Circulating adipocyte-fatty acid binding protein levels predict the development of the metabolic syndrome: a 5-year prospective study

Circulation. 2007 Mar 27;115(12):1537-43. doi: 10.1161/CIRCULATIONAHA.106.647503.


Background: Adipocyte-fatty acid binding protein (A-FABP), a major cytoplasmic protein in adipocytes, plays a central role in the development of diabetes and atherosclerotic cardiovascular disease in experimental animals. We have previously shown that A-FABP is present in the bloodstream and that its circulating levels correlate with metabolic risk factors in a cross-sectional study. In the present study, we further evaluated the prospective association of A-FABP with the metabolic syndrome (MetS) as defined by the updated National Cholesterol Education Program criteria.

Methods and results: In the present study, 495 nondiabetic adults from the population-based Hong Kong Cardiovascular Risk Factor Prevalence Study were prospectively followed up for 5 years. The relationship of serum A-FABP with the MetS and its components was investigated. At baseline, high A-FABP levels were associated with the MetS (odds ratio, 4.0; 95% CI, 1.5 to 10.4; highest versus lowest sex-specific tertile, adjusted for age, body mass index, the homeostasis model assessment index for insulin resistance, C-reactive protein, and adiponectin, P=0.005). On long-term follow-up, subjects with higher baseline A-FABP levels had progressively worse cardiometabolic risk profile and increasing risk of the MetS. Among 376 subjects without the MetS at baseline, 50 had developed it at 5 years. Apart from the homeostasis model assessment index for insulin resistance (P=0.001), baseline A-FABP was the only independent predictor of the development of the MetS during the 5-year follow-up (odds ratio, 4.7; 95% CI, 1.8 to 11.9; highest versus lowest sex-specific tertile, P=0.001, adjusted for the homeostasis model assessment index for insulin resistance and body mass index). A-FABP was predictive of the MetS even after adjustment for each of its individual components.

Conclusions: Circulating A-FABP predicts the development of the MetS independently of adiposity and insulin resistance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipose Tissue / chemistry
  • Adult
  • Aged
  • Animals
  • Blood Glucose / analysis
  • Body Mass Index
  • Cross-Sectional Studies
  • Fatty Acid-Binding Proteins / blood*
  • Female
  • Follow-Up Studies
  • Homeostasis
  • Hong Kong / epidemiology
  • Humans
  • Hypertension / epidemiology
  • Hypertriglyceridemia / epidemiology
  • Insulin Resistance
  • Likelihood Functions
  • Male
  • Metabolic Syndrome / blood*
  • Metabolic Syndrome / epidemiology
  • Metabolic Syndrome / etiology
  • Mice
  • Mice, Inbred C57BL
  • Middle Aged
  • Models, Biological
  • Obesity / epidemiology
  • Odds Ratio
  • Prospective Studies
  • Risk Factors


  • Blood Glucose
  • Fatty Acid-Binding Proteins