Diabetes Metab J.  2020 Dec;44(6):875-886. 10.4093/dmj.2019.0221.

Serum Levels of Adipocyte Fatty Acid-Binding Protein Are Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Preserved Renal Function

• Seo DH
• Nam M
• Jung M
• Suh YJ
• Ahn SH
• Hong S
• Kim SH

• KMID: 2513051
• DOI: http://doi.org/10.4093/dmj.2019.0221

Abstract

Recent studies have demonstrated that the levels of adipocyte fatty acid-binding protein (A-FABP) are closely associated with diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM). This study aimed to examine the association between serum A-FABP level and rapid renal function decline in patients with T2DM and preserved renal function.

This was a prospective observational study of 452 patients with T2DM and preserved renal function who had serial measurements of estimated glomerular filtration rate (eGFR). Rapid renal function decline was defined as an eGFR decline of >4% per year. The association between baseline serum A-FABP level and rapid renal function decline was investigated.

Over a median follow-up of 7 years, 82 participants (18.1%) experienced rapid renal function decline. Median A-FABP levels were significantly higher in patients with rapid renal function decline, compared to non-decliners (20.2 ng/mL vs. 17.2 ng/mL, P=0.005). A higher baseline level of A-FABP was associated with a greater risk of developing rapid renal function decline, independent of age, sex, duration of diabetes, body mass index, systolic blood pressure, history of cardiovascular disease, baseline eGFR, urine albumin creatinine ratio, total cholesterol, glycosylated hemoglobin, high-sensitivity C-reactive protein and use of thiazolidinedione, insulin, angiotensin-converting-enzyme inhibitors and angiotensin II-receptor blockers and statin (odds ratio, 3.10; 95% confidence interval, 1.53 to 6.29; P=0.002).

A high level of serum A-FABP is associated with an increased risk of rapid renal function decline in patients with T2DM and preserved renal function. This suggests that A-FABP could play a role in the progression of DKD in the early stages.

Keyword

Diabetes mellitus, type 2; Diabetic nephropathies; FABP4 protein, human

Figure

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  Fig. 1 Comparison of plasma adipocyte fatty acid-binding protein (A-FABP) levels (µg/L) based on sex (A), the presence of rapid renal function decline (B), or albuminuria (C). The bottom of the box plots indicates the 25th percentile and the top indicates the 75th percentile. The middle line of the box indicates the median. The lower and the upper ends of the whiskers indicate the minimum and the maximum observations below the upper fence (1.5 interquartile range above the 75th percentile), respectively.

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