الفهرس 
AIM OF THE STUDYOnly 14 pages are availabe for public view
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Abstract
Retinol binding protein-4 is a newly discovered adipokine, which is mainly secreted
by liver and originally known to be the only specific transport protein for vitamin A in the
circulation. Recently, RBP-4 is found to be expressed in the adipose tissue and correlated
with obesity, IR and type 2 diabetes mellitus (T2DM).
Menopause is defined as the permanent cessation of menses as a consequence of the
loss of ovarian follicular function or of surgical removal of ovaries. During this period
many psychological, physiological and pathological modifications occur.
It is well known that there is a higher prevalence of cardiovascular risk factors and
metabolic syndrome (MS) in postmenopausal women. Postmenopausal status is believed to
be a risk factor for IR in women. Insulin resistance has a causal role in the development of
T2DM. Even in the absence of hyperglycemia or diabetes, IR per se contributes to an
increased risk of CVD.
The aim of this study was to evaluate the influence of menopausal status on RBP-4
concentrations and to investigate the association of plasma RBP-4 with IR in
postmenopausal women with or without CVD.
The present study included 25 apparently healthy premenopausal women, 25
apparently healthy postmenopausal women and 25 postmenopausal women with CVD.
The following were done for all participants:
1. Clinical examination:
• Thorough history taking: with special stress on family history of diabetes mellitus and
any drug intake.
• Complete physical examination.
2. Anthropometric measurements:
• Body mass index (BMI).
• Waist to hip ratio (WHR).
• Blood pressure.
3. Laboratory measurements:
• Lipid profile including total cholesterol (TC), high density lipoprotein cholesterol
(HDL-C), low density lipoprotein cholesterol (LDL-C) and triglycerides (TG).
• Fasting and post prandial plasma glucose.
• Determination of plasma insulin using immunoenzymatic assay technique.
• Assessments of IR by homeostasis model assessment (HOMA) score.
HOMA score = fasting insulin (μIU/ml) × fasting glucose (mg/dl) / 405
Summary
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• Serum creatinine.
• The estimated glomerular filtration rate (eGFR) was calculated using the Cockcroft
Gault equation:
eGFR = [(140 – age) ×body weight (kg) ×0.85 if female] / [72×serum creatinine (mg/dl)].
• Liver enzymes including serum aspartate aminotransferase (AST), serum alanine
aminotransferase (ALT) activities.
• Determination of plasma RBP-4 using ELISA technique.
In this study it was noticed that blood pressure, glucose, insulin and HOMA-IR were
not influenced by menopause and the impact of menopause in limited to adverse effect on
lipids such as TC, LDL-C and TG and this may explain why postmenopausal women
appear to be more susceptible to atherosclerotic cardiovascular events.
Moreover, the data showed that RBP-4 in postmenopausal women was significantly
higher than that in premenopausal women, and positively correlated with post prandial
glucose, total cholesterol and ALT and showed no significant correlation with, fasting
glucose, fasting insulin and HOMA-IR.
Also, postmenopausal women with CVD showed significantly higher plasma RBP-4,
blood pressure (systolic and diastolic), lipid profile (TC, LDL-C, TG and TG/HDL-C
ratio), insulin and HOMA-IR than those in postmenopausal women. In addition, RBP-4
significantly positively correlated with FG, post prandial glucose, insulin, HOMA-IR, TC,
TG, TG/HDL-C ratio and ALT.