Relationship of NEFA concentrations to RBP4 and to RBP4/retinol in prepubertal children with and without obesity

Background The regulation of adipose tissue metabolism in early childhood obesity is not well understood. Insulin levels are higher and insulin resistance seems to be present in prepubertal children with obesity but, differing from their behavior in adults with obesity, non-esterified fatty acid (NEFA) concentrations are not increased. Retinol-binding protein (RBP)-4 concentration is associated with obesity and insulin resistance conditions, but the means of this relationship remain unclear, and few studies have taken retinol values into account to evaluate it. Objective To analyze the relationship between RBP4 concentration and lipolytic products in plasma in 141 prepubertal children aged 6 to 8 years, with and without obesity. Methods Plasma glucose, insulin, triacylglycerols, NEFA, glycerol, leptin, RBP4, and retinol were analyzed in obese and in their normal-weight counterparts. Homeostatic model assessment, quantitative insulin sensitivity check index, and fasting glucose to insulin ratio were calculated as indicators of insulin resistance. Results Fasted plasma NEFA concentrations were lower in children with obesity than in their normal weight counterparts, despite leptin, insulin resistance indices, RBP4, retinol, and RBP4/retinol (an index of free-RBP4) being higher. NEFA and glycerol concentrations were inversely correlated with RBP4/retinol in children with obesity but not in those without obesity. In normal weight children, total RBP4 correlated negatively with NEFA and glycerol concentrations and positively with insulin and homeostasis model assessment for insulin resistance. These results indicate that a low saturation of RBP4 with retinol, which implies a higher concentration of free-RBP4, may preserve the antilipolytic function of insulin in adipose tissue in children with obesity. Conclusion Our findings suggest that, in prepubertal children with obesity and insulin resistance, the amount of RBP4/retinol correlates with the antilipolytic response of the adipose tissue to insulin rather than the total RBP4 concentration.