 |
|
RBP4 predicts type 2 diabetes
June 15, 2006Elevation of fat-derived molecule foretells early insulin resistance
BOSTON — A study in the June 15 issue of The New England Journal of Medicine (NEJM) reveals that elevated levels of a molecule called RBP4 (retinol binding protein 4) can foretell early stages in the development of insulin resistance, a major cause of type 2 diabetes as well as cardiovascular disease.
The new findings, led by researchers at Beth Israel Deaconess Medical Center (BIDMC), offer a potential new target for the development of anti-diabetic therapies to lower serum RBP4 levels as well as an early means of identifying individuals who are at risk of developing diabetes — before the onset of overt disease.
"Type 2 diabetes is a rapidly increasing epidemic in the Western world," explains senior author Barbara Kahn, MD, Chief of the Division of Diabetes, Endocrinology and Metabolism at BIDMC and 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 resistance develops when the body's muscles, fat and liver cells lose the ability to respond to the hormone insulin. Because insulin is necessary to enable the body to take up sugar from blood and convert it into energy, this impairment results in a buildup of glucose in the bloodstream.
"Insulin resistance not only predisposes individuals to type 2 diabetes, it is also a major risk factor for cardiovascular disease," adds co-lead author Timothy Graham, MD, an investigator in the Kahn laboratory. "Unfortunately, in the clinical setting, it is often difficult to distinguish individuals with and without insulin resistance."
Last year, in a study conducted in animals, Kahn's laboratory made the discovery that RBP4, a protein secreted from fat, can cause insulin resistance. Prior to this, the molecule was recognized only for its role in the transport of vitamin A.
In this new research, Graham, together with co-lead author Qin Yang, MD, PhD, set out to determine whether levels of RBP4, as measured in blood, correlate with the presence or absence of insulin resistance. (Study subjects represented three separate cohorts from San Diego, California; Goteberg, Sweden; and Leipzig, Germany.)
They first studied individuals with either obesity, impaired glucose tolerance (a "pre-diabetic" state), or with type 2 diabetes, comparing the blood levels of RBP4 in these insulin-resistant subjects with levels found in non-obese healthy subjects. Their results showed that not only were RBP4 levels higher in all cases in which insulin resistance was high, but that elevated serum RBP4 was also closely associated with components of the metabolic syndrome, including increased body mass index, waist-to-hip ratio, serum triglyceride levels, and systolic blood pressure, as well as decreased levels of high-density lipoprotein (HDL), or good, cholesterol.
The study was then extended to subjects with normal body weight and normal blood glucose, but with a strong family history of type 2 diabetes. "These are people who appear healthy, but have a high risk of developing diabetes due to their genetic background," explains Ulf Smith, MD, PhD, of Sahlgrenska Hospital, Goteberg, Sweden, where this group of subjects was based. As predicted, the investigators found elevated RBP4 levels among this group as well.
Finally, the authors tested whether a therapeutic intervention — in this case, exercise — could lower RBP4 levels and increase insulin sensitivity. They found that all of the people who improved their insulin sensitivity with exercise also lowered their serum RBP4 levels. Among the one-third of the subjects who did not improve their insulin sensitivity, neither did RBP4 levels go down.
"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," says Kahn. Furthermore, she adds, because RBP4 levels consistently corresponded with insulin resistance — even among lean subjects whose genetic risk for the development of diabetes might otherwise be overlooked — this protein could be an important marker for type 2 diabetes among the general population.
"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 antidiabetic medication. Either way, these findings could help clinicians to better manage this growing epidemic."
Beth Israel Deaconess Medical Center
Insulin resistance develops when the body's muscles, fat and liver cells lose the ability to respond to the hormone insulin. Because insulin is necessary to enable the body to take up sugar from blood and convert it into energy, this impairment results in a buildup of glucose in the bloodstream.
"Insulin resistance not only predisposes individuals to type 2 diabetes, it is also a major risk factor for cardiovascular disease," adds co-lead author Timothy Graham, MD, an investigator in the Kahn laboratory. "Unfortunately, in the clinical setting, it is often difficult to distinguish individuals with and without insulin resistance."
Last year, in a study conducted in animals, Kahn's laboratory made the discovery that RBP4, a protein secreted from fat, can cause insulin resistance. Prior to this, the molecule was recognized only for its role in the transport of vitamin A.
In this new research, Graham, together with co-lead author Qin Yang, MD, PhD, set out to determine whether levels of RBP4, as measured in blood, correlate with the presence or absence of insulin resistance. (Study subjects represented three separate cohorts from San Diego, California; Goteberg, Sweden; and Leipzig, Germany.)
They first studied individuals with either obesity, impaired glucose tolerance (a "pre-diabetic" state), or with type 2 diabetes, comparing the blood levels of RBP4 in these insulin-resistant subjects with levels found in non-obese healthy subjects. Their results showed that not only were RBP4 levels higher in all cases in which insulin resistance was high, but that elevated serum RBP4 was also closely associated with components of the metabolic syndrome, including increased body mass index, waist-to-hip ratio, serum triglyceride levels, and systolic blood pressure, as well as decreased levels of high-density lipoprotein (HDL), or good, cholesterol.
The study was then extended to subjects with normal body weight and normal blood glucose, but with a strong family history of type 2 diabetes. "These are people who appear healthy, but have a high risk of developing diabetes due to their genetic background," explains Ulf Smith, MD, PhD, of Sahlgrenska Hospital, Goteberg, Sweden, where this group of subjects was based. As predicted, the investigators found elevated RBP4 levels among this group as well.
Finally, the authors tested whether a therapeutic intervention — in this case, exercise — could lower RBP4 levels and increase insulin sensitivity. They found that all of the people who improved their insulin sensitivity with exercise also lowered their serum RBP4 levels. Among the one-third of the subjects who did not improve their insulin sensitivity, neither did RBP4 levels go down.
"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," says Kahn. Furthermore, she adds, because RBP4 levels consistently corresponded with insulin resistance — even among lean subjects whose genetic risk for the development of diabetes might otherwise be overlooked — this protein could be an important marker for type 2 diabetes among the general population.
"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 antidiabetic medication. Either way, these findings could help clinicians to better manage this growing epidemic."
Beth Israel Deaconess Medical Center
Type 2 Diabetes Current Events and Type 2 Diabetes News RSSAmerican Dietetic Association Releases Updated Position Paper Promoting and Supporting Breastfeeding
The American Dietetic Association has released an updated position paper on breastfeeding that details health benefits for both infants and mothers and encourages promotion of breastfeeding whenever possible.
UM Scientists Create Fruit Fly Model to Help Unravel Genetics of Human Diabetes
As rates of obesity, diabetes, and related disorders have reached epidemic proportions in the US in recent years, scientists are working from many angles to pinpoint the causes and contributing factors involved in this public health crisis.
A decade later, lifestyle changes or metformin still lower type 2 diabetes risk
Intensive lifestyle changes aimed at modest weight loss reduced the rate of developing type 2 diabetes by 34 percent compared with placebo in people at high risk for the disease, researchers conclude based on 10 years of data.
Exercise Keeps Dangerous Visceral Fat Away a Year After Weight Loss, Finds UAB Study
A study conducted by exercise physiologists in the University of Alabama at Birmingham (UAB) Department of Human Studies finds that as little as 80 minutes a week of aerobic or resistance training helps not only to prevent weight gain, but also to inhibit a regain of harmful visceral fat one year after weight loss.
Protein critical for insulin secretion may be contributor to diabetes
A cellular protein from a family involved in several human diseases is crucial for the proper production and release of insulin, new research has found, suggesting that the protein might play a role in diabetes.
Puberty a gateway to heart disease for Canada's teens
A seven-year ongoing study examining over 20,000 Canadian grade 9 students shows most already have at least one major risk factor for heart disease and stroke, Dr. Brian McCrindle told the Canadian Cardiovascular Congress 2009, co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society.
Aerobic exercise no big stretch for older adults but helps elasticity of arteries
Just three months of physical activity reaps heart health benefits for older adults with type 2 diabetes by improving the elasticity in their arteries - reducing risk of heart disease and stroke.
Mayo Clinic Clinicians Develop New Decision Aid Tool to Help Type 2 Diabetes Patients
Mayo Clinic clinicians and designers, along with colleagues from other institutions, have developed and tested a tool to involve patients more in their diabetes treatment and medication choices.
UT Southwestern study shows how substance in grapes may squeeze out diabetes
A naturally produced molecule called resveratrol, found in the skin of red grapes, has been shown to lower insulin levels in mice when injected directly into the brain, even when the animals ate a high-fat diet.
Healthy neighborhoods may be associated with lower diabetes risk
Individuals living in neighborhoods conducive to physical activity and providing access to healthy foods may have a lower risk of developing type 2 diabetes in a five-year period, according to a report in the October 12 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
More Type 2 Diabetes Current Events and Type 2 Diabetes News Articles
 |
The First Year: Type 2 Diabetes: An Essential Guide for the Newly Diagnosed (First Year, The) by Gretchen Becker (Author), Allison B. Goldfine (Foreword) After Gretchen Becker was diagnosed with type 2 diabetes in 1996, she educated herself on every aspect of this chronic condition — by reading medical and scientific books and journals, talking with doctors and listening to her own body. In 2001, she marshaled everything she had learned as a "patient-expert" into the first edition of this book, which she has now completely updated and revised. The First Year®—Type 2 Diabetes uniquely guides you step-by-step through your first year with diabetes, walking you through everything you need to learn and do each day of your first week after diagnosis, each subsequent week of the first month, and each subsequent month of the crucial first year. In clear, concise, accessible language, Becker covers a wide range of practical, medical, and... |
 |
Blood Sugar 101: What They Don't Tell You About Diabetes by Jenny Ruhl (Author) Based on the award winning Bloodsugar101.com web site, this book explains what peer-reviewed research published in top medical journals has to say about: What is a normal blood sugar? How does diabetes develop? What really causes diabetes? What blood sugar levels cause complications? Must you deteriorate? What diet is right for you? How can you make that diet work? What medications are safe? What supplements lower blood sugar? Written in clear and understandable language, this book provides all the tools needed to understand how blood sugar works and achieve blood sugar health. |
 |
The Other Diabetes: Living and Eating Well with Type 2 Diabetes by Elizabeth N. Hiser (Author) Our national epidemic of type 2 diabetes, obesity, and heart disease is the price we pay for a diet that is too rich for our modern lifestyle. To fight back, we have focused on eating low-fat foods and quick-fix diets that just don't seem to work. The Other Diabetes, a consumer guide to type 2 diabetes, can help you change all that with the optimal eating plan. The Good Fat Diet offers a collection of eighty healthy and wholesome recipes. |
 |
A Field Guide to Type 2 Diabetes by American Diabetes Association (Author), Marie McCarren (Author) The best consumer guide to type 2 diabetes. Explains in down-to-earth language the best way to live with this chronic disease that is affecting a growing number of people. Information for all the "times" with type 2 diabetes that you will experience over the years--when you are newly diagnosed; taking one, two, or three kinds of diabetes pills; or adding insulin. It explains the tools to use to prevent complications. It includes chapters on women, children and teens, and how to prevent diabetes from occuring in family members who are at high risk for it. |
 |
Diachrome Advanced Nutrient-Based Support for Type 2 Diabetes, Easy-To-Swallow, 60 Capsules by Nutrition 21 Nutritional Supplement. Supports oral diabetes prescription medications. Unique Dual Effect: Helps maintain blood sugar control. Promotes health cholesterol. Doctor-recommended. Is Diachrome Right for You? Are You: Trying to help maintain your blood sugar control? Concerned about your HbA1c? Concerned about your cholesterol? Looking for a supplement that is safe to take with your other diabetes, cholesterol and blood pressure lowering medications? Wanting to take only doctor recommended supplements? Trying to help manage weight gain that results from taking multiple oral antidiabetes medications? If you answered yes to any of the above questions, you may benefit from Diachrome's unique, dual effect. Studies at the Harvard School of Public Health and John Hopkins University have suggested... |
 |
The Complete Idiot's Guide to Type 2 Diabetes by M.D. Mayer B. Davidson (Author), Debra L. Gordon (Author) The most complete book on the epidemic of Type 2 Diabetes. Over the next decade, the number of diagnosed diabetes cases worldwide is expected to exceed 220 million, 90-95% of which will be Type 2 Diabetes. Here is a guide that answers all the questions patients have: What is it? How will it affect my life? What do I need to do? It teaches readers how to manage the disease and live a healthy, normal life. -More than 18 million Americans have diabetes -The number of U.S. adults with diagnosed diabetes has increased 61% since 1991, and will more than double by 2050 -1 in 5 people over the age of 65 has diabetes, indicating that the disease indirectly affects many people in care-giving roles -Diabetes is one of our health care system’s most expensive diseases, costing the... |
 |
Mayo Clinic Wellness Solutions for Type 2 Diabetes Starring: Rodney Yee, Dr. Brent A. Bauer Mayo Clinic and Dr. Lori R. Roust Mayo Clinic Directed By: Cathe Neukum TAKE CHARGE OF YOUR HEALTH Mayo Clinic, one of the top medical centers in the country, and GAIAM, the health and wellness experts, team up to bring you this groundbreaking, integrated health action plan designed specifically to improve control of diabetes. Changing the way you live can change the way you feel. PART 1: UNDERSTANDING YOUR CONDITION A 30-minute conversation with Mayo Clinic specialists. Dr. Brent Bauer introduces you to the integrative treatment approach, and Mayo Clinic doctors share everything you need to know about diabetes and the array of conventional and alternative therapy options. PART 2: EAT WELL TO FEEL WELL Change your diet to feel better. Dr. Donald Hensrud, Chair, Preventive Medicine, Mayo Clinic, takes you grocery shopping and shares smart... |
 |
American Medical Association Guide to Living with Diabetes: Preventing and Treating Type 2 Diabetes - Essential Information You and Your Family Need to Know by American Medical Association (Author), Boyd E. Metzger MD (Author) More Than 3 Million American Medical Association Books Sold From America's Most Trusted Health Authority, the Ultimate Guide to Understanding, Preventing, and Managing Type 2 Diabetes Millions of Americans have type 2 diabetes, and millions more are at risk of developing the disease. The good news is that it is both preventable and treatable. In the American Medical Association Guide to Living with Diabetes you'll learn everything you need to know to prevent type 2 diabetes, take control of it if you already have it, and reduce your risk of life-threatening complications. This book provides clear, easy-to-understand explanations of what type 2 diabetes is, what causes it, and how to determine if you are at risk. You'll find a detailed,... |
 |
Diabetes Type 2: Complete Food Management Program by Sherri Shafer (Author) Now You Can Keep Diabetes Under Control It's simple: If you have type 2 diabetes, the only way to ward off serious symptoms is to keep your blood sugar within acceptable levels. So how can you do it? Through proper nutrition, the master key to controlling blood sugar. You need to understand which foods to eat, when to eat them, and in what amounts, and at the same time, establish regular exercise habits to optimize your health. Inside is everthing you need to know about managing type 2 diabetes through proper nutrition. From how to handle the initial diagnosis to discussions on every major dietary component, you'll uncover the science behind treating diabetes the right way. Inside, everything you need to know about nutrition and diabetes, including: ·How can exercise and... |
 |
Type 2 Diabetes, Your Healthy Living Guide (4th Edition) by American Diabetes Association (ADA) (Author) Over 20,000 units sold of the third edition alone |
| © 2009 BrightSurf.com |