Clinical significance of urinary liver-type fatty acid-binding protein in diabetic nephropathy of type 2 diabetic patients.
Clinical significance of urinary liver-type fatty acid-binding protein in diabetic nephropathy of type 2 diabetic patients.
复制标题
DOI：
10.2337/dc10-1392
复制
发表时间：
2011-03
期刊：
影响因子：
16.2
通讯作者：
Kimura K
中科院分区：
文献类型：
--
作者：
Kamijo-Ikemori A;Sugaya T;Yasuda T;Kawata T;Ota A;Tatsunami S;Kaise R;Ishimitsu T;Tanaka Y;Kimura K
尿肝型脂肪酸结合蛋白（L-FABP）是一个有前途的指标，但不是肾小球肾小管损伤。本研究的目的是评估尿L-FABP作为2型糖尿病肾病损害的预后生物标志物的临床实用性。本研究包括对尿L-FABP水平与进展性肾病之间关系的横向和纵向分析。采用酶联免疫吸附法测定尿L-FABP。在横断面分析中，研究了140例2型糖尿病患者和412例健康对照者尿L-FABP与糖尿病肾病严重程度的关系。在前一项研究中，104例患者已随访4年。糖尿病肾病进展定义为进行性蛋白尿、终末期肾病或诱导血液透析。尿L-FABP水平在正常、微量或大量白蛋白尿受试者中逐渐升高，在终末期肾病患者中进一步升高。在纵向分析中，高尿L-FABP水平与白蛋白尿增加、进展为终末期肾病或诱导血液透析相关。这在无肾功能不全的患者亚组（n = 59）中尤其明显，其中高尿L-FABP水平与糖尿病肾病进展相关。尿L-FABP能准确反映2型糖尿病肾病的严重程度，且在尿白蛋白正常的患者中水平较高。此外，高尿L-FABP是糖尿病肾病进展的危险因素。
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. 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. 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. 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.