Abstract
Adipocyte fatty acid binding protein (A-FABP) is predictive of type 2 diabetes mellitus incidences and metabolic syndrome and is independently associated with atherosclerosis. The present study aimed to assess the association between serum A-FABP levels and future first hospitalization events in kidney transplantation (KT). We enrolled 72 KT patients from January through April 2012 and followed up on these subjects until June 2017. The first hospitalization events incidence was the primary endpoint. Using a commercially available enzyme immunoassay, serum A-FABP levels were measured from the patient’s fasting blood samples. During a median 65-month follow-up, 49 first hospitalization events occurred. KT patients with first hospitalization events had greater incidences of hypertension, diabetes, and higher serum blood urea nitrogen, creatinine, triglyceride, and A-FABP levels than those without the events. Kaplan–Meier analysis showed that the cumulative incidence of first hospitalization events was greater in the high A-FABP group than in the low A-FABP group. Multivariate Cox analysis with significant variables showed that serum A-FABP (hazard ratio = 1.012; 95% confidence interval = 1.000–1.025; p = 0.044) was independently associated with first hospitalization events among KT patients. The results revealed that serum A-FABP is associated with first hospitalization events in KT patients. However, further prospective studies are needed to determine the mechanisms underlying this association.
Highlights
Adipocyte fatty acid binding protein (A-FABP), an adipokine that has been implicated in lipid metabolism, lipolysis, and insulin sensitivity, can be used to predict the incidence of metabolic syndrome (MetS) and type 2 diabetes mellitus (DM)
Patients with first hospitalization events had a higher prevalence of DM (p = 0.027), hypertension (p = 0.049), and steroid used (p = 0.024) as well as higher serum TG (p = 0.040), blood urea nitrogen (BUN) (p = 0.012), creatinine (p = 0.032), and A-FABP (p = 0.011) levels than those without the events (Table 2)
Patients with acute kidney injury related first hospitalization events had a higher prevalence of hypertension (p = 0.042), steroid used (p = 0.038) as well as higher serum BUN (p < 0.001), creatinine (p = 0.008) and A-FABP (p = 0.004) levels, and lower estimate glomerular filtration rate (eGFR) (p = 0.004)
Summary
Adipocyte fatty acid binding protein (A-FABP), an adipokine that has been implicated in lipid metabolism, lipolysis, and insulin sensitivity, can be used to predict the incidence of metabolic syndrome (MetS) and type 2 diabetes mellitus (DM). Res. Public Health 2020, 17, 7567 cardiovascular disease (CVD) than the general population, successful KT leads to a reduced risk of CVD in these patients [5]. Studies have shown that these patients have a high prevalence of CVD risk factors before KT, and they suffer from new-onset diabetes, MetS, or coronary heart disease after KT, all of which are risk factors for allograft failure [8,9,10]. The use of immunosuppressive medications is a risk factor, as it may induce MetS, diabetes, and coronary heart disease in KT patients [10,11]. Far, no study has investigated whether the usefulness of serum A-FABP level is associated with first hospitalization events in KT patients. The present study aimed to determine whether serum A-FABP can be used as a prognostic marker of first hospitalization events in KT patients
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