Urinary fatty acid-binding protein as a new clinical marker of the progression of chronic renal disease
Urinary fatty acid-binding protein as a new clinical marker of the progression of chronic renal disease
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DOI：
10.1016/j.lab.2003.08.001
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发表时间：
2004-01-01
期刊：
影响因子：
--
通讯作者：
Omata, M
中科院分区：
文献类型：
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作者：
Kamijo, A;Kimura, K;Omata, M
以往的研究表明，大量蛋白尿时，与白蛋白结合的游离脂肪酸（FFA）在近端小管中超载，并加重肾小管间质损伤。肝型脂肪酸结合蛋白（L-FABP）是脂肪酸的细胞内载体蛋白，表达于人肾脏近曲小管。我们试图评估尿L-FABP作为慢性肾脏疾病的临床标志物。本文应用新建立的酶联免疫吸附法（ELISA）测定了120例非糖尿病慢性肾脏病患者尿L-脂肪酸结合蛋白（L-FABP）。然后我们对这些患者进行了15至51个月的监测。对临床资料进行多因素分析。尿L-FABP与尿蛋白、尿α 1-微球蛋白和血清肌酐浓度相关。随访开始时的尿L-FABP（F = 17.1，r = 0.36，P <0.0001）被选为与进展率相关的重要临床因素，进展率定义为血清肌酐随时间的倒数的斜率。然后我们从所有120例患者中选择轻度肾功能不全患者（n = 35），并根据进展率将其分为2组：进展组（n = 22）和非进展组（n = 13）。随访开始时，进展组的血清肌酐和尿蛋白浓度以及血压均高于非进展组，但我们发现两组之间无显著差异。尿L-FABP前者明显高于后者（P <0.05）。结果表明，尿L-FABP可反映慢性肾脏病的临床预后。尿L-FABP可能是一个临床指标，可以帮助预测慢性肾小球疾病的进展。
Previous studies have indicated that in massive proteinuria, free fatty acids (FFAs) bound to albumin were overloaded in the proximal tubule and exacerbated tubulointerstitial damage. Liver-type fatty acid-binding protein (L-FABP) is an intracellular carrier protein of FFAs that is expressed in the proximal tubule of human kidney. We sought to evaluate urinary L-FABP as a clinical marker in chronic renal disease. Urinary L-FABP was measured in patients with nondiabetic chronic renal disease (n = 120) with the use of a newly established ELISA method. We then monitored these patients for 15 to 51 months. Clinical data were analyzed with multivariate analysis. Urinary L-FABP was correlated with urinary protein, urinary alpha(1)-microglobulin, and serum creatinine concentrations. Urinary L-FABP at the start of follow-up (F = 17.1, r = .36, P < .0001) was selected as a significant clinical factor correlated with the progression rate, defined as a slope of a reciprocal of serum creatinine over time. We next selected the patients with mild renal dysfunction (n = 35) from all 120 patients and divided them into 2 groups according to progression rate: the progression group (n = 22) and the nonprogression group (n = 13). Serum creatinine and urinary protein concentrations and blood pressure at the start of follow-up were higher in the progression group than in the nonprogression group, although we detected no significant difference between the 2 groups. Urinary L-FABP was significantly higher in the former group than in the latter (P < .05). The results showed that urinary L-FABP reflected the clinical prognosis of chronic renal disease. Urinary L-FABP may be a clinical marker that can help predict the progression of chronic glomerular disease.