Increased Serum Adipocyte Fatty Acid-Binding Protein Concentrations Are Associated with Aortic Stiffness in Nondialysis Diabetic Kidney Disease

Abstract

BACKGROUND: Adipocyte fatty acid-binding protein (A-FABP) is a novel adipokine with proinflammatory properties that contributes to the development of cardiovascular disease. This cross-sectional study evaluated the correlation between serum A-FABP and aortic stiffness in patients with stages 3-5 nondialysis chronic kidney disease due to type 2 diabetes mellitus (T2DM). METHODS: Fasting blood samples were obtained from 96 patients with stages 3-5 nondialysis chronic kidney disease due to T2DM. Pressure applanation tonometry was used to measure the carotid-femoral pulse wave velocity (cfPWV). Patients with a cfPWV ＞ 10 m/s were defined as having increased aortic stiffness according to the guidelines of the European Society of Hypertension and European Society of Cardiology 2013. Serum A-FABP levels were determined using a commercial enzyme immunoassay. RESULTS: There were 53 (55.2%) patients in the aortic stiffness group, of which higher prevalence rates were found for the male sex (P = 0.015), older age (P = 0.025), higher systolic blood pressure (BP) (P = 0.001), diastolic BP (P = 0.037), urine albumin/creatinine ratio (P = 0.007), serum levels of total cholesterol (P = 0.030), low-density lipoprotein cholesterol (P = 0.043), and A-FABP (P ＜ 0.001) compared with the group with normal aortic stiffness. After adjusting for factors that are significantly associated with aortic stiffness based on multivariable logistic regression analysis, serum A-FABP (odds ratio, 1.487; 95% confidence interval, 1.210-1.829; P ＜ 0.001) was an independent predictor of aortic stiffness in patients with diabetes-associated stages 3-5 nondialysis chronic kidney disease. Multivariable regression analysis with forward stepwise selection revealed that the serum level of logarithmically transformed A-FABP (β = 0.587; adjusted R^2 change, 0.426; P ＜ 0.001) was positively associated with cfPWV in patients with diabetes-associated stages 3-5 nondialysis chronic kidney disease. CONCLUSION: After adjusting for significant confounders, the serum A-FABP level was positively correlated with cfPWV and was an independent predictor of aortic stiffness in patients with diabetes-associated stages 3-5 nondialysis chronic kidney disease.