Change Of Fatty Acid-binding Protein In Patients With Diabetic Nephropathy And Clinical

ObjectivesTo determine the expression of serum FABP in elderly patients with diabetes, locate the contacts of the change of FABP and diabetic nephropathy related biochemical indicators and discuss the prediction value in diabetic nephropathy.Materials and Methods51 cases of elderly endocrinologlst hospitalized patients with type 2 diabetes were recruited from May 2009 to October 2010, and 15 cases without diabetes as the control group.51 cases of diabetes were divided into three groups in accordance with different urinary albumin excretion rates,11 cases with clinical proteinuria (UAER>200μg/min),19 cases with microalbuminuria (20μg/min≤UAER≤200μg/min),21 cases with normal albuminuria (UAER<20μg/min),15 cases of patients without diabetes as the control group. Determined the Fatty acid binding protein(FABP) by Enzyme-linked immunosorbent assay(ELISA), analysis the relationship between FABP and Body mass index(BMI), Blood fat, Non-esterified fatty acid (NEFA), Fast blood sugar(FBS), Fasting insulin(FINS), Insulin resistance index(HOMA-IR), Urinary albumin excretion rate(UAER), Serum creatinine (Scr), creatinine clearance (Ccr) and Glomerular filtration rate (GFR),Results:(1) General information Comparison:The general information among three diabetic groups and control group are not significant. (P>0.05).(2) The FABP among four groups is statistically significant (P<0.05). FABP is positively correlated with UAER(P<0.05).(3) FABP is positively correlated with BMI (P<0.05). FABP has no correlations with age, duration of diabetes, Systolic blood pressure and diastolic pressure (P> 0.05).(4) The TG, N-EFA among three diabetics and control group are statistically significant (P<0.05). The FBS is not significant among three diabetics. The TC, HDL, LDL are not statistically significant among four groups(P>0.05). FABP is positively correlated with TG, N-EFA(P<0.05), and HDL-C negatively correlated (P<0.05), FABP has no significant correlations with TC, LDL-C (P> 0.05).(5) The Scr. Ccr. GFR are statistically significant (P<0.05).FABP has no significant correlations with Scr, Ccr, GFR(P>0.05).(6) The FINS, HOMA-IR are statistically significant (P<0.05). FABP is positively correlated with FINS, HOMA-IR(P< 0.05).(7) Multiple linear regression analysis shows that:FABP is closely related to NEFA, TG, BMI. Standardized regression coefficients are respectively:0.608,0.277,0.105, P value:0.000,0.009,0.045. UAER is closely related EFA, FBS, HOMA-IR. Standardized regression coefficients are respectively:0.387,0.295,0.495, P value:0.040,0.032, 0.000.(8) Relative risk analysis shows that:The median of FABP is 13.175ng/ml in this population. The risk of FABP high-value group (FABP>13.175ng/ml) suffer diabetic nephropathy is 4.033 times than low-value group(FABP<13.175ng/ml).(95%CI=1.445-11.257, P=0.008)Conclusions:(1) FABP elevates in diabetic patients with diabetic nephropathy, FABP has close relations with the free fatty acid, obesity, lipid metabolism, insulin resistance, etc.(2) As the risk factors increases, the increase of fatty acid binding protein increases the risk of diabetic nephropathy of elderly diabetic patients.