title: Serum fatty acid-binding protein 4 is a predictor of cardiovascular events in end-stage renal disease.
abstract: BACKGROUND
  Fatty acid-binding protein 4 (FABP4/A-FABP/aP2), a lipid chaperone, is expressed in both adipocytes and macrophages. Recent studies have shown that FABP4 is secreted from adipocytes and that FABP4 level is associated with obesity, insulin resistance, and atherosclerosis. However, little is known about the impact of FABP4 concentrations on prognosis. We tested the hypothesis that FABP4 level predicts prognosis of patients with end-stage renal disease (ESRD), a group at high risk for atherosclerosis-associated morbidity and mortality.
  
  
  RESULTS
  Biochemical markers including FABP4 were determined in 61 ESRD patients on chronic hemodialysis (HD). Serum FABP4 level in females (404.2±30.5 ng/ml) was significantly higher than that in males (315.8±30.0 ng/ml), and the levels in ESRD patients were about 20-times higher than those in age-, gender- and body mass index (BMI)-matched control subjects with normal renal function. FABP4 level was decreased by 57.2% after HD and was positively correlated with blood pressure, BMI, and levels of lipids and insulin. Multiple regression analysis indicated that HD duration, BMI, and triglycerides level were independent determinants for FABP4 level. ESRD patients with high FABP4 levels had higher cardiovascular mortality during the 7-year follow-up period. Cox proportional hazard regression analysis showed that logarithmically transformed FABP4 level was an independent predictor of cardiovascular death adjusted for age, gender, HD duration, BMI, and triglycerides level (hazard ratio, 7.75; 95% CI, 1.05-25.31).
  
  
  CONCLUSIONS
  These findings suggest that FABP4 level, being related to adiposity and metabolic disorders, is a novel predictor of cardiovascular mortality in ESRD.
authors.affiliation: Second Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan. furuhasi@sapmed.ac.jp
authors.forename: Masato
authors.initials: M
authors.lastname: Furuhashi
authors.forename: Shutaro
authors.initials: S
authors.lastname: Ishimura
authors.forename: Hideki
authors.initials: H
authors.lastname: Ota
authors.forename: Manabu
authors.initials: M
authors.lastname: Hayashi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nishitani
authors.forename: Marenao
authors.initials: M
authors.lastname: Tanaka
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yoshida
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Shimamoto
authors.forename: Gökhan S
authors.initials: GS
authors.lastname: Hotamisligil
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Miura
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D016022:Case-Control Studies; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis; D015996:Survival Rate
chemical_list: D015415:Biomarkers; C493410:FABP4 protein, human; D050556:Fatty Acid-Binding Proteins
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