Ito Hiroyuki, Yamashita Hitomi, Nakashima Mina, Takaki Akifusa, Yukawa Chiduko, Matsumoto Suzuko, Omoto Takashi, Shinozaki Masahiro, Nishio Shinya, Abe Mariko, Antoku Shinichi, Mifune Mizuo, Togane Michiko
Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
Laboratory Department, Edogawa Hospital, Tokyo, Japan.
J Clin Med Res. 2017 Apr;9(4):366-373. doi: 10.14740/jocmr2934w. Epub 2017 Feb 21.
We aimed to study the association between urinary liver-type fatty acid-binding protein (L-FABP), a biomarker of tubulointerstitial injury, and the clinical characteristics of normoalbuminuric and albuminuric patients with type 2 diabetes in order to detect the factors affecting urinary L-FABP.
Urinary L-FABP levels were measured in 788 patients with type 2 diabetes and again in 666 patients at 6 months after the initial measurement. The association between the urinary L-FABP level and the clinical parameters was investigated in a retrospective cross-sectional study and a subsequent observation.
The HbA1c (odds ratio (OR): 1.42; 95% confidence interval (CI): 1.11 - 1.79; P < 0.01), systolic blood pressure (OR: 1.03; 95% CI: 1.01 - 1.05; P < 0.01) levels and estimated glomerular filtration rate (OR: 0.98; 95% CI: 0.96 - 1.00; P = 0.01) were significantly associated with the high levels of urinary L-FABP (> 8.4 μg/gCr) in normoalbuminuric patients. However, a logistic regression analysis revealed that use of renin-angiotensin system (RAS) inhibitors (OR: 2.22; 95% CI: 1.16 - 4.89; P = 0.02), urinary albumin-to-creatinine ratio (ACR) (OR: 1.01; 95% CI: 1.00 - 1.01; P < 0.01) and serum HDL-cholesterol concentration (OR: 0.33; 95% CI: 0.11 - 0.89; P = 0.03) were significantly associated in albuminuric patients. In the follow-up observation, the change in urinary L-FABP was found to be significantly (P < 0.01) influenced by the change in the HbA1c level in both the normoalbuminuric and albuminuric patients.
High urinary L-FABP is associated with part of the current metabolic abnormalities, including high levels of HbA1c and systolic blood pressure among normoalbuminuric patients with type 2 diabetes.
我们旨在研究肾小管间质损伤的生物标志物——尿肝型脂肪酸结合蛋白（L-FABP）与2型糖尿病正常白蛋白尿和白蛋白尿患者临床特征之间的关联，以检测影响尿L-FABP的因素。
对788例2型糖尿病患者测定尿L-FABP水平，并在初次测量6个月后对666例患者再次测量。在一项回顾性横断面研究及后续观察中，研究尿L-FABP水平与临床参数之间的关联。
在正常白蛋白尿患者中，糖化血红蛋白（HbA1c）（比值比（OR）：1.42；95%置信区间（CI）：1.11 - 1.79；P < 0.01）、收缩压（OR：1.03；95% CI：1.01 - 1.05；P < 0.01）水平及估计肾小球滤过率（OR：0.98；95% CI：0.96 - 1.00；P = 0.01）与高尿L-FABP水平（> 8.4 μg/gCr）显著相关。然而，逻辑回归分析显示，在白蛋白尿患者中，肾素-血管紧张素系统（RAS）抑制剂的使用（OR：2.22；95% CI：1.16 - 4.89；P = 0.02）、尿白蛋白与肌酐比值（ACR）（OR：1.01；95% CI：1.00 - 1.01；P < 0.01）及血清高密度脂蛋白胆固醇浓度（OR：0.33；95% CI：0.11 - 0.89；P = 0.03）显著相关。在随访观察中，发现正常白蛋白尿和白蛋白尿患者的尿L-FABP变化均受HbA1c水平变化的显著影响（P < 0.01）。
高尿L-FABP与当前部分代谢异常相关，包括2型糖尿病正常白蛋白尿患者中的高HbA1c水平和收缩压。
