elevated in EH+T2D (49.17 ± 19.37 mg/L, P < 0.0001), suggesting its potential role in the shared pathophysiology of primary hypertension and type 2 diabetes. Pearson’s correlation analysis revealed associations between RBP4 levels, metabolic, and cardiovascular parameters, underscoring its potential as a link between these conditions. Conclusion: Elevated serum RBP4 levels suggest its potential as a novel biomarker in the shared pathophysiology of primary hypertension and type 2 diabetes. The correlation analysis highlights the intricate interplay between metabolic, lipid, and cardiovascular parameters, emphasizing the need for holistic interventions.