Department of Endocrinology and Metabolism, Eskisehir State Hospital, Eskisehir.
Department of Medical Biology, Baskent University, Ankara.
Clin Interv Aging. 2017 Dec 5;12:2063-2068. doi: 10.2147/CIA.S137247. eCollection 2017.
Cardiovascular disease (CVD) is reported to be higher in elderly diabetics. Serum heart-type fatty acid binding protein (H-FABP) is a serum marker of myocardial ischemia. We aimed to investigate the association between serum H-FABP level and conventional cardiovascular risk factors, inflammatory markers and subclinical atherosclerosis in elderly diabetics without overt CVD.
A total of 50 elderly diabetic patients without overt CVD and 30 age-, sex- and body mass index (BMI)-matched healthy controls were enrolled. Anthropometric and biochemical parameters, serum H-FABP, high-sensitivity C-reactive protein (hs-CRP), fibrinogen and carotid intima-media thickness (CIMT) were measured. Logistic regression analyses (adjustments for age, sex, hypertension, smoking, diabetes, BMI, blood pressure, lipid, blood glucose, hemoglobin A1c, hs-CRP and fibrinogen) were performed to evaluate the association between H-FABP and cardiovascular risk factors and atherosclerosis indices.
Serum fibrinogen (421.50±85.52 mg/dL vs 319.17±30.77 mg/dL, =0.023), CIMT (0.70±0.12 mm vs 0.59±0.06 mm, <0.001) and hs-CRP (5.72±4.50 mg/dL vs 1.60±0.72 mg/dL, <0.001) were significantly higher in diabetic patients than controls. The mean serum H-FABP level did not differ between groups (1571.79±604.60 ng/mL vs 1500.25±463.35 ng/mL, =0.905). H-FABP was positively correlated with fibrinogen (=0.473, <0.001), hs-CRP (=0.323, =0.003) and CIMT (=0.467, <0.001). After full adjustments, the serum H-FABP level was independently associated with an increase in the fibrinogen level (odds ratio [OR] =4.21, 95% confidence level [CI] =1.49-11.90).
Serum H-FABP was similar in the elderly diabetic patients without known CVD when compared with the nondiabetic control group. H-FABP does not possess a high diagnostic value as a cardiovascular marker when used alone; however, it may add supplementary information in patients with a high fibrinogen level.
心血管疾病（CVD）在老年糖尿病患者中更为常见。血清心脏型脂肪酸结合蛋白（H-FABP）是心肌缺血的血清标志物。我们旨在研究血清 H-FABP 水平与老年糖尿病患者中无明显 CVD 的常规心血管危险因素、炎症标志物和亚临床动脉粥样硬化之间的关系。
共纳入 50 例无明显 CVD 的老年糖尿病患者和 30 名年龄、性别和体重指数（BMI）匹配的健康对照者。测量人体测量和生化参数、血清 H-FABP、高敏 C 反应蛋白（hs-CRP）、纤维蛋白原和颈动脉内膜中层厚度（CIMT）。进行逻辑回归分析（调整年龄、性别、高血压、吸烟、糖尿病、BMI、血压、血脂、血糖、糖化血红蛋白、hs-CRP 和纤维蛋白原），以评估 H-FABP 与心血管危险因素和动脉粥样硬化指数之间的关系。
与对照组相比，糖尿病患者的血清纤维蛋白原（421.50±85.52 mg/dL 比 319.17±30.77 mg/dL，=0.023）、CIMT（0.70±0.12 mm 比 0.59±0.06 mm，<0.001）和 hs-CRP（5.72±4.50 mg/dL 比 1.60±0.72 mg/dL，<0.001）明显更高。两组间平均血清 H-FABP 水平无差异（1571.79±604.60 ng/mL 比 1500.25±463.35 ng/mL，=0.905）。H-FABP 与纤维蛋白原（=0.473，<0.001）、hs-CRP（=0.323，=0.003）和 CIMT（=0.467，<0.001）呈正相关。经充分调整后，血清 H-FABP 水平与纤维蛋白原水平升高独立相关（比值比[OR]=4.21，95%置信区间[CI]=1.49-11.90）。
与非糖尿病对照组相比，无明显 CVD 的老年糖尿病患者的血清 H-FABP 水平相似。H-FABP 作为心血管标志物单独使用时没有很高的诊断价值；然而，在纤维蛋白原水平较高的患者中，它可能提供补充信息。
