Zhang YL, Peng GL, Leng WL, Lian Y, Cheng LQ, Li X, Wang YL, Zhou L, Long M. Association between serum retinol-binding protein and lower limb atherosclerosis risk in type 2 diabetes mellitus. World J Diabetes 2025; 16(3): 98590 [DOI: 10.4239/wjd.v16.i3.98590]
Corresponding Author of This Article
Min Long, Associate Chief Physician, Associate Professor, Department of Endocrinology, Southwest Hospital, Army Medical University (The Third Military Medical University), No. 30 Gaotanyan Main Street, Shapingba District, Chongqing 400038, China. longmin@tmmu.edu.cn
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Mar 15, 2025; 16(3): 98590 Published online Mar 15, 2025. doi: 10.4239/wjd.v16.i3.98590
Table 1 Baseline characteristics in the study participants
Characteristic
Overall (n = 4428)
Non-lower limb atherosclerosis (n = 1913)
Lower limb atherosclerosis (n = 2515)
P value
RBP, mg/L
31.90 [26.15, 38.90]
30.96 [25.50, 36.95]
32.76 [26.80, 40.50]
< 0.001
Age, years
56.00 [48.00, 65.00]
50.00 [40.00, 58.00]
59.00 [52.00, 68.00]
< 0.001
Male, n (%)
2691 (60.77)
1051 (54.94)
1640 (65.21)
< 0.001
Cigarette smoking history, n (%)
1786 (40.33)
649 (33.93)
1137 (45.21)
< 0.001
Alcohol consumption history, n (%)
1722 (38.89)
671 (35.08)
1051 (41.79)
< 0.001
Hypertension, n (%)
2765 (62.44)
995 (52.01)
1770 (70.38)
< 0.001
Hyperlipidemia, n (%)
2521 (56.93)
1102 (57.61)
1419 (56.42)
0.449
CHD, n (%)
838 (18.93)
227 (11.87)
611 (24.29)
< 0.001
SBP, mmHg
129.00 [116.00, 143.00]
126.00 [114.00, 139.00]
132.00 [119.00, 145.00]
< 0.001
DBP, mmHg
80.50 [73.00, 89.00]
81.00 [73.00, 90.00]
80.00 [73.00, 89.00]
0.196
BMI, kg/m2
24.20 [21.80, 26.60]
24.20 [21.70, 26.90]
24.10 [21.90, 26.40]
0.132
HbA1c, %
8.40 [7.00, 10.30]
8.30 [6.80, 10.45]
8.50 [7.10, 10.20]
0.020
FBG, mmol/L
8.49 [6.56, 11.40]
8.29 [6.38, 11.59]
8.62 [6.70, 11.29]
0.054
TC, mmol/L
4.59 [3.87, 5.39]
4.62 [3.92, 5.34]
4.58 [3.82, 5.42]
0.67
LDL, mmol/L
2.86 [2.35, 3.41]
2.86 [2.37, 3.35]
2.87 [2.33, 3.46]
0.383
TG, mmol/L
1.56 [1.11, 2.35]
1.57 [1.10, 2.43]
1.56 [1.13, 2.27]
0.351
HDL, mmol/L
1.10 [0.92, 1.30]
1.11 [0.94, 1.32]
1.09 [0.92, 1.29]
0.004
WBC count, 109/L
6.30 [5.24, 7.64]
6.10 [5.10, 7.41]
6.46 [5.35, 7.86]
< 0.001
CRP, mg/L
2.93 [1.19, 11.58]
2.62 [1.08, 9.14]
3.20 [1.26, 14.24]
< 0.001
AST, IU/L
20.67 [17.00, 26.10]
21.10 [17.20, 27.40]
20.40 [16.85, 25.10]
< 0.001
ALT, IU/L
19.45 [14.10, 28.80]
20.90 [15.00, 32.75]
18.65 [13.70, 26.62]
< 0.001
UA, μmol/L
326.20 [265.00, 398.00]
326.00 [265.10, 396.00]
327.00 [264.00, 399.50]
0.850
eGFR, mL/minute/1.73 m2
97.66 [77.73, 113.18]
104.67 [88.91, 120.20]
91.16 [69.40, 107.07]
< 0.001
Table 2 Baseline characteristics in the study participants based on serum retinol-binding protein tertiles
Characteristic
Q1 (n = 1474)
Q2 (n = 1478)
Q3 (n = 1476)
P value
lower limb atherosclerosis, n (%)
759 (51.49)
794 (53.73)
962 (66.18)
< 0.001
Age, years
56.00 [47.00, 64.00]
55.00 [47.25, 64.75]
56.00 [49.00, 65.00]
0.130
Male, n (%)
775 (52.58)
893 (60.42)
1023 (69.31)
< 0.001
Cigarette smoking history, n (%)
501 (33.99)
595 (40.26)
690 (46.75)
< 0.001
Alcohol consumption history, n (%)
469 (31.82)
578 (39.11)
675 (45.73)
< 0.001
Hypertension, n (%)
727 (49.32)
912 (61.71)
1126 (76.29)
< 0.001
CHD, n (%)
207 (14.04)
279 (18.88)
352 (23.85)
< 0.001
Hyperlipidemia, n (%)
598 (40.57)
905 (61.23)
1018 (68.97)
< 0.001
SBP, mmHg
126.00 [113.00, 139.00]
129.00 [117.00, 142.00]
132.00 [119.00, 148.00]
< 0.001
DBP, mmHg
79.00 [71.00, 87.00]
81.00 [73.00, 89.75]
83.00 [75.00, 92.00]
< 0.001
BMI, kg/m2
23.20 [20.70, 26.00]
24.20 [22.10, 26.40]
24.90 [22.60, 27.20]
< 0.001
RBP, mg/L
23.80 [20.40, 26.15]
31.90 [30.07, 33.90]
42.61 [38.90, 48.16]
< 0.001
HbA1c, %
9.00 [7.20, 10.90]
8.30 [7.00, 10.20]
8.05 [6.80, 9.70]
< 0.001
FBG, mmol/L
8.93 [6.52, 12.57]
8.37 [6.52, 11.19]
8.23 [6.59, 10.78]
< 0.001
TC, mmol/L
4.38 [3.68, 5.12]
4.66 [3.92, 5.42]
4.80 [4.00, 5.63]
< 0.001
LDL, mmol/L
2.74 [2.23, 3.25]
2.88 [2.41, 3.46]
2.96 [2.39, 3.52]
< 0.001
TG, mmol/L
1.27 [0.94, 1.80]
1.57 [1.15, 2.32]
1.95 [1.37, 2.91]
< 0.001
HDL, mmol/L
1.10 [0.90, 1.34]
1.11 [0.94, 1.30]
1.08 [0.94, 1.28]
0.440
WBC count, 109/L
6.17 [4.99, 7.56]
6.18 [5.22, 7.44]
6.58 [5.46, 7.89]
< 0.001
CRP, mg/L
3.87 [1.32, 21.64]
2.37 [1.08, 7.73]
2.74 [1.19, 9.30]
< 0.001
AST, IU/L
20.60 [16.36, 27.80]
20.50 [17.21, 25.30]
20.98 [17.30, 25.75]
0.466
ALT, IU/L
18.65 [13.11, 30.30]
19.73 [14.61, 27.90]
19.90 [14.75, 29.10]
0.027
UA, μmol/L
277.00 [227.00, 333.00]
325.00 [270.89, 384.00]
380.00 [321.00, 441.12]
< 0.001
eGFR, mL/minute/1.73 m2
105.85 [90.95, 120.70]
100.24 [85.50, 114.03]
81.76 [53.80, 101.49]
< 0.001
Table 3 Association between serum retinol-binding protein levels and lower limb atherosclerosis risk in type 2 diabetes mellitus patients
Serum RBP levels
Model 1, OR (95%CI)
Model 1, P value
Model 2, OR (95%CI)
Model 2, P value
Model 3, OR (95%CI)
Model 3, P value
Continuous
1.02 (1.02, 1.03)
< 0.001
1.01 (1.01, 1.02)
< 0.001
1.01 (1.00, 1.02)
0.004
Tertiles
Q1
Reference
Reference
Reference
Q2
1.09 (0.95, 1.26)
0.200
1.00 (0.84, 1.18)
0.900
1.00 (0.84, 1.19)
0.900
Q3
1.76 (1.52, 2.04)
< 0.001
1.44 (1.21, 1.71)
< 0.001
1.36 (1.12, 1.67)
0.002
P for trend
< 0.001
< 0.001
0.005
Table 4 Subgroup analysis of relationship between serum retinol-binding protein level and lower limb atherosclerosis risk in type 2 diabetes mellitus patients
Subgroups
OR (95%CI)
P value
P for interaction
Age
0.019
< 60 years
1.01 (1.00, 1.02)
0.016
≥ 60 years
1.01 (0.99, 1.02)
0.400
Sex
0.700
Male
1.02 (1.01, 1.03)
0.003
Female
1.01 (0.99, 1.02)
0.500
BMI
0.900
< 25 kg/m2
1.01 (1.00, 1.02)
0.110
≥ 25 kg/m2
1.02 (1.00, 1.03)
0.011
Hypertension
0.800
Yes
1.01 (1.00, 1.02)
0.037
No
1.02 (1.00, 1.03)
0.036
Hyperlipidemia
0.700
Yes
1.01 (1.00, 1.02)
0.022
No
1.01 (1.00, 1.02)
0.091
CHD
0.200
Yes
1.03 (1.01, 1.06)
0.003
No
1.01 (1.00, 1.02)
0.069
eGFR
0.800
≤ 60 mL/minute/1.73 m2
1.02 (1.00, 1.03)
0.046
> 60 mL/minute/1.73 m2
1.01 (1.00, 1.02)
0.027
Citation: Zhang YL, Peng GL, Leng WL, Lian Y, Cheng LQ, Li X, Wang YL, Zhou L, Long M. Association between serum retinol-binding protein and lower limb atherosclerosis risk in type 2 diabetes mellitus. World J Diabetes 2025; 16(3): 98590