Clinical significance of urinary liver-type fatty acid-binding protein in diabetic nephropathy of type 2 diabetic patients

Diabetes Care. 2011 Mar;34(3):691-6. doi: 10.2337/dc10-1392. Epub 2011 Jan 27.

Abstract

Objective: Urinary liver-type fatty acid-binding protein (L-FABP) is a promising indicator of tubular but not glomerular damage. The aim of this study was to evaluate the clinical usefulness of urinary L-FABP as a prognostic biomarker in impaired diabetic nephropathy in type 2 diabetes.

Research design and methods: This investigation involved a cross-sectional and longitudinal analysis of the relationship between urinary L-FABP levels and progressive nephropathy. Urinary L-FABP was measured with enzyme-linked immunosorbent assay. In the cross-sectional analysis, the association of urinary L-FABP, with the severity of diabetic nephropathy, was investigated in 140 patients with type 2 diabetes and in 412 healthy control subjects. Of the patients in the former study, 104 have been followed for 4 years. The progression of diabetic nephropathy was defined as progressive albuminuria, end-stage renal disease, or induction of hemodialysis.

Results: Urinary L-FABP levels were progressively increased in subjects with normo-, micro-, or macroalbuminuria and further increased in patients with end-stage renal disease. In the longitudinal analysis, high urinary L-FABP levels were associated with the increase in albuminuria, progression to end-stage renal disease, or induction of hemodialysis. This was particularly demonstrated in the subgroup of patients without renal dysfunction (n = 59), where high urinary L-FABP levels were associated with the progression of diabetic nephropathy.

Conclusions: Urinary L-FABP accurately reflected the severity of diabetic nephropathy in type 2 diabetes, and its level was high in the patients with normoalbuminuria. Moreover, higher urinary L-FABP was a risk factor for progression of diabetic nephropathy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / urine*
  • Diabetic Nephropathies / urine*
  • Enzyme-Linked Immunosorbent Assay
  • Fatty Acid-Binding Proteins / urine*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Prospective Studies

Substances

  • Fatty Acid-Binding Proteins