TY - JOUR
T1 - Retinol binding protein
T2 - Marker for insulin resistance and inflammation postburn?
AU - Kraft, Robert
AU - Herndon, David N.
AU - Kulp, Gabriela A.
AU - Mecott, Gabriel A.
AU - Trentzsch, Heiko
AU - Jeschke, Marc G.
N1 - Funding Information:
Financial disclosure: This study was supported by the American Surgical Association Foundation ; Shriners Hospitals for Children 8660 , 8760 , and 9145 ; NIH R01-GM56687 , T32 GM008256 , and P50 GM60338 , R01 GM087285 ; and NIDRR H133A020102 .
PY - 2011/11
Y1 - 2011/11
N2 - Introduction: Burn injury leads to vast changes in both metabolic and inflammatory responses and is associated with increased morbidity and mortality. Insulin resistance (IR) and hyperglycemia are major components of the hypermetabolic response found in burn-injured patients and subsequently contribute to adverse outcomes. Studies have shown that increased systemic retinol binding protein (RBP) levels are associated with IR and hyperinflammation in diabetic and obese patients. The aim of this study was to determine RBP profiles and to test the hypothesis that elevated RBP levels are associated with both IR and the inflammatory response in burned patients. Methods: RBP was measured in 372 patients during the acute stay postburn. Patients' demographics, glucose levels, and insulin administration were recorded. Cytokines, hormones, plasma proteins, and organ markers were measured. The average of all measurements of RBP (2.1 mg/dL) was used to divide patients into high and low groups. Statistical analysis was performed by Student t test. Statistical significance was accepted at P <.05. Results: Fifty-one patients (high group) had elevated RBP levels during acute hospitalization and demonstrated a significant higher incidence of multiorgan failure, sepsis, and mortality (P <.05). Moreover, in the high group, a significant increase of IR, inflammatory cytokines, and catabolic and organ-specific markers were detected (P <.05). Conclusions: Increased RBP levels postburn correlate with increased IR, inflammatory and catabolic responses, incidence of multiorgan failure, and mortality. RBP may be a novel biomarker to monitor these detrimental responses postburn.
AB - Introduction: Burn injury leads to vast changes in both metabolic and inflammatory responses and is associated with increased morbidity and mortality. Insulin resistance (IR) and hyperglycemia are major components of the hypermetabolic response found in burn-injured patients and subsequently contribute to adverse outcomes. Studies have shown that increased systemic retinol binding protein (RBP) levels are associated with IR and hyperinflammation in diabetic and obese patients. The aim of this study was to determine RBP profiles and to test the hypothesis that elevated RBP levels are associated with both IR and the inflammatory response in burned patients. Methods: RBP was measured in 372 patients during the acute stay postburn. Patients' demographics, glucose levels, and insulin administration were recorded. Cytokines, hormones, plasma proteins, and organ markers were measured. The average of all measurements of RBP (2.1 mg/dL) was used to divide patients into high and low groups. Statistical analysis was performed by Student t test. Statistical significance was accepted at P <.05. Results: Fifty-one patients (high group) had elevated RBP levels during acute hospitalization and demonstrated a significant higher incidence of multiorgan failure, sepsis, and mortality (P <.05). Moreover, in the high group, a significant increase of IR, inflammatory cytokines, and catabolic and organ-specific markers were detected (P <.05). Conclusions: Increased RBP levels postburn correlate with increased IR, inflammatory and catabolic responses, incidence of multiorgan failure, and mortality. RBP may be a novel biomarker to monitor these detrimental responses postburn.
KW - burn injury
KW - catabolism
KW - inflammation
KW - insulin resistance
KW - renal function
KW - retinol binding protein (RBP)
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U2 - 10.1177/0148607111413901
DO - 10.1177/0148607111413901
M3 - Article
C2 - 22042048
AN - SCOPUS:80455129286
SN - 0148-6071
VL - 35
SP - 695
EP - 703
JO - Journal of Parenteral and Enteral Nutrition
JF - Journal of Parenteral and Enteral Nutrition
IS - 6
ER -