Study Of The Correlation Between RBP4and Erythropoietin Responsiveness In Maintenance Hemodialysis Patients With T2DM

Objective: To investigate the clinical significance of Retinol binding protein4(RBP4) inmaintenance hemodialysis (MHD) patients with type2diabetes mellitus (T2DM),through studying the correlations among RBP4, insulin resistance (IR) anderythropoietin responsiveness. The focus is on the correlation between RBP4anderythropoietin responsiveness, aiming to improve erythropoietin responsiveness,and resulting in the improvement of the anemic status of dialysis patients withT2DM.Methods: A total of40subjects were included in this study. Of the40subjects,30wereMHD patients,10were normal subjects as control group in “group c”.15MHDpatients with T2DM were allocated into “group a”, the other15MHD patientswithout T2DM were in “group b”. All of the blood samples were taken frompatients in the morning without breakfast. ELISA was used to assess the serumconcentrations of RBP4and Ins. The erythropoietin responsiveness index(rHuEPO/Hb) is represented by the ratio of amount use of EPO per kilogram ofbody weight per week and average hemoglobin in recent12weeks. HOMA-IR=FINS (mU/L)×FPG (mmol/L)/22.5. Then we made correlation analysis of RBP4,HOMA-IR and (rHuEPO/Hb).Results:(1) RBP4serum concentrations have no significant differences between MHDpatients with T2DM group and MHD patients without T2DM group (P>0.05),and both of these two groups had higher RBP4serum concentrations thancontrol group(P<0.05).(2) RBP4has positive correlation with HOMA-IR, TG and TCHOL in MHDpatients with T2DM group (P<0.05).(3) In the two dialysis groups, RBP4has positive correlation with CRP and thenumber of PMNLs(P<0.05).(4) MHD patients with T2DM group have higher (rHuEPO/Hb) than MHD patients without T2DM group (P<0.05).(rHuEPO/Hb) has negative correlation withRBP4in MHD patients with T2DM group (P<0.05).Conclusions:(1) Serum concentrations of RBP4increased significantly in MHD patients, andare mainly related to renal function rather than IR.(2) Under the same MHD conditions, T2DM patients have a more severedyslipidemia, which is related to serum RBP4concentrations.(3) In MHD patients, RBP4serum concentrations have positive correlation withinflammatory reaction, more obvious in MHD patients with T2DM.(4) In MHD patients, who have T2DM have lower erythropoietin responsiveness,and the erythropoietin responsiveness are related to IR which is caused byRBP4; the erythropoietin responsiveness is decreased corresponding to theincreasing of RBP4.