Retinol-binding protein 4 and hyperinsulinemia: The link between obesity and cardiovascular disease

Cardiovascular disease (CVD) is the leading cause of death in the world and obesity is one of the main risk factors. Irregular secretion of adipokines [e.g. high retinol binding protein 4 (RBP4), resisting, leptin, respectively, but low adiponectin], low-grade inflammation, as well as an increased production of reactive oxygen species, may lead to impaired insulin signaling, insulin resistance (IR) and CVD. RBP4 is a recently discovered adipokine which is supposed to be closely related to IR. Despite contradictory results obtained from a large number of studies, it is assumed to be a significant cardiometabolic risk factor, leading to metabolic syndrome, type 2 diabetes and CVD development. Better understanding of the patophysiological mechanisms of increased RBP4 and hyperinsulinemia in circulation may lead to a discovery of new target therapy in prevention of CVD, especially in those people who are overweight/obese.