Department of Nephrology, Peking University Third Hospital, Beijing, China.
Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.
Ren Fail. 2023;45(2):2262624. doi: 10.1080/0886022X.2023.2262624. Epub 2023 Oct 2.
To explore the prospective role of serum fatty acid-binding protein 4 (FABP4) in the outcomes of peritoneal dialysis (PD) patients.
A prospective observational study was conducted with 159 patients on PD. Demographic and clinical data at baseline were collected from medical records. Biochemical data were recorded based on blood samples measured in a central laboratory. Serum FABP4 concentrations were determined using enzyme-linked immunosorbent assay. Body composition was measured using a Body Composition Monitor. Abdominal lateral plain radiography was used to evaluate vascular calcification. The primary endpoints were all-cause and cardiovascular death.
The median of serum FABP4 concentration was 154.6 ng/mL (interquartile range, 132.8-269.7 ng/mL). Increased serum FABP4 was associated with increased vascular calcification proportion, time on dialysis, body mass index, high-sensitivity C-reactive protein (hs-CRP), intact parathyroid hormone (iPTH), triglycerides, body fat mass, and body fat percentage ( < 0.05). Increased serum FABP4 was associated with decreased residual kidney Kt/V urea ( < 0.05). Patients with hs-CRP≥ 3 mg/L had significantly higher serum FABP4 than those with hs-CRP< 3 mg/L ( < 0.05). Patients with vascular calcification had significantly higher serum FABP4 than those without vascular calcification ( < 0.05). During a median follow-up of 58.0 months, 58 all-cause deaths and 26 cardiovascular deaths occurred. High serum FABP4 levels were independently predictive for all-cause [hazard ratio (HR), 1.003; 95% confidence interval (CI), 1.001-1.005; = 0.016] and cardiovascular death (HR, 1.005; 95% CI, 1.001-1.008; = 0.006) in PD patients.
Increased serum FABP4 levels can independently predict all-cause and cardiovascular death in patients on PD.
探讨血清脂肪酸结合蛋白 4（FABP4）在腹膜透析（PD）患者预后中的前瞻性作用。
本前瞻性观察性研究纳入了 159 例 PD 患者。从病历中收集基线时的人口统计学和临床数据。根据中心实验室测量的血液样本记录生化数据。使用酶联免疫吸附试验测定血清 FABP4 浓度。使用身体成分监测仪测量身体成分。腹部侧位平片用于评估血管钙化。主要终点为全因和心血管死亡。
血清 FABP4 浓度中位数为 154.6ng/mL（四分位距，132.8-269.7ng/mL）。血清 FABP4 升高与血管钙化比例增加、透析时间、体重指数、高敏 C 反应蛋白（hs-CRP）、完整甲状旁腺激素（iPTH）、甘油三酯、体脂肪量和体脂肪百分比增加相关（ < 0.05）。血清 FABP4 升高与残余肾 Kt/V 尿素降低相关（ < 0.05）。hs-CRP≥3mg/L 的患者血清 FABP4 显著高于 hs-CRP<3mg/L 的患者（ < 0.05）。有血管钙化的患者血清 FABP4 显著高于无血管钙化的患者（ < 0.05）。在中位随访 58.0 个月期间，发生了 58 例全因死亡和 26 例心血管死亡。高血清 FABP4 水平与全因死亡（风险比[HR]，1.003；95%置信区间[CI]，1.001-1.005； = 0.016）和心血管死亡（HR，1.005；95%CI，1.001-1.008； = 0.006）独立相关。
血清 FABP4 水平升高可独立预测 PD 患者的全因和心血管死亡。
