title: Plasma fatty acid-binding protein 4, nonesterified fatty acids, and incident diabetes in older adults.
abstract: OBJECTIVE
  To examine the relation of fatty acid-binding protein (FABP)4 and nonesterified fatty acids (NEFAs) to diabetes in older adults.
  
  
  METHODS
  We ascertained incident diabetes among 3,740 Cardiovascular Health Study participants (1992-2007) based on the use of hypoglycemic medications, fasting glucose ≥ 126 mg/dL, or nonfasting glucose ≥ 200 mg/dL. FABP4 and NEFA were measured on specimens collected between 1992 and 1993.
  
  
  RESULTS
  Mean age of the 3,740 subjects studied was 74.8 years. For each SD increase in log FABP4, hazard ratios (HRs) for diabetes were 1.35 (95% CI 1.10-1.65) for women and 1.45 (1.13-1.85) for men controlling for age, race, education, physical activity, cystatin C, alcohol intake, smoking, self-reported health status, and estrogen use for women (P for sex-FABP4 interaction 0.10). BMI modified the FABP4-diabetes relation (P = 0.009 overall; 0.02 for women and 0.135 for men), in that statistically significant higher risk of diabetes was mainly seen in men with BMI <25 kg/m(2) (HR per SD: 1.78 [95% CI 1.13-2.81]). There was a modest and nonsignificant association of NEFA with diabetes (P(trend) = 0.21). However, when restricted to the first 5 years of follow-up, multivariable-adjusted HRs for diabetes were 1.0 (ref.), 1.68 (95% CI 1.12-2.53), and 1.63 (1.07-2.50) across consecutive tertiles of NEFA (P(trend) = 0.03).
  
  
  CONCLUSIONS
  Plasma FABP4 was positively associated with incident diabetes in older adults, and such association was statistically significant in lean men only. A significant positive association between plasma NEFA and incident diabetes was observed during the first 5 years of follow-up.
authors.affiliation: Division of Aging, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA. ldjousse@rics.bwh.harvard.edu
authors.forename: Luc
authors.initials: L
authors.lastname: Djoussé
authors.forename: Owais
authors.initials: O
authors.lastname: Khawaja
authors.forename: Traci M
authors.initials: TM
authors.lastname: Bartz
authors.forename: Mary L
authors.initials: ML
authors.lastname: Biggs
authors.forename: Joachim H
authors.initials: JH
authors.lastname: Ix
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Zieman
authors.forename: Jorge R
authors.initials: JR
authors.lastname: Kizer
authors.forename: Russell P
authors.initials: RP
authors.lastname: Tracy
authors.forename: David S
authors.initials: DS
authors.lastname: Siscovick
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Mukamal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000097:blood* / Q000453:epidemiology*; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005230:Fatty Acids, Nonesterified / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; C493410:FABP4 protein, human; D050556:Fatty Acid-Binding Proteins; D005230:Fatty Acids, Nonesterified