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Obesity (Silver Spring). 2007 Sep;15(9):2225-32.

Visceral adiposity is associated with serum retinol binding protein-4 levels in healthy women.

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Department of Family Medicine, Yonsei University, College of Medicine, Yong-dong Severance Hospital, Kangnam P.O. Box 1217, Seoul, Korea.



Retinol binding protein-4 (RBP4) has been reported to impair insulin sensitivity throughout the body. We investigated the relationship between serum RBP4 levels and adiposity indices as well as metabolic risk variables.


We recruited a total of 102 healthy women 21 to 67 years old. We assessed body composition by computed tomography and divided the study population into four groups based on body weight and visceral fat area (non-obese without visceral adiposity, non-obese with visceral adiposity, obese without visceral adiposity, and obese with visceral adiposity). Serum RBP4 levels were measured by radioimmunoassay.


Despite similar levels of total body fat, non-obese women had lower systolic blood pressure, total cholesterol, triglyceride (TG), low-density lipoprotein (LDL)-cholesterol levels, insulin resistance indices, and RBP4 levels than non-obese women with visceral adiposity and had higher high-density lipoprotein-cholesterol levels. Similarly, obese women without visceral adiposity had lower blood pressure, total cholesterol, TG levels, insulin resistance indices, and RBP4 levels than obese women with visceral adiposity. In addition, despite having increased body fat, obese women without visceral adiposity had lower TGs, insulin resistance indices, and serum RBP4 levels than non-obese women with visceral adiposity. By step-wise multiple regression analysis, visceral fat areas and LDL-cholesterol levels independently affected RBP4 levels.


We determined that serum RBP4 levels are independently associated with visceral fat and LDL-cholesterol levels. These results suggest that, irrespective of body weight, visceral obesity is an independent predictor of serum RBP4 levels, and RBP4 may represent a link between visceral obesity and cardiovascular disease.

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