Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Department of Cardiovascular Medicine, Shimokamagari Public Hospital, Hiroshima, Japan.
Am J Hypertens. 2020 Jul 18;33(7):604-609. doi: 10.1093/ajh/hpaa035.
Urinary liver-type fatty acid-binding protein (L-FABP) has been known as a potential biomarker for acute kidney injury. It has also been suggested to have an effective predictive value for cardiovascular mortality in patients with diabetes or critically ill condition. Therefore, this study aimed to examine the ability of urinary L-FABP in predicting mid-term cardiovascular morbidity and mortality in patients with hypertension.
Urinary L-FABP levels in stable outpatients without diabetes who were treated with antihypertensive drugs were measured, and a 5-year follow-up was planned. The primary end-point was a combination of acute heart failure requiring hospitalization, myocardial infarction, stroke, and cardiovascular death. The secondary end-point was kidney disease progression defined as a relative decline in the estimated glomerular filtration rate of ≥30% from the baseline.
A total of 197 patients were recruited. Primary and secondary end-points occurred in 24 (12.2%) and 42 (21.3%) patients, respectively, during a median follow-up of 5.7 years. Patients with urinary L-FABP levels higher than the upper limit (8.4 µg/g creatinine) were more likely to reach the primary (30.43% vs. 9.77%; P = 0.003) and secondary end-points (56.52% vs. 16.67%; P < 0.001) than those with urinary L-FABP levels within the normal limits. Urinary L-FABP level was independently associated with both primary (hazard ratio (HR) 1.21; P = 0.03) and secondary end-points (HR 1.19; P = 0.02).
This study demonstrated that increased urinary L-FABP levels may predict adverse cardiovascular events and renal dysfunction progression even among stable nondiabetic patients with hypertension.
尿肝型脂肪酸结合蛋白（L-FABP）已被认为是急性肾损伤的潜在生物标志物。它还被认为对糖尿病或危重病患者的心血管死亡率具有有效的预测价值。因此，本研究旨在探讨尿 L-FABP 在预测高血压患者中期心血管发病率和死亡率方面的能力。
测量接受降压药物治疗的稳定门诊非糖尿病患者的尿 L-FABP 水平，并计划进行 5 年随访。主要终点是急性心力衰竭需要住院、心肌梗死、中风和心血管死亡的组合。次要终点是定义为从基线估算肾小球滤过率下降≥30%的肾脏疾病进展。
共招募了 197 名患者。在中位数为 5.7 年的随访中，主要终点和次要终点分别在 24 名（12.2%）和 42 名（21.3%）患者中发生。尿 L-FABP 水平高于上限（8.4 µg/g 肌酐）的患者更有可能达到主要终点（30.43%比 9.77%；P = 0.003）和次要终点（56.52%比 16.67%；P < 0.001）。尿 L-FABP 水平与主要终点（危险比（HR）1.21；P = 0.03）和次要终点（HR 1.19；P = 0.02）均独立相关。
本研究表明，即使在稳定的非糖尿病高血压患者中，尿 L-FABP 水平升高也可能预测不良心血管事件和肾功能障碍进展。
