Urinary Liver-Type Fatty Acid-Binding Protein and Progression of Diabetic Nephropathy in Type 1 Diabetes

The aim of this work was to study the levels of the heart fatty acid-binding protein (h-FABP), interleukin6 (IL-6) and interleukin-8 (IL-8), in diabetic nephropathy (DN) in patients with type 1 diabetes mellitus (T1DM). Material and methods. We examined 87 patients aged 18 to 54 with T1DM within the study group. 30 patients with type 1 diabetes were diagnosed with normoalbuminuria, 29 patients – with microalbuminuria and 28 patients – with proteinuria. The control group consisted of 24 healthy donor aged 22 to 29. The comparison group included 22 patients aged 20 to 42 with verified diagnosis of essential arterial hypertension (AH) without carbohydrate metabolism disorders. The daily urinary albumin excretion was determined by immunoturbidimetric technique. 30 patients with type 1 diabetes were diagnosed with normoalbuminuria, 29 patients – with microalbuminuria and 28 patients with proteinuria.Calculation of glomerular filtration rate was performed according to the Hoek formula with the use of cystatinС serum concentrations. Contents of h-FABP, IL-6 and cystatin C in serum and h-FABP, IL-8 inurine were determined by enzyme-linked immunosorbent assay. Results. Analysis of the h-FABP content in serum showed that the concentration of this marker in individuals with T1DM was higher than in patients of the control group and the comparison group. Analysis of the h-FABP content in the urine revealed that individuals with essential hypertension showed an increased level of h-FABP while patients with T1DM demonstrated the highest concentration of h-FABP. The concentration of IL-6 inindividuals with T1DM and in individuals with AH significantly exceeded the control values. The contents of h-FABP and IL-6 inserum and h-FABP and IL-8 inurine increased with the progression of DN and reached maximum in individuals of the proteinuria subgroup. At the same time, the levels of h-FABP and IL-8 inthe urine of patients in the microalbuminuria (MAU) subgroup were higher compared to those in individuals of the normoalbuminuria (NAU) subgroup. Noteworthy is the fact that the h-FABP content in the urine of individuals in NAU subgroup was higher compared to the control group. Furthermore, higher rates of h-FABP and IL-8 urinary excretions were observed in individuals with CKD stage 2 as compared to individuals with CKD stage1 inthe MAU subgroup. Conclusion. Thus, the results obtained in the course of the study indicate that h-FABP and IL-8 can be considered as alternative markers of DN progression in patients with T1DM.

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Urinary liver-type fatty acid-binding protein as a Marker for Early Diagnosis of Diabetic Nephropathy in Type 1 Diabetic Children.

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v11i5.23518 ◽

2018 ◽

Vol 11 (5) ◽

pp. 329

Author(s):

Mones M Abushady ◽

Gihan A Fathy ◽

Inas R El-alameey ◽

Abbas Ma ◽

Essam M Galal ◽

...

Keyword(s):

Diabetic Nephropathy ◽

Fatty Acid ◽

Early Diagnosis ◽

Fatty Acid Binding Protein ◽

Binding Protein ◽

Linear Regression Analysis ◽

Fatty Acid Binding ◽

Acid Binding Protein ◽

The Mean

Objectives: Renal failure and premature mortality are fatal prognosis of diabetic nephropathy. To improve patient outcome, early diagnosis of diabetic nephropathy is necessary. The study was designed to evaluate urinary liver-type fatty acid binding protein (L-FABP), as an early biomarker of tubulointerstitial injury, and its association with the clinical characteristics of type 1 diabetic children.Methods: Fifty randomly selected patients with type 1 diabetes mellitus (DM) attending the diabetes outpatient clinic of Ain Shams University Children’s Hospital were included in the study. 50 age and sex-matched healthy subjects were enrolled as controls. Urinary L-FABP, 24 h urine albumin, hemoglobin A1c (HbA1c), serum creatinine, and lipid profile were measured.Results: Diabetic subjects had higher mean urinary L-FABP than controls (p<0.05). In microalbuminuric diabetic subjects, the mean urinary L-FABP was detected to be significantly higher than that in normoalbuminuric diabetic subjects, and significantly higher values of the mean urinary L-FABP were detected in the microalbuminuric and the normoalbuminuric subjects than the controls (p<0.05). Multiple linear regression analysis showed that duration of DM and HbA1c was the main predictors of urinary L-FABP in diabetic subjects.Conclusion: In patients with childhood-onset T1D, urinary L-FABP may be used as an indicator of renal injury in early stages of nephropathy, even in the normoalbuminuric state.

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