Horm Metab Res 2009; 41(3): 221-226
DOI: 10.1055/s-0028-1100411
Humans, Clinical

© Georg Thieme Verlag KG Stuttgart · New York

Visceral Obesity is Associated with the Metabolic Syndrome and Elevated Plasma Retinol Binding Protein-4 Level in Obstructive Sleep Apnea Syndrome

S. Makino 1 , M. Fujiwara 1 , K. Suzukawa 2 , H. Handa 2 , T. Fujie 2 , Y. Ohtaka 2 , Y. Komatsu 2 , Y. Aoki 2 , H. Maruyama 3 , Y. Terada 3 , K. Hashimoto 3 , T. Sugimoto 2
  • 1Department of Internal Medicine, Osaka Gyomeikan Hospital, Konohana-ku, Osaka, Japan
  • 2Respiratory Therapy Department, Osaka Gyomeikan Hospital, Konohana-ku, Osaka, Japan
  • 3Second Department of Internal Medicine, Kochi Medical School, Okoh-cho, Nankoku, Kochi, Japan
Further Information

Publication History

received 25.02.2008

accepted 25.09.2008

Publication Date:
10 November 2008 (online)


Obstructive sleep apnea syndrome (OSAS) is related to the increased prevalence of cardiovascular disease and metabolic syndrome (MS). A novel adipokine, retinol binding protein-4 (RBP4), was reported to be associated with insulin resistance and the prevalence of type 2 diabetes. To examine whether plasma RBP4 is associated with insulin resistance and MS development in OSAS, we measured plasma RBP4 levels in 181 Japanese men (24 healthy controls and 40 mild, 64 moderate, and 53 severe OSAS) of whom 26 had mild glucose intolerance with HbA1c ≦6.0%. After a full polysomnography, blood was collected between 06:00 and 07:00 AM. Plasma RBP4 levels in moderate/severe OSAS patients were higher than in control subjects. Plasma RBP4 was not correlated with apnea variables, HOMA-IR, or blood pressure. However, it was positively correlated with visceral fat areas and plasma triglyceride levels. The prevalence of MS was higher in severe OSAS patients than in mild/moderate OSAS and control subjects. Plasma RBP4 was higher in OSAS patients with MS than in those without MS. This study indicates that plasma RBP4 is associated with dyslipidemia, but not with insulin resistance, glucose intolerance, or hypertension in patients with OSAS. Visceral obesity may play key roles in increasing the plasma RBP4 level and MS development in OSAS.



S. Makino, MD 

Department of Internal Medicine

Osaka Gyomeikan Hospital

1-22-12 Kasugade-naka


554-0022 Osaka


Phone: +81/6/6462 02 61

Fax: +81/6/6462 03 62

Email: [email protected]