Evaluation of Retinol Binding Protein 4 Level in Iraqi Patients with Type 2 Diabetes and Pre-diabetes Status as a Predictive Factor


  • Heba Mohammed Hatem Department of Chemistry, College of Science for Women, University of Baghdad, Baghdad, Iraq. https://orcid.org/0009-0004-8122-8142
  • Kadhim K. Ghudhaib Department of Chemistry, College of Science for Women, University of Baghdad, Baghdad, Iraq.




Diabetes mellitus II, HOMA-IR, Insulin, Pre-diabetes, Retinol binding protein 4.


The prevalence of type 2 diabetes has doubled in recent years due to a defect in insulin production, which can develop to form diabetes complications that affect the kidneys, nerves, and eyes. As a result, early diagnosis and classification of Type II diabetes are critical to aiding physician assessments. Accordingly, the current study aimed to determine Retinol binding protein 4 (RBP4) levels in patients with T2DM and pre-DM as early predictors for disease cases. The current study included 138 subjects, divided into three groups, on the basis of FBG and HbA1c criteria, including (DM, 46 patients, pre-DM, 46 participants, and healthy subject,46 persons), when they enrolled in the National Diabetes Center- Al-Mustansiriya University. Enzyme-linked immunosorbent assays (ELISA) were used to detect the levels of Retinol Binding Protein 4 and Insulin, and spectrophotometric techniques were used to determine the levels of FBG and lipid profile.  Retinol binding protein 4 results revealed significant differences (P≤0.0001) among the studied groups. Also, the insulin results showed significant differences (P≤0.0001) between the diabetic and control groups. The results of HOMA-IR showed significant differences (P≤0.0001). It also showed a lipid profile significant effect (P≤0.0022), (P≤0.0001), (P≤ 0.050) between the studied groups, except HDL that showed no significant difference(P≤.0.148). In conclusion, retinol-binding protein 4 can serve as an early indicator of T2DM, and this conclusion can be reinforced by the results of the ROC analysis, which indicated that Retinol binding protein 4 is an excellent indicator for diagnosis of the studied condition.


Artasensi A, Pedretti A, Vistoli G, Fumagalli L. Type 2 diabetes mellitus: A review of multi-target drugs. Molecules. 2020; 25(8): 1–20. http://dx.doi.org/10.3390/molecules25081987.

Sadiq CH, Hussein RH, Maulood IM. Ghrelin and Leptin and their relations with Insulin resistance in Diabetes Mellitus type 2 patients. Baghdad Sci J. 2022; 19(1): 33–42. http://dx.doi.org/10.21123/bsj.2022.19.1.0033.

Khaleel FM, Murtadha JH, Abdulrazzaq H. Estimation of Blood (TG, TC and LDL) As Markers of Lipid Profile And Urea, Uric Acid And Creatinine As Markers Of Kidney Function In Diabetic Patients. Rjpbcs Res J. 2019; 10(1): 79-84.

Han YM, Yang H, Huang QL, Sun ZJ, Li ML, Zhang JB, et al. Risk prediction of diabetes and pre-diabetes based on physical examination data. Math Biosci Eng. 2022; 19(4): 3597–608. http://dx.doi.org/10.3934/mbe.2022166.

Farhan LO. Determanation of Several Biochemical Parameters in Sera of Iraqi Patients with type 2 Diabetes. Baghdad Sci J. 2015; 12(2): 362-370. http://dx.doi.org/10.21123/bsj.12.2.362-370.

Hamid GS, Allawi AA, Ghudhaib KK. Correlation of Pentosidine with Kidney Diseases in Iraqi Patients with Diabetic Nephropathy. Iraqi J Sci. 2021; 62(10): 3436–42. http://dx.doi.org/10.24996/ijs.2021.62.10.2

Salman ZA, Ghudhaib KK. Association of Osteopontin and Alkaline Phosphatase in Male Patients with Diabetes Mellitus Type 2 and Periodontitis. Iran J War Public Heal. 2022; 14(1): 105–9.

Wu CZ, Yuan YH, Liu HH, Li SS, Zhang BW, Chen W, et al. Epidemiologic relationship between periodontitis and type 2 diabetes mellitus. BMC Oral Health. 2020; 20(1): 1–15. https://doi.org/10.1186/s12903-020-01180-w.

Abbas A, Basharat S, Shahid M, Raza F , Tariq N , Arshad M . Therapeutic Comparison of Flaxseed and Black Seed Supplementation for Treatment of Type II Diabetic Patients. Pak J Med Sci.. 2021; 5(3): 13–17. https://doi.org/10.54393/pbmj.v5i3.304.

Shabir K, Brown JE, Afzal I, Gharanei S, Weickert MO, Barber TM, et al. Asprosin, a novel pleiotropic adipokine implicated in fasting and obesity-related cardio-metabolic disease: Comprehensive review of preclinical and clinica levidence. Cytokine Growth Factor Rev.2021; 60:120–132. https://doi.org/10.1016/j.cytogfr.2021.05.002

Rett K, Hostalek U. Understanding prediabetes: definition, prevalence, burden and treatment options for an emerging disease. Curr Med Res Opin .2019; 35(9): 1529–34. https://doi.org/10.1080/03007995.2019.1601455.

Echouffo-Tcheugui JB, Selvin E. Prediabetes and What It Means: The Epidemiological Evidence. Annu Rev Public Health. 2020; 42: 59–77. https://doi.org/10.1146/annurev-publhealth-090419-102644.

Miao Z, Alvarez M, Ko A, Bhagat Y, Rahmani E, Jew B, et al. The causal effect of obesity on prediabetes and insulin resistance reveals the important role of adipose tissue in insulin resistance. PLoS Genet. 2020; 16(9): 1–23. http://dx.doi.org/10.1371/journal.pgen.1009018.

Huang R, Bai X, Li X, Wang X, Zhao L. Retinol-Binding Protein 4 Activates STRA6, Provoking Pancreatic b-Cell Dysfunction in Type 2 Diabetes. Diabetes. 2021; 70(2): 449–63. https://doi.org/10.1111/dom.14388.

Majnun YO, Altaie AF. Correlation Study of Retinol Binding Protein4, Vitamin A with Liver Function Enzymes in Iraqi Fracture Patients with and without DM2. Ibn AL-Haitham J Pure Appl Sci. 2022; 35(4): 151–60. http://dx.doi.org/10.30526/35.4.2830.

Qassim M. Effect of Age and Gender on Some Biochemical, Hormones and Adipocytokines Parameters in Iraqi Type 2 Diabetes MellItus. Int Res J Pharm. 2019; 9(12): 23-30. http://dx.doi.org/10.7897/2230-8407.0912286.

Lai Y, Qi J, Tao X, Huang K, Yan S, Chen M, et al. Associations of grandparental diabetes mellitus with grandchild BMI status. BMC Public Health. 2019; 19(1): 1–8. http://dx.doi.org/10.1186/s12889-019-6485-y.

Evers J, Grotenhuis AJ, Aben KKH, Kiemeney LALM, Vrieling A. No clear associations of adult BMI and diabetes mellitus with non-muscle invasive bladder cancer recurrence and progression. PLoS One. 2020; 15(3): 1–17 http://dx.doi.org/10.1371/journal.pone.0229384.

Joshi B, Shrestha L. A Comparative Study of Waist Hip Ratio and Body Mass Index (BMI) in Diabetic and Non-Diabetic Individuals of Chitwan, Nepal. J Diabetes Metab. 2019; 10(01): 1-6. http://dx.doi.org/10.35248/2155-6156.19.10.817.

Awasthi A, Rao CR, Hegde DS, Rao N K. Association between type 2 diabetes mellitus and anthropometric measurements - A case control study in South India. J Prev Med Hyg. 2017; 58(1): E56–62. http://dx.doi.org/10.15167/2421-4248/jpmh2017.58.1.648.

Sun Y, Liu B, Snetselaar LG, Wallace RB, Caan BJ, Rohan TE, et al. Association of Normal-Weight Central Obesity with All-Cause and Cause-Specific Mortality among Postmenopausal Women. JAMA Netw Open. 2019; 2(7): 1–13. http://dx.doi.org/10.1001/jamanetworkopen.2019.7337.

Elimam H, Abdulla AM, Taha IM. Inflammatory markers and control of type 2 diabetes mellitus. Diabetes Metab Syndr. 2019; 13(1): 800–4. https://doi.org/10.1016/j.dsx.2018.11.061.

Misra A, Bloomgarden ZT. Discordance between HbA1c and glycemia. J Diabetes. 2018; 10(12): 908–10. https://doi.org/10.1111/1753-0407.12843.

Sati A, Varma A, Kumar N, Masood T. Insulin Resistance in Type II Diabetes Mellitus Patients and Their First-Degree Relatives- An Observational Study. J Pharm Res Int. 2021; 33(59A): 198-204. http://dx.doi.org/10.9734/jpri/2021/v33i59A34264.

Elias NG, Al-Shammaa NMJ; Evaluation of Fetuin-A and Insulin Resistance among Iraqi Type 2 Diabetic Patients with and without Ischemic Heart Disease. Ibn AL-Haitham J Pure Appl Sci. 2022; 12(2): 738-742. http://dx.doi.org/10.25258/ijddt.12.2.48

Wali JA, Thomas HE, Sutherland APR. Linking obesity with type 2 diabetes: The role of T-bet. Diabetes Metab Syndr Obes . 2014; 7: 331–40. http://dx.doi.org/10.2147/DMSO.S51432.

Yassin MM, Altibi HI, Shanti AF El. Clinical and Biochemical Features of Type 2 Diabetic Patients in Gaza Governorate, Gaza Strip Aspects cliniques et biochimiques du diabète de type 2 dans la province de Gaza, Bande de Gaza. West Afr J Med. 2011; 30(1). http://dx.doi.org/10.4314/wajm.v30i1.69918.

Ali EEM, Dafalla AM, Mohammed YA, Nour BYM. Correlation between Serum CD36 Level and Lipid Profile in Patients with Type 2 Diabetes Mellitus, Khartoum State, Sudan. J Diabetes Mellit. .2023; 13(01): 68-75 http://dx.doi.org/10.4236/jdm.2023.131007.

Murata M, Saito T, Otani T, Sasaki M, Ikoma A, Toyoshima H, et al. An increase in serum retinol-binding protein 4 in the type 2 diabetic subjects with nephropathy. Endocr J. 2009; 56(2): 287–94. http://dx.doi.org/10.1507/endocrj.K08E-242.

Takebayashi K, Suetsugu M, Wakabayashi S, Aso Y, Inukai T. Retinol binding protein-4 levels and clinical features of type 2 diabetes patients. J Clin Endocrinol Metab. 2007; 92(7): 2712–9. http://dx.doi.org/10.1210/jc.2006-1249.

Ali EY, Hegazy GA, Hashem EM. Evaluation of irisin, retinol-binding protein 4, and leptin serum levels as biomarkers of macrovascular complications involvement in Saudi type 2 diabetes mellitus. A case-control study. Saudi Med J. 2020; 41(12): 1369–74. http://dx.doi.org/10.15537/smj.2020.12.25461.

Olsen T, Blomhoff R. Retinol, Retinoic Acid, and Retinol-Binding Protein 4 are Differentially Associated with Cardiovascular Disease, Type 2 Diabetes, and Obesity: An Overview of Human Studies. Adv Nutr. 2020; 11(3): 644–66. http://dx.doi.org/10.1093/advances/nmz131.





How to Cite

Evaluation of Retinol Binding Protein 4 Level in Iraqi Patients with Type 2 Diabetes and Pre-diabetes Status as a Predictive Factor. Baghdad Sci.J [Internet]. [cited 2024 Jul. 22];22(1). Available from: https://bsj.uobaghdad.edu.iq/index.php/BSJ/article/view/9088