Objective:To explore the association of fatty acid-binding protein 4(FABP4)with type 2 diabetic nephropathy(DN)and the value of FABP4 for early diagnosis of DN.Methods:218 type 2 diabetic mellitus(T2DM)patients and 20 healthy controls(control group)were recruited.The general clinical and anthropometric information of participants,such as height,weight,waist circumference,duration of diabetes were recorded at baseline,and calculate BMI.Plasma glucose,glycosylated hemoglobin,fasting insulin and C-peptide,liver and kidney function,blood lipids and other indicators were measured.Homeostasis model assessment-insulin resistance index(HOMA-IR)was calculated.Serum FABP4 levels were measured by ELISA.The glomerular filtration rate was estimated using a collaborative epidemiological equation for chronic kidney diseasa using a combination of serum creatinine(Scr)and cystatin C(Cys C).Urinary albumin to creatinine ratio(UACR)was calculated as the ratio of urinary albumin level to urinary creatinine level.According to estimated glomerular filtration rate(eGFR),all T2DM patients were divided into three subgroups:normal renal function group(eGFR ≥90 mUmin/1.73 m2),mild renal dysfunction group(60 mUmin/1.73 m2≤eGFR＜90 mL/min/1.73 m2),and moderate renal dysfunction group(30 mL/min/1.73 m2≤eGFR＜60 mL/min/1.73 m2).According to UACR,subgroups were:normal albuminuria group(UACR＜30 mg/g),microalbuminuria group(30 mg/g≤UACR＜300 mg/g),and macroalbuminuria group(UACR ≥300 mg/g).Multivariate regression analyses were employed to assess the correlation between FABP4 and eGFR and UACR.Results:(1)Comparing with the control group,serum FABP4 levels in T2DM patients were significantly higher.(2)Among three subgroups stratified according to eGFR,serum FABP4 levels increased significantly as eGFR decreased(P＜0.001).No significant differences were observed among UACR subgroups(P=0.382).(3)Spearman correlation analysis showed that serum FABP4 was negatively correlated eGFR(r=-0.203,P=0.001),but not with UACR(r=0.130,P=0.055).(4)Multiple linear regression showed that FABP4 was negatively correlated with eGFR(r=-0.211,P＜0.001),but not with UACR(r=-0.047,P=0.534).(5)The best cut-off value of FABP4 for diagnosing DN was 103.9 μg/L,the AUC was 0.745(sensitivity 51.2％,specificity 92.7％).Conclusion:The elevated serum FABP4 level in T2DM patients is associated with the development of DN.It may be used as a biomarker for early diagnosis of DN.
type 2 diabetes mellitusdiabetic nephropathyfatty acid-binding protein 4early diagnosisbiomarkers
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NSTL
万方数据
