1. Retinol and Retinol Binding Protein 4 Levels and Cardiometabolic Disease Risk
- Author
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Catarina Schiborn, Daniela Weber, Tilman Grune, Ronald Biemann, Susanne Jäger, Natascha Neu, Marie Müller von Blumencron, Andreas Fritsche, Cornelia Weikert, Matthias B. Schulze, and Clemens Wittenbecher
- Subjects
Male ,Physiology ,Nutrition Surveys ,Diabetes Mellitus, Type 2 ,Cardiovascular Diseases ,Risk Factors ,Hypertension ,lipoprotein ,risk ,hypertension ,cardiovascular diseases ,myocardial infarction ,Humans ,Female ,Prospective Studies ,Vitamin A ,Cardiology and Cardiovascular Medicine ,Retinol-Binding Proteins, Plasma ,Biomarkers - Abstract
Background: Despite mechanistic studies linking retinol and RBP4 (retinol binding protein 4) to the pathogenesis of cardiovascular diseases (CVD) and type 2 diabetes (T2D), epidemiological evidence is still conflicting. We investigated whether conflicting results of previous studies may be explained by differences in the association of retinol and RBP4 with cardiometabolic risk across subgroups with distinct sex, hypertension state, liver, or kidney function. Methods: We used case-cohorts nested in the EPIC (European Prospective Investigation Into Cancer and Nutrition)-Potsdam cohort (N=27 548) comprising a random sample of participants (n=2500) and all physician-verified cases of incident CVD (n=508, median follow-up time 8.2 years) and T2D (n=820, median follow-up time 6.3 years). We estimated nonlinear and linear multivariable-adjusted associations between the biomarkers and cardiometabolic diseases by restricted cubic splines and Cox regression, respectively, testing potential interactions with hypertension, liver, and kidney function. Additionally, we performed 2-sample Mendelian Randomization analyses in publicly available data. Results: The association of retinol with cardiometabolic risk was modified by hypertension state ( P interaction CVDP interaction T2Dper SD [95% CI]: CVD, 0.71 [0.56–0.90]; T2D, 0.81 [0.70–0.94]) but with higher cardiometabolic risk in normotensive participants (CVD, 1.32 [1.06–1.64]; T2D, 1.15 [0.98–1.36]). Our analyses also indicated a significant interaction between RBP4 and hypertension on CVD risk ( P interaction=0.04). Regarding T2D risk, we observed a u-shaped association with RBP4 in women ( P nonlinearity=0.01, P effect=0.02) and no statistically significant association in men. The biomarkers’ interactions with liver or kidney function were not statistically significant. Hypertension state-specific associations for retinol concentrations with cardiovascular mortality risk were replicated in National Health and Nutrition Examination Survey III. Conclusions: Our findings suggest a hypertension-dependent relationship between plasma retinol and cardiometabolic risk and complex interactions of RBP4 with sex and hypertension on cardiometabolic risk.
- Published
- 2022