Liver function critically determines serum retinol-binding protein 4 (RBP4) levels in patients with chronic liver disease and cirrhosis
✍ Scribed by Frank Tacke; Ralf Weiskirchen; Christian Trautwein
- Publisher
- John Wiley and Sons
- Year
- 2008
- Tongue
- English
- Weight
- 103 KB
- Volume
- 48
- Category
- Article
- ISSN
- 0270-9139
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✦ Synopsis
We read with great interest the recent work by Petta et al. suggesting serum levels of retinol-binding protein 4 (RBP4) as a marker for the degree of steatosis in patients infected with hepatitis C virus (HCV). 1 RBP4 has provoked exceptional attention because it has been linked to the pathogenesis of insulin resistance in mice and humans. 2,3 Petta et al. now reported an association between elevated serum RBP4 and hepatic steatosis as well as insulin resistance in patients with nonalcoholic steatohepatitis (NASH), and serum RBP4 appeared to be a strong independent predictor of hepatic steatosis in nondiabetic, nonobese patients chronically infected with HCV genotype 1. 1 However, from our own 4 and other studies, 5 we would like to stress important potential confounding factors that have neither been evaluated nor discussed by the authors and might greatly hamper the diagnostic usefulness of serum RBP4 in patients with liver disease in the real clinical setting. It is well known that the liver is the major source of circulating RBP4 in humans, 3 and therefore the hepatic