The Potential Role of Retinol-Binding Protein 4 in Heart Failure: A Review

Heart failure (HF) is a heterogeneous clinical syndrome, the prevalence of which is increasing among younger adults, promoting global concern due to its significant morbidity and mortality. Therefore, predicting the occurrence of HF using risk-related biomarkers is essential for screening and prevention. Retinol-binding protein 4 (RBP4) is a 21 kDa secreted factor produced by the liver and adipose tissue. Elevated serum RBP4 levels​ are consistently observed in HF patients and are associated with different New York Heart Association (NYHA) class and left ventricular dysfunction. In addition to its role in retinol transport, emerging evidence suggests that RBP4 contributes to the pathogenesis of HF by inducing insulin resistance, triggering chronic inflammation, and directly injuring cardiomyocytes. Studies have found that RBP4 is a potential diagnostic biomarker for HF; however, its clinical relevance is limited due to a paucity of clinical studies and basic science research. This article reviews the current clinical and experimental evidence regarding the pathophysiological effects of RBP4 related to its role in the progression of HF.