title: Level of urinary liver-type fatty acid-binding protein is associated with cardiac markers and electrocardiographic abnormalities in type-2 diabetes with chronic kidney disease stage G1 and G2.
abstract: Urinary liver-type fatty acid-binding protein (L-FABP) reflects the degree of stress in proximal tubules of the kidney. We examined the level of L-FABP in type-2 diabetes mellitus (T2DM) patients with chronic kidney disease (CKD) stage G1 and G2, and its relationship with cardiac markers and electrocardiographic (ECG) abnormalities. T2DM patients whose estimated glomerular filtration rate (eGFR) was ≥60 mL/min/1.73 m(2) were recruited [n = 276 (165 males), mean age 64 years]. The median level of urinary L-FABP was 6.6 μg/gCr. Urinary L-FABP showed significant correlation with urinary albumin-to-creatinine ratio (ACR) (r = 0.51, p < 0.0001). Median (25th-75th percentile) eGFR was 82 (72-95) mL/min/1.73 m2. We divided patients into four subgroups (group 1, L-FABP ≤8.4 μg/gCr and ACR ≤30 mg/gCr; group 2, L-FABP ≤8.4 μg/gCr and ACR >30 mg/gCr; group 3, L-FABP >8.4 μg/gCr and ACR ≤30 mg/gCr; group 4, L-FABP >8.4 μg/gCr and ACR >30 mg/gCr). Compared with group 1, group 4 was significantly higher in systolic blood pressure, and eGFR using standardized serum cystatin C, high-sensitivity troponin T, and N-terminal pro-brain natriuretic peptide (NT-proBNP). Group 4 had significantly higher level of NT-proBNP than group 3. Groups 2, 3 and 4 showed more ECG abnormalities than group 1. These findings suggest that simultaneous measurement of urinary L-FABP and ACR should be useful to assess cardiovascular damage reflecting on the elevation of cardiac markers and ECG abnormalities in T2DM with CKD G1 and G2.
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
authors.forename: Yoshiteru
authors.initials: Y
authors.lastname: Maeda
authors.forename: Atsushi
authors.initials: A
authors.lastname: Suzuki
authors.forename: Junnichi
authors.initials: J
authors.lastname: Ishii
authors.forename: Sahoko
authors.initials: S
authors.lastname: Sekiguchi-Ueda
authors.forename: Megumi
authors.initials: M
authors.lastname: Shibata
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Yoshino
authors.forename: Shogo
authors.initials: S
authors.lastname: Asano
authors.forename: Nobuki
authors.initials: N
authors.lastname: Hayakawa
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nakamura
authors.forename: Yasukazu
authors.initials: Y
authors.lastname: Akiyama
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Kitagawa
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Sakuishi
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujita
authors.forename: Shuji
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Yukio
authors.initials: Y
authors.lastname: Ozaki
authors.forename: Mitsuyasu
authors.initials: M
authors.lastname: Itoh
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000175:diagnosis / Q000209:etiology / Q000652:urine; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000652:urine*; D015415:Biomarkers / Q000097:blood / Q000652:urine; D003404:Creatinine / Q000652:urine; D055316:Cystatin C / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis / Q000652:urine; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000209:etiology / Q000652:urine*; D004562:Electrocardiography; D050556:Fatty Acid-Binding Proteins / Q000652:urine*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011237:Predictive Value of Tests; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000652:urine*; D012307:Risk Factors; D020107:Troponin T / Q000097:blood
chemical_list: D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; C493319:FABP1 protein, human; D050556:Fatty Acid-Binding Proteins; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D003404:Creatinine