Circulating retinol binding protein 4 levels in coronary artery disease: a systematic review and meta-analysis

Hengying Chen; Jiaying Zhang; Jiayu Lai; Yingyu Zhou; Xiaoping Lin; Guifang Deng; Zheqing Zhang; Liping Li

doi:10.1186/s12944-021-01516-7

Circulating retinol binding protein 4 levels in coronary artery disease: a systematic review and meta-analysis

Lipids Health Dis. 2021 Aug 21;20(1):89. doi: 10.1186/s12944-021-01516-7.

Authors

Hengying Chen^{1

2}, Jiaying Zhang³, Jiayu Lai³, Yingyu Zhou³, Xiaoping Lin³, Guifang Deng⁴, Zheqing Zhang⁵, Liping Li^{6

7}

Affiliations

¹ Injury Prevention Research Center, Shantou University Medical College, Shantou, China.
² School of Public Health, Shantou University, Shantou, China.
³ Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China.
⁴ Department of Clinical Nutrition, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China.
⁵ Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China. zzqaa501@smu.edu.cn.
⁶ Injury Prevention Research Center, Shantou University Medical College, Shantou, China. lpli@stu.edu.cn.
⁷ School of Public Health, Shantou University, Shantou, China. lpli@stu.edu.cn.

Abstract

Background: Retinol binding protein 4 (RBP4) has been proposed to play a role in the pathophysiology of coronary artery disease (CAD), but previous findings on the association of RBP4 levels with CAD are inconsistent.

Methods: A meta-analysis based on observational studies was conducted to evaluate the association between circulating RBP4 levels and CAD. Databases including PubMed, Web of Science, Embase, Google Scholar and ClinicalTrials.gov database were searched for eligible studies published up to 12 July 2021. Standard mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using the inverse variance heterogeneity (IVhet) and random-effects model for data with moderate and high heterogeneity (I² > 30%) and data with low heterogeneity were analysed using a fixed-effects model (I² ≤ 30%). Moreover, a bias-adjusted quality-effects model was generated, and the prediction interval was also calculated under the random-effects model.

Results: Two nested case-control studies, one cohort study and twelve case-control studies with a total of 7111 participants were included. Circulating RBP4 levels in patients with CAD were comparable to those in the controls under the IVhet model (SMD: 0.25, 95% CI: - 0.29-0.79, I²: 96.00%). The quality-effects model produced consistent results. However, the association turned to be significant under the random-effect model (SMD: 0.46, 95% CI: 0.17-0.75, I²: 96.00%), whereas the 95% predictive interval (PI) included null values (95% PI: - 0.82-1.74). Subgroup analyses illustrated a positive relationship between CAD and RBP4 levels in patients with complications (SMD: 1.34, 95% CI: 0.38-2.29, I²: 96.00%). The meta-regression analysis revealed that the mean BMI of patients (P = 0.03) and complication status (P = 0.01) influenced the variation in SMD.

Conclusions: There was low-quality evidence that patients with CAD exhibited similar circulating RBP4 levels compared with controls, and high inter-study heterogeneity was also observed. Thus, RBP4 might not be a potential risk factor for CAD. Comparisons among different subtypes of RBP4 with larger sample size are needed in the future.

Keywords: Coronary artery disease; Ischemic heart disease; Meta-analysis; Retinol binding protein 4; Systematic review.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Coronary Artery Disease / blood*
Humans
Retinol-Binding Proteins, Plasma / analysis*

Substances

RBP4 protein, human
Retinol-Binding Proteins, Plasma

Abstract

Publication types

MeSH terms

Substances

Grants and funding