title: Clinical significance of urinary liver-type fatty acid-binding protein in diabetic nephropathy of type 2 diabetic patients.
abstract: OBJECTIVE
  Urinary liver-type fatty acid-binding protein (L-FABP) is a promising indicator of tubular but not glomerular damage. The aim of this study was to evaluate the clinical usefulness of urinary L-FABP as a prognostic biomarker in impaired diabetic nephropathy in type 2 diabetes.
  
  
  METHODS
  This investigation involved a cross-sectional and longitudinal analysis of the relationship between urinary L-FABP levels and progressive nephropathy. Urinary L-FABP was measured with enzyme-linked immunosorbent assay. In the cross-sectional analysis, the association of urinary L-FABP, with the severity of diabetic nephropathy, was investigated in 140 patients with type 2 diabetes and in 412 healthy control subjects. Of the patients in the former study, 104 have been followed for 4 years. The progression of diabetic nephropathy was defined as progressive albuminuria, end-stage renal disease, or induction of hemodialysis.
  
  
  RESULTS
  Urinary L-FABP levels were progressively increased in subjects with normo-, micro-, or macroalbuminuria and further increased in patients with end-stage renal disease. In the longitudinal analysis, high urinary L-FABP levels were associated with the increase in albuminuria, progression to end-stage renal disease, or induction of hemodialysis. This was particularly demonstrated in the subgroup of patients without renal dysfunction (n = 59), where high urinary L-FABP levels were associated with the progression of diabetic nephropathy.
  
  
  CONCLUSIONS
  Urinary L-FABP accurately reflected the severity of diabetic nephropathy in type 2 diabetes, and its level was high in the patients with normoalbuminuria. Moreover, higher urinary L-FABP was a risk factor for progression of diabetic nephropathy.
authors.affiliation: Department of Nephrology and Hypertension, Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Kamijo-Ikemori
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sugaya
authors.forename: Takashi
authors.initials: T
authors.lastname: Yasuda
authors.forename: Takehiro
authors.initials: T
authors.lastname: Kawata
authors.forename: Akio
authors.initials: A
authors.lastname: Ota
authors.forename: Shinobu
authors.initials: S
authors.lastname: Tatsunami
authors.forename: Ruriko
authors.initials: R
authors.lastname: Kaise
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ishimitsu
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kimura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000652:urine*; D003928:Diabetic Nephropathies / Q000652:urine*; D004797:Enzyme-Linked Immunosorbent Assay; D050556:Fatty Acid-Binding Proteins / Q000652:urine*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies
chemical_list: D050556:Fatty Acid-Binding Proteins