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
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
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DOI：
10.1007/s00380-014-0489-4
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发表时间：
2015-05-01
影响因子：
1.5
通讯作者：
Itoh, Mitsuyasu
中科院分区：
文献类型：
--
作者：
Maeda, Yoshiteru;Suzuki, Atsushi;Itoh, Mitsuyasu
尿肝型脂肪酸结合蛋白（L-FABP）反映了肾脏近端小管的应激程度。我们检测了2型糖尿病（T2 DM）伴慢性肾脏病（CKD）G1和G2期患者的L-FABP水平，及其与心脏标志物和心电图（ECG）异常的关系。招募肾小球滤过率（eGFR）估计值≥ 60 mL/min/1.73 m2的T2 DM患者[n = 276（165名男性），平均年龄64岁]。尿L-FABP的中位数为6.6 μ g/gCr。尿L-FABP与尿白蛋白/肌酐比值（ACR）呈显著相关（r = 0.51，p < 0.0001）。eGFR中位数（第25 - 75百分位数）为82（72-95）mL/min/1.73 m（2）。我们将患者分为四个亚组（组1，L-FABP 30 mg/gCr）。与第1组相比，第4组的收缩压和eGFR（使用标准化血清胱抑素C、高敏肌钙蛋白T和N末端脑钠肽前体（NT-proBNP））显著升高。第4组NT-proBNP水平显著高于第3组。第2、3和4组的ECG异常多于第1组。这些结果表明，同时测量尿L-FABP和ACR应有助于评估心血管损伤，反映了T2 DM伴CKD G1和G2的心脏标志物升高和ECG异常。
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 mu g/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 m(2). We divided patients into four subgroups (group 1, L-FABP 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.