Consumption of Sugar-Sweetened Beverage and Circulating retinol-binding protein 4 levels connected to adolescent cardiometabolic risk components and metabolic syndrome

• Main Authors: Te-Fu Chan, 詹德富
• Other Authors: Chih-Lung Lin
• Format: Others
• Language: en_US
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/73772176182319545237

博士 === 高雄醫學大學 === 醫學研究所 === 102 === The metabolic effect of fructose in sugar-sweetened beverages (SSB) has been linked to de novo lipogenesisand uric acid (UA) production. This study investigated the biological effects of SSB consumption on serum lipid profiles and retinol-binding protein 4 (RBP4) among Taiwanese adolescents. We evaluated the anthropometric parameters and biochemical outcomes of 200 representative adolescents (98 boys and 102 girls) who were randomly selected from a large-scale cross-sectional study. Data were analyzed using multiple regression models adjusted for covariates. Results: Increased SSB consumption was associated with increased waist and hip circumferences, body mass index (BMI) values and serum UA, triglyceride (TG) and RBP4 levels. Adolescents who consumed >500 ml/day of beverages half-to-heavily sweetened with high-fructose corn syrup (HFCS) exhibited TG and RBP4 levels 22.7 mg/dl and 13.92 ng/ml higher than non-drinkers, respectively. HFCS drinkers with hyperuricemia had higher TG levels than HFCS drinkers with normal UA levels (98.6 vs. 81.6 mg/dl). The intake of HFCS-rich SSBs and high value of BMI (≥24) interactively reinforced RBP4 levels among overweight/obese adolescents. Circulating RBP4 levels were significantly correlated with weight-related outcomes and TG and UA concentration among HFCS drinkers ( r= 0.253 to 0.404), but not among non-drinkers. In conclusion, high-quantity HFCS-rich beverage consumption is associated with higher TG and RBP4 levels. Hyperuricemia is likely to intensify the influence of HFCS-rich SSB intake on elevated TG levels, and in overweight and obese adolescents, high BMI may modify the action of fructose on higher circulating levels of RBP4. RBP4 has been proposed to be a vital mediator connecting obesity and insulin resistance (IR). This study investigated the role of RBP4 in the adolescent “adipo-cardiovascular axis” by investigating the association of its circulating concentrations with cardiometabolic risk components and outcomes. We assessed the cardiometabolic risk factors and metabolic outcomes of 272 representative adolescents (132 boys and 140 girls) who were randomly selected from a large-scale cross-sectional study. Data were analyzed using principal component analysis and multivariate regression models adjusted for covariates. Three principal components were extracted from 12 cardiometabolic risk factors and the first principal component (PC1) accounted for 38.7% of the total variance. RBP4 levels were positively correlated to body-weight-related parameters, triglyceride, systolic blood pressure and uric acid in both sexes and to metabolic syndrome (MetS) and IR. Significant multivariate-adjusted differences at RBP4 levels (1.999 ng/dl in boys and 2.377 ng/dl in girls) for a one-unit increase in PC1 scores were found among adolescents with hyperuricemia, but not among those without. Circulating RBP4 levels were notably capable at discriminating the presence of MetS and IR. A one-standard deviation increment of RBP4 was associated with a 2.5- and 1.9-fold risk of contracting MetS and IR, respectively, and explained 5.5% and 13.7% of the excess risk of PC1 on these two metabolic disorders. In conclsion, circulating RBP4 levels are associated with combined-cardiometabolic risk components and adolescent MetS and IR. Hyperuricemia demonstrates clinical implications on the positive correlation between continuous cardiometabolic risk-scores and RBP4 levels.