Diabetes Metab J.  2022 Jul;46(4):640-649. 10.4093/dmj.2021.0195.

Fatty Acid-Binding Protein 4 in Patients with and without Diabetic Retinopathy

• Huang P
• Zhao X
• Sun Y
• Wang X
• Ouyang R
• Jiang Y
• Zhang X
• Hu R
• Tang Z
• Gu Y

• KMID: 2531967
• DOI: http://doi.org/10.4093/dmj.2021.0195

Abstract

Background
Fatty acid-binding protein 4 (FABP4) has been demonstrated to be a predictor of early diabetic nephropathy. However, little is known about the relationship between FABP4 and diabetic retinopathy (DR). This study explored the value of FABP4 as a biomarker of DR in patients with type 2 diabetes mellitus (T2DM).
Methods
A total of 238 subjects were enrolled, including 20 healthy controls and 218 T2DM patients. Serum FABP4 levels were measured using a sandwich enzyme-linked immunosorbent assay. The grade of DR was determined using fundus fluorescence angiography. Based on the international classification of DR, all T2DM patients were classified into the following three subgroups: non-DR group, non-proliferative diabetic retinopathy (NPDR) group, and proliferative diabetic retinopathy (PDR) group. Multivariate logistic regression analyses were employed to assess the correlation between FABP4 levels and DR severity.
Results
FABP4 correlated positively with DR severity (r=0.225, P=0.001). Receiver operating characteristic curve analysis was used to assess the diagnostic potential of FABP4 in identifying DR, with an area under the curve of 0.624 (37% sensitivity, 83.6% specificity) and an optimum cut-off value of 76.4 μg/L. Multivariate logistic regression model including FABP4 as a categorized binary variable using the cut-off value of 76.4 μg/L showed that the concentration of FABP4 above the cut-off value increased the risk of NPDR (odds ratio [OR], 3.231; 95% confidence interval [CI], 1.574 to 6.632; P=0.001) and PDR (OR, 3.689; 95% CI, 1.306 to 10.424; P=0.014).
Conclusion
FABP4 may be used as a serum biomarker for the diagnosis of DR.

Keyword

Biomarkers; Diabetes mellitus, type 2; Diabetic retinopathy; Diagnosis; Fatty acid-binding proteins

Figure

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  Fig. 1. (A) Comparison of serum fatty acid-binding protein 4 (FABP4) levels among subgroups divided by the severity of diabetic retinopathy (DR). P for trend by Kruskal-Wallis test. (B) The correlation between serum FABP4 levels and the severity of DR. NDR, non-diabetic retinopathy; NPDR, non-proliferative diabetic retinopathy; PDR, proliferative diabetic retinopathy.

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  Fig. 2. Diagnostic performance of fatty acid-binding protein 4 in identifying diabetic retinopathy. ROC, receiver operating characteristic; AUC, area under curve.

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