Serum Adipocyte Fatty Acid-binding Protein Research Articles

The association of initial and changes in serum A-FABP level with the development and improvement of pre-sarcopenia.

Several cross-sectional studies have reported the association between serum adipocyte fatty acid binding protein (A-FABP) level and pre-sarcopenia. However, data on the impacts of serum A-FABP level and its changes over time on the development and improvement of pre-sarcopenia are scarce. This longitudinal cohort study included 1496 adults (41.2% men; median age, 58 [53-63] years) in 2013-2014 and was followed up to 2015-2016. Participants underwent serum A-FABP level measurements at baseline and follow-up visit. Visceral fat area (VFA) was measured using magnetic resonance imaging. Skeletal muscle mass (SMM) was estimated by bioelectrical impedance analysis and converted to skeletal muscle index (SMI). Pre-sarcopenia was defined as SMI < 1 standard deviation of the sex-specific mean for the young reference group. During an average follow-up period of 2.1 years, baseline serum A-FABP level was positively associated with the incidence of pre-sarcopenia (standardized by weight: risk ratio [RR] 3.22, 95% confidence interval [CI] 1.96-5.38; standardized by VFA: RR 2.11, 95%CI 1.29-3.51) and negatively associated with the improvement of pre-sarcopenia (standardized by weight: RR 0.66, 95%CI 0.45-0.97; standardized by VFA: RR 0.71, 95%CI 0.54-0.94), regardless of whether SMM was standardized by weight or VFA. Moreover, changes in serum A-FABP level provided additional information on the incidence and improvement of pre-sarcopenia, independent of baseline serum A-FABP level (all P < 0.05). Baseline serum A-FABP level and its changes were positively associated with the incidence, and negatively associated with the improvement of pre-sarcopenia.

Dysregulation of adipokines levels among healthy first-degree relatives of type 2 diabetes patients

BackgroundLeptin, adiponectin and its ratio (L/A), as well as adipocyte fatty acid binding protein (A-FABP) have shown association to type 2 diabetes and atherosclerosis. Since first degree relatives (FDR) of type 2 diabetes are known to have higher risks of developing aforementioned diseases, this study aimed to see differences in adipokines profiles between FDR of type 2 diabetes and non-FDR counterpart. MethodsAge, sex and body mass index (BMI)-matched normotensive-normoglycemic subjects, aged 19–39 years with BMI<30 kg/m2, were included in this cross-sectional study. Serum adiponectin, leptin, and A-FABP levels were measured by sandwich ELISA while HOMA-IR was calculated from fasting blood glucose and insulin levels. ResultsOf 116 subjects recruited, there were significant difference of insulin level (6.00 vs 5.00 μIU/mL, P = 0.029) and HOMA-IR (1.27 vs 1.10, P = 0.028). Adiponectin, leptin, L/A ratio, and A-FABP levels were not statistically different between FDR and non-FDR groups. Stratified by BMI, non-obese FDR had higher L/A ratio (0.83 vs 0.49, P = 0.020) compared to those of corresponding non-FDR. In multivariate analysis, after adjusting for age, sex, waist circumference, BMI, and metabolic profiles (HbA1C, HOMA-IR, LDL-C, HDL-C, and triglyceride levels), FDR status became significantly associated with adiponectin level, and in non-obese subgroup, remained its significance with L/A ratio. ConclusionThe FDR status was independently associated with adiponectin level. Furthermore, higher L/A ratio was more pronounced in non-obese FDR than those of non-FDR subjects, suggesting that FDR status may already contribute to the development of adipokines dysregulation before obesity occurs.

Study on the Association Between Dietary Quality and Overweight/Obesity of Han Nationality with Cold in Yunnan Plateau by DBI-16 - A Study Based on a Multi-Ethnic Cohort in China.

In recent years, with the rapidly development of economic globalization, residents' dietary structure has undergone major changes, and diet have emerged as an important environmental factors linked to the increased incidence of obesity. Therefore, evaluating the overall dietary quality and structure of residents, further clarifying the main dietary factors that lead to disease occurrence, is of great practical significance for disease prevention and control. Baseline data from the China Multi-Ethnic Cohort study (CMEC), Han people living in high-altitude and cold regions of Yunnan Province, which was 1518 participants. In this study, the dietary balance index (DBI-16) was used (i) To evaluate the dietary quality of Han nationality residents 30-79 years old in the Yunnan plateau; (ii) To analyze the correlation between the dietary quality and overweight/obesity; (iii) And to provide reference basis of nutritional intervention for local residents and explore the main dietary factors affecting their health status. The dietary structure of the Han nationality residents in the cold regions of Yunnan plateau is unreasonable. Firstly, the intake of cereals, fruits, dairy, eggs and fishes is insufficient to varying degrees, while the intake of beans, poultry, and cooking oil is relatively high. Secondly, the dietary patterns of normal groups, the overweight and obese groups obeyed the A, E, H and I dietary patterns, and the serum Leptin and adipocyte fatty acid binding protein (A-FABP) levels of the overweight and obese group were higher than the normal group between the different dietary patterns (P < 0.05, r > 0). Additionally, excessive dietary intake was positively correlated with a higher serum UCP1 level (P < 0.05, r > 0). In comparison, insufficient dietary intake was positively correlated with a higher serum A-FABP level (P < 0.05, r > 0). Through the DBI-16, it is found that the dietary structure of the Han nationality residents in the cold regions of Yunnan plateau was in a serious imbalance state, and nutritional guidance and intervention should be further strengthened.

1411-P: Serum Adipocyte Fatty Acid–Binding Protein Is Related to the Development of Prediabetes—Tokushima Cohort Study

Adipocyte fatty acid-binding protein (A-FABP/FABP4) is abundantly expressed in mature adipocytes and presumably secreted into the plasma from these cells. Emerging evidence suggests that FABP4 may be involved in the development of insulin resistance. However, prospective cohort studies to prove their causative relationship are still limited. The aim of the present study was to investigate the association between serum concentration of FABP4 and incidence of prediabetes. Here we analyzed data of a prospective cohort study, which was conducted during 2008-2019 in Japan. A total of 527 subjects without prediabetes aged 20 to 60 years were followed up prospectively. Prediabetes was defined as either: 1) fasting plasma glucose ≥ 100 mg/dl, 2) HbA1c ≥ 5.7% or 3) medication for hyperglycemia. The subjects were divided into three categories based on the tertiles of baseline serum FABP4 for each sex (male: &amp;lt; 7.8, 7.8-11.3 and &amp;gt; 11.3 ng/ml, female: &amp;lt;10.0, 10.0-13.0 and &amp;gt; 13.0 ng/ml). The age- and sex-adjusted incidence of prediabetes significantly increased with increasing tertile of serum FABP4 level at baseline (P for trend&amp;lt;0.001). In multivariate analysis after adjusting for age, sex, BMI, smoking habit, alcohol intake, regular exercise, HDL cholesterol, triglycerides, family history of diabetes, and hypertension, the hazard ratio of prediabetes was 1.65 [95% confidence interval:1.09 to 2.50, P=0.02] in the highest tertile of baseline serum FABP4, when compared with the lowest tertile. In addition, serum FABP4 at baseline was significantly higher in the subjects who developed diabetes, rather than prediabetes, during the follow-up period. Our findings suggest that increased serum concentration of FABP4 is an independent predictor of the incidence of prediabetes in Japanese and is related to the severity of future glucose intolerance. These results imply that altered FABP4 may associate with disorders of glucose metabolism from the early stages. Disclosure A.Hata: None. N.Aki: None. T.Ichihara: None. T.Minagawa: None. A.Tamura: None. Y.Kuwamura: None. M.Funaki: Board Member; Mechanogenic, Inc. Funding Grants-in-Aid for Scientific Research (to M.F.); Japan Society for the Promotion of Science (25860439 to A.H.)

Circulating AFABP, FGF21, and PEDF Levels as Prognostic Biomarkers of Sight-threatening Diabetic Retinopathy.

Adipocyte fatty acid-binding protein (AFABP), fibroblast growth factor 21 (FGF21), and pigment epithelium-derived factor (PEDF) are 3 diabetes-related biomarkers whose circulating levels had been shown to associate with nephropathy progression in Chinese patients with type 2 diabetes. Here, we evaluated and compared their prospective associations with the development of sight-threatening DR (STDR), another important diabetic microvascular complication. Baseline serum AFABP, PEDF, and FGF21 levels were measured in 4760 Chinese individuals with type 2 diabetes and without STDR at baseline. The associations of these biomarkers with incident STDR were analyzed using Cox regression analysis. Among these 4760 participants (mean diabetes duration of 11 years and ≥ 50% with nonproliferative DR at baseline), 172 participants developed STDR over a median follow-up of 8.8 years. Participants with incident STDR had comparable baseline serum FGF21 levels but significantly higher baseline serum AFABP and PEDF levels (both P < .001) than those without. However, in multivariable Cox regression analysis, only serum AFABP remained independently associated with incident STDR (hazard ratio 1.28; 95% CI, 1.05-1.55; P = .013). The addition of serum AFABP to a clinical model of conventional STDR risk factors including diabetes duration, glycemic control, albuminuria, and baseline DR status significantly improved the c statistics (P < .001), net reclassification index (P = .0027), and integrated discrimination index (P = .033) in predicting incident STDR among participants without DR or with mild DR at baseline. Among the 3 diabetes-related biomarkers, serum AFABP level appeared to be a more clinically useful biomarker for predicting incident STDR in type 2 diabetes.

The Association and Joint Effect of Adipocyte Fatty Acid Binding Protein and Obesity Phenotype With Cardiovascular Events.

There is little evidence regarding the joint effect of serum adipocyte fatty acid binding protein (A-FABP) levels and obesity phenotype on the risk of cardiovascular events. To explore the association between serum A-FABP levels and obesity phenotype defined by fat percentage (fat%) and visceral fat area (VFA), and their joint impact on incident cardiovascular events. A total of 1345 residents (579 men and 766 women) without previous cardiovascular diseases at baseline, with body composition and serum A-FABP data available, were included. A bioelectrical impedance analyzer and magnetic resonance imaging were used to assess fat% and VFA, respectively. During a mean follow-up of 7.6 years, 136 cases of cardiovascular events (13.9 per 1000 person-years) occurred. Per 1-unit increase in loge-transformed A-FABP levels was associated with an increase in cardiovascular events risk (hazard ratio [HR] 1.87, 95% CI 1.33-2.63). The highest tertiles of fat% and VFA levels were related to higher risks of cardiovascular events (fat%: HR 2.38, 95% CI 1.49-3.81; VFA: HR 1.79, 95% CI 1.09-2.93). The association between A-FABP levels and cardiovascular events was more pronounced in participants with low fat%, regardless of VFA levels. The joint effect of high A-FABP levels and obesity resulted in a greater risk of cardiovascular events. Serum A-FABP levels were significantly associated with the risk of cardiovascular events, and this pattern of association was more prominent among the population with low fat%, which was independent of VFA.

Serum Adipocyte Fatty-Acid Binding Protein as an Independent Marker of Peripheral Artery Disease in Patients with Type-2 Diabetes Mellitus.

The adipocyte fatty-acid binding protein (A-FABP) is predominantly expressed in macrophages and adipocytes and is an essential mediator of inflammation and atherosclerosis pathogenesis. Atherosclerosis is an aggravating factor for peripheral arterial disease (PAD). Our study intended to study the association between PAD and serum A-FABP levels in type-2 diabetes mellitus (T2DM) patients. One hundred and twenty T2DM subjects were enrolled in the study. Fasting blood samples were collected to determine biochemical data and A-FABP levels. By the automatic oscillometric method, the ankle–brachial index (ABI) was measured. Low ABI was defined as any value < 0.9. Twenty participants with T2DM (16.7%) were included in the low ABI group. Low ABI T2DM participants had an increased mean body mass index, body fat mass, systolic blood pressure, C-reactive protein, urine albumin–creatinine ratio, and A-FABP levels compared to those in the normal ABI group. After variables significantly associated with PAD were adjusted by multivariate logistic regression analyses, circulating A-FABP levels (odds ratio [OR]: 1.138; 95 percent confidence interval [CI]: 1.023–1.266; p = 0.017) were identified as the independent marker of PAD. In conclusion, fasting serum A-FABP value has positive association with PAD in T2DM patients.

Serum adipocyte fatty acid-binding protein level is positively associated with aortic stiffness in nondialysis chronic kidney disease patients: A cross-sectional study.

Aortic stiffness (AS) is a major predictor of cardiovascular disease and mortality in patients with chronic kidney disease (CKD) and adipocyte fatty acid-binding protein (A-FABP) is a novel adipokine that is positively correlated with AS in the general population. Therefore, we investigated the correlation between serum A-FABP levels and AS in nondialysis CKD patients.Fasting blood samples and baseline characteristics were obtained in 270 patients with nondialysis CKD. Serum A-FABP concentrations were determined by enzyme immunoassay and carotid–femoral pulse wave velocity (cfPWV) measurements were acquired using a validated tonometry system. Patients with cfPWV >10 m/s formed the AS group, while those with values ≤10 m/s comprised the comparison group.Among 270 CKD patients, 92 patients (34.1%) were in the AS group. Compared to those in the comparison group, patients in the AS group were older (P < .001), had a higher prevalence of diabetes, along with higher serum A-FABP level (P < .001), larger waist circumference (P = .004), and lower estimated glomerular filtration rate (P = .001) but higher levels of body fat mass (P = .010), systolic blood pressure (P < .001), fasting glucose (P = .014), blood urea nitrogen (P = .009), and serum creatinine (P = .004). The serum log-A-FABP level was positively associated with log-cfPWV (β = 0.178, P = .001) in nondialysis CKD patients and multivariable logistic regression analysis identified serum A-FABP (P = .006), age (P = .001), and systolic blood pressure (P = .015) as independent predictors of AS in nondialysis-dependent CKD patients.Elevated A-FABP levels may be a significant predictor of AS in nondialysis CKD patients.

Age and Serum Adipocyte Fatty-Acid-Binding Protein Level Are Associated with Aortic Stiffness in Coronary Artery Bypass Graft Patients.

Old age has been proven to be related to progressed arterial or aortic stiffness. Aortic stiffness is an independent predictor of all-cause and cardiovascular disease mortalities in patients who have undergone coronary artery bypass grafting (CABG) surgery. Higher serum concentrations of adipocyte fatty-acid-binding protein (A-FABP) could be considered a predictor of aortic stiffness in patients with hypertension or diabetes mellitus. This study aims to investigate the relationships between A-FABP and aortic stiffness in patients who have received CABG. A total of 84 CABG patients were enrolled in our study from September 2018 to May 2019. Serum A-FABP levels were determined using a commercial enzyme immunoassay. Carotid–femoral pulse wave velocity (cfPWV) > 10 m/s was defined as aortic stiffness. Of the 84 CABG patients, 28 (33.3%) with aortic stiffness had a higher average age; exhibited higher rates of diabetes; and had higher serum creatinine, C-reactive protein, and A-FABP levels compared to controls. Multivariable logistic regression revealed that serum A-FABP levels (odds ratio (OR) = 1.068, 95% confidence interval (CI) 1.017–1.121, p = 0.008) and age (OR = 1.204, 95% CI 1.067–1.359, p = 0.003) were independent predictors of aortic stiffness. Multivariable stepwise linear regression revealed significant positive correlations of age and A-FABP levels with cfPWV values. Serum A-FABP level is positively correlated with cfPWV values, and a high serum A-FABP level is associated with aortic stiffness in patients who have undergone CABG.

Association between Serum Adipocyte Fatty Acid Binding Protein Level and Endothelial Dysfunction in Chronic Hemodialysis Patients.

Adipocyte fatty acid binding protein (A-FABP) is associated with atherosclerosis, and endothelial dysfunction is one of the reasons for adverse cardiovascular outcomes in patients undergoing hemodialysis (HD). This study investigated the correlation between serum A-FABP levels and endothelial function in HD patients. Fasting blood samples were collected from 90 HD patients. A-FABP levels were measured using a commercial enzyme immunoassay kit. Endothelial function was evaluated by a digital thermal monitoring test to measure vascular reactivity index (VRI). VRI < 1.0, 1.0 ≤ VRI < 2.0, and VRI ≥ 2.0 indicated poor, intermediate, and good vascular reactivity, respectively. In total, 14 (15.6%), 38 (42.2%), and 38 (42.2%) HD patients had poor, intermediate, and good VRI, respectively. Patients with poor VRI had lower pre-HD and post-HD body weight, body mass index, and serum creatinine level but higher serum A-FABP level (p = 0.001) than those with intermediate and good VRI. Log-transformed VRI (log-VRI) positively correlated with serum creatinine and negatively correlated with A-FABP by multivariate linear regression analysis. We concluded that A-FABP correlated with endothelial dysfunction in chronic HD patients.

Prospective association of serum adipocyte fatty acid-binding protein with heart failure hospitalization in diabetes.

AimsAdipocyte fatty acid‐binding protein (AFABP) is associated with cardiovascular diseases in type 2 diabetes. Whether circulating AFABP levels are associated with the risk of heart failure (HF) in type 2 diabetes remains undefined. We investigated the prospective association of circulating AFABP levels with incident HF hospitalization in type 2 diabetes, and its relationship to the use of sodium glucose co‐transporter 2 inhibitors (SGLT2i) which reduce HF risk.Methods and resultsBaseline serum AFABP level was measured in 3322 Chinese participants without known history of cardiovascular diseases or hospitalization for HF, recruited from the Hong Kong West Diabetes Registry. Its association with incident HF hospitalization was evaluated using multivariable Cox regression analysis. Use of SGLT2i was included as a time‐dependent covariate. Among these 3322 participants (52.9% men; mean age 60.0 ± 12.6), 176 (5.3%) developed HF hospitalization over a median follow‐up of 8 years. Seven hundred and thirty‐one (22%) were started on SGLT2i during the study period (empagliflozin 55.1%, dapagliflozin 44.2%, canagliflozin 0.4%, and ertugliflozin 0.3%). Serum AFABP levels were significantly higher in participants who developed HF hospitalization than those who did not (men: 14.8 vs. 8.3 ng/mL; women: 21.5 vs. 14.6 ng/mL; all: 18.6 vs. 10.9 ng/mL, P < 0.001). In multivariable Cox regression analysis, baseline serum AFABP level was significantly associated with incident HF hospitalization [hazard ratio (HR) 1.38, 95% confidence interval (CI) 1.06–1.80, P = 0.019] independent of the use of SGLT2i, in a model also consisting of age; sex; body mass index; smoking status; duration of diabetes; hypertension, dyslipidaemia; atrial fibrillation; presence of chronic kidney disease and albuminuria; glycated haemoglobin and high‐sensitivity C‐reactive protein levels; and use of metformin, insulin, aspirin, furosemide, and beta‐blockers at baseline. High cumulative defined daily dose (cDDD) of SGLT2i was protective of incident HF hospitalization (HR 0.10, 95% CI 0.01–0.68, P = 0.019). The addition of circulating AFABP level to a clinical model of conventional HF risk factors provided significant improvement in the category‐free net reclassification index (11.5%, 95% CI 1.6–22.1, P = 0.02) and integrated discrimination improvement (0.3%, 95% CI 0.1–1.7, P = 0.04). A dose‐dependent reduction in cumulative incidence of HF hospitalization in response to SGLT2i, based on cDDD, was more clearly observed in participants with a higher baseline AFABP level above the sex‐specific median (P for trend <0.01).ConclusionsCirculating AFABP level is independently associated with incident HF hospitalization in type 2 diabetes and is potentially helpful in risk stratification for the prevention of HF hospitalization.

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

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.

Positive Associations between Adipocyte Fatty Acid-Binding Protein Level and Central Arterial Stiffness in Peritoneal Dialysis Patients.

Background Adipocyte fatty acid-binding protein (A-FABP) plays essential roles in lipolysis, insulin resistance, and atherosclerosis. This study aimed to evaluate the relationship between serum A-FABP levels and carotid-femoral pulse wave velocity (cfPWV) in peritoneal dialysis (PD) patients. Methods This study obtained fasting blood samples from 76 PD patients. A validated tonometry system was used to measure cfPWV. Patients with cfPWV values >10 m/s were classified into the high arterial stiffness group, whereas patients with values ≤10 m/s were classified into the low arterial stiffness group, according to the ESH-ESC 2013 guidelines. Serum A-FABP levels were measured using a commercial enzyme-linked immunosorbent assay kit. Results Twenty-five (32.9%) of the 76 PD patients were classified in the high arterial stiffness group. Compared with the patients in the low arterial stiffness group, the high arterial stiffness group was older (P = 0.002) and had a longer PD vintage (P = 0.011), higher diastolic blood pressure (DBP, P = 0.036), higher fasting glucose levels (P = 0.012), higher serum C reactive protein levels (P = 0.001), and higher serum A-FABP levels (P < 0.001). A multivariate logistic regression analysis of the factors significantly associated with central arterial stiffness revealed that A-FABP (odds ratio (OR): 1.165, 95% confidence interval (CI): 1.056–1.284, P = 0.002), age (OR: 1.423, 95% CI: 1.153–1.757, P = 0.001), PD vintage (OR: 1.049, 95% CI: 1.015–1.085, P = 0.005), and DBP (OR: 1.152, 95% CI: 1.033–1.285, P = 0.011) were independent predictors of central arterial stiffness in PD patients. Furthermore, serum A-FABP levels (β = 0.476, adjusted R2 change: 0.197, P < 0.001) were significantly positively correlated with cfPWV according to the multivariable forward stepwise linear regression analysis. Conclusions A-FABP levels are an independent marker of central arterial stiffness in PD patients.

Serum Levels of Adipocyte Fatty Acid-Binding Protein Are Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Preserved Renal Function

BackgroundRecent studies have demonstrated that the levels of adipocyte fatty acid-binding protein (A-FABP) are closely associated with diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM). This study aimed to examine the association between serum A-FABP level and rapid renal function decline in patients with T2DM and preserved renal function.MethodsThis was a prospective observational study of 452 patients with T2DM and preserved renal function who had serial measurements of estimated glomerular filtration rate (eGFR). Rapid renal function decline was defined as an eGFR decline of >4% per year. The association between baseline serum A-FABP level and rapid renal function decline was investigated.ResultsOver a median follow-up of 7 years, 82 participants (18.1%) experienced rapid renal function decline. Median A-FABP levels were significantly higher in patients with rapid renal function decline, compared to non-decliners (20.2 ng/mL vs. 17.2 ng/mL, P=0.005). A higher baseline level of A-FABP was associated with a greater risk of developing rapid renal function decline, independent of age, sex, duration of diabetes, body mass index, systolic blood pressure, history of cardiovascular disease, baseline eGFR, urine albumin creatinine ratio, total cholesterol, glycosylated hemoglobin, high-sensitivity C-reactive protein and use of thiazolidinedione, insulin, angiotensin-converting-enzyme inhibitors and angiotensin II-receptor blockers and statin (odds ratio, 3.10; 95% confidence interval, 1.53 to 6.29; P=0.002).ConclusionA high level of serum A-FABP is associated with an increased risk of rapid renal function decline in patients with T2DM and preserved renal function. This suggests that A-FABP could play a role in the progression of DKD in the early stages.

Increased Serum Adipocyte Fatty Acid-Binding Protein Levels Are Associated with Decreased Sensitivity to Thyroid Hormones in the Euthyroid Population.

Background: Serum adipocyte fatty acid-binding protein (A-FABP) and thyroid hormones are closely associated with metabolic disorders; however, their relationship remains unknown. We aimed at investigating the associations of serum A-FABP levels with single and composite indices of the thyroid system. Methods: The study included 1057 community-based euthyroid participants (age range: 27-81 years) in Shanghai, among whom 601 were women. Serum free triiodothyronine (fT3), free thyroxine (fT4), and thyrotropin (TSH) were measured by electrochemical luminescence immunoassay. The thyroid feedback quantile-based index (TFQI), thyrotropin index (TSHI), and thyrotroph thyroxine resistance index (TT4RI) were calculated to evaluate central sensitivity to thyroid hormones. Peripheral sensitivity to thyroid hormones was evaluated by the fT3 to fT4 ratio (fT3/fT4). Enzyme-linked immunosorbent assay was used to measure serum A-FABP levels. Results: Serum A-FABP levels were 6.41 [95% confidence interval: 6.10-6.74] ng/mL among all subjects. Multiple cardiovascular metabolic risk factors were adjusted in the multivariate linear regression analysis and the multinomial logistic regression analysis (nonordinal). In both sexes, serum A-FABP levels were positively associated with fT4 (men: standardized β = 0.150, p = 0.001; women: standardized β = 0.218, p < 0.001), TFQI (men: standardized β = 0.119, p = 0.009; women: standardized β = 0.165, p < 0.001), and TSHI (men: standardized β = 0.108, p = 0.017; women: standardized β = 0.114, p = 0.005); while they were negatively associated with fT3/fT4 (men: standardized β = -0.122, p = 0.008; women: standardized β = -0.129, p = 0.001). Serum A-FABP levels were not associated with fT3, TSH, or TT4RI. Compared with the first quartile group of TFQI, for every 10 ng/mL increase in A-FABP, the odds ratio (OR) for the third quartile group of TFQI was 2.213 in women (p = 0.035); the ORs for the fourth quartile group of TFQI were 2.614 in men (p = 0.022) and 3.425 in women (p = 0.002). Conclusions: In a euthyroid population, increased serum A-FABP levels were associated with decreased sensitivity to thyroid hormones, suggesting that A-FABP may mediate the "cross-talk" between adipose tissue and the thyroid system.

Relationship between Serum Adipocyte Fatty Acid-Binding Protein Levels and Systemic Inflammation in Hemodialysis Patients

Relationship between Serum Adipocyte Fatty Acid-Binding Protein Levels and Systemic Inflammation in Hemodialysis Patients

High Serum Adipocyte Fatty Acid-Binding Protein Is Associated With Peripheral Artery Disease in Peritoneal Dialysis Patients

BACKGROUND: Peripheral arterial disease (PAD) is a vascular disorder wherein peripheral ischemia is caused by arterial obstruction and results in increased events of cardiovascular disease (CVD). Peritoneal dialysis (PD) is an independent predictor of subclinical PAD and the subsequent mortality in patients with end-stage renal disease. Adipocyte fatty acid-binding protein (A-FABP) is a potential biomarker for CVD risk, especially in patients with overt atherosclerosis. This study was conducted to determine the relationship between PAD and fasting serum levels of A-FABP in patients undergoing PD. METHODS: Fasting blood samples were obtained from 66 PD patients. A-FABP levels were measured using a commercially available enzyme immunoassay kit. Ankle-brachial index (ABI) values were measured using the automated oscillometric method. Serum left or right ABI values of ＜ 0.9 were included in the low ABI group. RESULTS: There were 14 patients (21.2%) in the low ABI group. Compared with patients in the control group, those in the low ABI group had a higher prevalence of diabetes (P = 0.045) and higher serum C-reactive protein (P ＜ 0.001) and A-FABP (P ＜ 0.001) levels but lower weekly Kt/V (P = 0.014) and lower normalized protein equivalent of nitrogen appearance (P = 0.034) values. Multivariate logistic regression analysis of the factors that were significantly associated with PAD revealed that A-FABP (odds ratio, 1.038; 95% confidence interval [CI], 1.004-1.074; P = 0.030) was an independent predictor of PAD in PD patients. The area under the curve plotted to estimate the optimal level of A-FABP predicting PAD in PD patients by the receiver operating characteristic curve analysis was 0.757 (95% CI, 0.636-0.854; P = 0.0004). CONCLUSION: This study demonstrated that a higher serum A-FABP level is an independent predictor of PAD in patients undergoing PD.

SAT-166 Increased Serum Adipocyte Fatty Acid Binding Protein Concentrations Are Associated with Aortic Stiffness in Diabetic Kidney Disease

Adipocyte fatty acid binding protein (A-FABP) is a novel adipokine that contributes to the development of cardiovascular disease because of pro-inflammatory properties. Our study aims to evaluate the correlation between serum A-FABP and aortic stiffness in diabetic kidney disease (DKD). Fasting blood samples were obtained from 96 type 2 diabetes mellitus patients with DKD. DKD is identified clinically by persistently high urinary albumin-to-creatinine ratio (UACR) ≥ 30 mg/g and/or sustained reduction in estimated glomerular filtration rate (eGFR) below 60 ml/min per 1.73 m2. Carotid-femoral pulse wave velocity (cfPWV) was measured by using pressure applanation tonometry. cfPWV values of > 10 m/s represented the high aortic stiffness group according to the ESH-ESC 2013. Serum A-FABP levels were determined using a commercial enzyme immunoassay. 53 participants (55.2%) fell under the high aortic stiffness group. This group, compared to the control group, showed higher prevalence of male (P = 0.015), older age (P = 0.025), higher systolic blood pressure (P = 0.001), diastolic blood pressure (P = 0.037), urine albumin-to-creatinine ratio (P = 0.007), serum total cholesterol (P = 0.030), low-density lipoprotein cholesterol (P = 0.043), and A-FABP (P < 0.001). After adjusting for factors significantly associated with aortic stiffness using multivariable logistic regression analysis, serum A-FABP [odds ratio = 1.487 (1.210–1.829), P < 0.001] was found to be an independent predictor of aortic stiffness in DKD patients. Multivariable forward stepwise linear regression analysis also showed that serum logarithmically transformed A-FABP level (log-A-FABP, β = 0.587, adjusted R2 change: 0.426, P <0.001) was positively associated with cfPWV values in DKD patients. In this study, serum A-FABP level is found to be positively correlated with cfPWV values and is identified as an independent predictor of aortic stiffness in DKD patients after adjusting for significant confounders.

Clinical Utility of Serum Adipocyte Fatty Acid Binding Protein (A-FABP) in Type 2 Diabetes Mellitus Patients Complicated with Metabolic Syndrome

Abstract Objective The adipocyte fatty acid-binding protein (A-FABP) has been described as a biomarker for adiposity and obesity-related disease. The aim of this study was to assess the association between fasting serum A-FABP level and the development of metabolic syndrome (MetS) among type 2 DM patients. Methods Fasting blood samples were obtained from 60 type 2 diabetic patients for assessment of serum A-FABP level (30 subjects without MetS and 30 subjects with MetS) compared to 30 healthy control subjects recruited from Endocrinology Department, Ain Shams University Hospitals. A-FABP protein was assayed using ELISA technique, MetS component (waist circumference, fasting serum glucose, triglycerides (TG), high density lipoprotein cholesterol (HDL-C) and blood pressure), as well as homeostasis model assessment of insulin resistance (HOMA-IR) and highly sensitive C-reactive protein ( hsCRP) were assayed for all subjects. Results Diabetic persons who had MetS had significantly higher serum A-FABP levels than either without MetS or healthy controls [Median (25-75 percentiles): 10.5(8.25-14.25); 3.4(0.20-6.00) and 1.5(0.78-2.63) respectively ; p &amp;lt; 0.01). However (HOMA-IR) and hsCRP did not show significant difference between diabetic patients with MetS versus diabetic patients without MetS (p &amp;gt; 0.05). Conclusions Our results indicate that serum A-FABP level is an early marker for the development of MetS in type 2 DM patients, thus its assessment could be beneficial in diagnosis of MetS.

Circulating Adipocyte Fatty Acid Binding Protein (A-FABP): Predictor of Metabolic Syndrome in Patients with Type 2DM

AbstractBackground: The circulating portion of adipocyte fatty acid binding protein (A-FABP) acts as a humoral factor potentially controlling inflammatory responses and insulin action in adipocyte. Most individuals with Type 2 diabetes mellitus (2DM) exhibit intra-abdominal obesity, insulin re-sistance and subsequent occurrence of metabolic syndrome (MetS).Aim of Study: This work aimed at evaluating A-FABP as a marker for MetS in type 2DM.Subjects and Methods: The study included (180) subjects divided into group I (120) adult patients with type 2DM diagnosed according to ADA 2016. They were subdivided into subgroup Ia (60 without MetS) and subgroup Ib (60 with MetS). Group II (control group) included (60) age- and sex-matched apparently healthy subjects. Circulating A-FABP was measured by ELISA. In addition, assay of fasting insulin (F.insulin), lipid profile, hsCRP, and calculation of HOMA-IR.Results: Highly significant increase in levels of A-FABP, F.insulin, HOMA-IR and hsCRP was observed in subgroup Ia compared to control group (Z: 5.691,4.902, 5.908, and 0.477; p 0.05). In subgroup Ib, there was a significant positive statistical correlation between A-FABP and weight and BMI (r:0.379 and 0.386, p<0.05; respectively). Stepwise multi-regression analysis indicated that triglycerides and A-FABP are the most sensitive independent predictors of MetS in diabetic patients (F-ratio:64.4 and p<0.001).Conclusion: High serum A-FABP level is strongly asso-ciated with MetS in type 2DM. It is a promising independent marker of MetS and is beneficial in its early diagnosis.