title: Current Metabolic Status Affects Urinary Liver-Type Fatty-Acid Binding Protein in Normoalbuminuric Patients With Type 2 Diabetes.
abstract: BACKGROUND
  We aimed to study the association between urinary liver-type fatty acid-binding protein (L-FABP), a biomarker of tubulointerstitial injury, and the clinical characteristics of normoalbuminuric and albuminuric patients with type 2 diabetes in order to detect the factors affecting urinary L-FABP.
  
  
  METHODS
  Urinary L-FABP levels were measured in 788 patients with type 2 diabetes and again in 666 patients at 6 months after the initial measurement. The association between the urinary L-FABP level and the clinical parameters was investigated in a retrospective cross-sectional study and a subsequent observation.
  
  
  RESULTS
  The HbA1c (odds ratio (OR): 1.42; 95% confidence interval (CI): 1.11 - 1.79; P < 0.01), systolic blood pressure (OR: 1.03; 95% CI: 1.01 - 1.05; P < 0.01) levels and estimated glomerular filtration rate (OR: 0.98; 95% CI: 0.96 - 1.00; P = 0.01) were significantly associated with the high levels of urinary L-FABP (> 8.4 μg/gCr) in normoalbuminuric patients. However, a logistic regression analysis revealed that use of renin-angiotensin system (RAS) inhibitors (OR: 2.22; 95% CI: 1.16 - 4.89; P = 0.02), urinary albumin-to-creatinine ratio (ACR) (OR: 1.01; 95% CI: 1.00 - 1.01; P < 0.01) and serum HDL-cholesterol concentration (OR: 0.33; 95% CI: 0.11 - 0.89; P = 0.03) were significantly associated in albuminuric patients. In the follow-up observation, the change in urinary L-FABP was found to be significantly (P < 0.01) influenced by the change in the HbA1c level in both the normoalbuminuric and albuminuric patients.
  
  
  CONCLUSIONS
  High urinary L-FABP is associated with part of the current metabolic abnormalities, including high levels of HbA1c and systolic blood pressure among normoalbuminuric patients with type 2 diabetes.
authors.affiliation: Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ito
authors.affiliation: Laboratory Department, Edogawa Hospital, Tokyo, Japan.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Yamashita
authors.affiliation: Laboratory Department, Edogawa Hospital, Tokyo, Japan.
authors.forename: Mina
authors.initials: M
authors.lastname: Nakashima
authors.affiliation: Laboratory Department, Edogawa Hospital, Tokyo, Japan.
authors.forename: Akifusa
authors.initials: A
authors.lastname: Takaki
authors.affiliation: Laboratory Department, Edogawa Hospital, Tokyo, Japan.
authors.forename: Chiduko
authors.initials: C
authors.lastname: Yukawa
authors.affiliation: Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
authors.forename: Suzuko
authors.initials: S
authors.lastname: Matsumoto
authors.affiliation: Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Omoto
authors.affiliation: Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shinozaki
authors.affiliation: Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Nishio
authors.affiliation: Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Abe
authors.affiliation: Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Antoku
authors.affiliation: Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
authors.forename: Mizuo
authors.initials: M
authors.lastname: Mifune
authors.affiliation: Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
authors.forename: Michiko
authors.initials: M
authors.lastname: Togane
keywords: Biomarker; Diabetic nephropathy; Tubulointerstitial injury; Urinary liver-type fatty-acid binding protein