Zamzam Abdelrahman, Syed Muzammil H, Greco Elisa, Wheatcroft Mark, Jain Shubha, Khan Hamzah, Singh Krishna K, Forbes Thomas L, Rotstein Ori, Abdin Rawand, Qadura Mohammad
Division of Vascular Surgery, St. Michael's Hospital, Toronto, ON M5B 1W8, Canada.
Department of Surgery, University of Toronto, Toronto, ON M5S 1A1, Canada.
J Clin Med. 2020 Sep 2;9(9):2843. doi: 10.3390/jcm9092843.
Diabetic patients with peripheral arterial disease (PAD) often suffer from poor clinical outcomes such as limb-loss. Fatty acid binding protein 4 (FABP4) is mainly expressed by adipocytes and is known to play a significant role in the development of atherosclerosis. In this study, we sought to investigate whether FABP4 is associated with PAD in patients with type 2 diabetes mellitus (DM). FABP4 plasma levels were studied in 119 diabetic patients with PAD (DM-PAD) and 49 diabetic patients without PAD (DM-noPAD) presenting to St. Michael's Hospital between October 2017 and September 2018. Levels of FABP4 in DM-PAD patients (23.34 ± 15.27 ng/mL) were found to be over two-fold higher than the levels in DM-noPAD patients (10.3 ± 7.59 ng/mL). Regression analysis demonstrated a significant association between FABP4 levels and DM-PAD after adjusting for age, sex, prior history of coronary arterial disease and white blood cells count (OR, 2.77; 95% CI, 1.81-4.31; -value = 0.001). Relative to DM-noPAD controls, plasma FABP4 levels in DM-PAD patients were noted to be inversely correlated with the ankle brachial index (ABI; r= -0.374, -value < 0.001). The diagnostic ability of FABP4 was investigated using receiver operator curves (ROC) and area under the curve (AUC) analysis. FABP4 had an AUC of 0.79, which improved to 0.86 after adjusting for age, sex and prior history of coronary arterial disease. This raises a possibility of utilizing FABP4 as a biomarker for diagnosing PAD in diabetic patients.
患有外周动脉疾病（PAD）的糖尿病患者常常面临诸如肢体丧失等不良临床结局。脂肪酸结合蛋白4（FABP4）主要由脂肪细胞表达，已知在动脉粥样硬化的发展中起重要作用。在本研究中，我们试图调查FABP4是否与2型糖尿病（DM）患者的PAD相关。对2017年10月至2018年9月期间在圣迈克尔医院就诊的119例患有PAD的糖尿病患者（DM-PAD）和49例无PAD的糖尿病患者（DM-noPAD）的FABP4血浆水平进行了研究。发现DM-PAD患者的FABP4水平（23.34±15.27 ng/mL）比DM-noPAD患者的水平（10.3±7.59 ng/mL）高出两倍多。回归分析表明，在调整年龄、性别、冠状动脉疾病既往史和白细胞计数后，FABP4水平与DM-PAD之间存在显著关联（OR，2.77；95%CI，1.81-4.31；P值=0.001）。相对于DM-noPAD对照组，DM-PAD患者的血浆FABP4水平与踝臂指数（ABI）呈负相关（r = -0.374，P值<0.001）。使用受试者工作特征曲线（ROC）和曲线下面积（AUC）分析研究了FABP4的诊断能力。FABP4的AUC为0.79，在调整年龄、性别和冠状动脉疾病既往史后提高到0.86。这增加了将FABP4用作诊断糖尿病患者PAD的生物标志物的可能性。
