Urinary L-FABP and anaemia: distinct roles of urinary markers in type 2 diabetes.

Abstract

BACKGROUND:

Urinary liver-type fatty acid binding protein (L-FABP) and kidney injury molecule (KIM)-1, novel urinary biomarkers of renal tubulointerstitial function, have previously been associated with acute ischaemic kidney injury. We studied the clinical significance of urinary L-FABP, KIM-1 and N-acetyl-beta-glucosaminidase (NAG) as potential markers of renal function and chronic ischaemic injury in patients with diabetic nephropathy.

MATERIAL AND METHODS:

A total of 130 type 2 diabetes patients with early diabetic nephropathy and 40 healthy controls were studied. Urinary L-FABP, KIM-1, NAG, albumin excretion rate (AER) and creatinine clearance were obtained from 24-h urine samples, and correlated with measures of red blood cell count, renal function and metabolic control.

RESULTS:

Urinary L-FABP was significantly increased in diabetes patients compared with healthy controls [8.1 (interquartile 0.6-11.6) vs. 2.4 (0.5-3.6) microg/g creatinine, P < 0.001] and correlated with AER (r = 0.276, P = 0.002), creatinine clearance (r = -0.189, P = 0.033) and haemoglobin levels (r = -0.190, P = 0.030). In multivariable linear regression analysis, haemoglobin (beta = -0.247, P = 0.015) and AER (beta = 0.198, P = 0.046) were significant predictors of urinary L-FABP. Prevalent anaemia was independently associated with a 6-fold risk for increased tubulointerstitial kidney damage (upper vs. lower two L-FABP tertiles: OR, 6.06; 95% CI: 1.65-22.23; P = 0.007). Urinary KIM-1 was not significantly associated with kidney function, AER, or measures of red blood cell count while urinary NAG was associated with parameters of glucose control and renal function.

CONCLUSIONS:

Different urinary biomarkers may reflect distinct pathophysiological mechanisms of tubulointerstitial damage in early diabetic nephropathy: Urinary L-FABP could be a novel biomarker for chronic intrarenal ischaemia.

• Authors: M von Eynatten, M Baumann, U Heemann, D Zdunek, G Hess, P P Nawroth, A Bierhaus, P M Humpert
• Journal: European journal of clinical investigation (Eur J Clin Invest) Vol. 40 Issue 2 Pg. 95-102 (Feb 2010) ISSN: 1365-2362 [Electronic] England
• PMID: 19912308 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Albumins
• Biomarkers
• Fatty Acid-Binding Proteins
• HAVCR1 protein, human
• Hemoglobins
• Hepatitis A Virus Cellular Receptor 1
• Membrane Glycoproteins
• NBAS protein, human
• Neoplasm Proteins
• Receptors, Virus
• Creatinine
• Glucose

Topics

• Aged
• Albumins (analysis)
• Anemia (diagnosis, epidemiology, urine)
• Biomarkers (urine)
• Creatinine (urine)
• Diabetes Mellitus, Type 2 (complications, urine)
• Diabetic Nephropathies (urine)
• Erythrocyte Count
• Fatty Acid-Binding Proteins (urine)
• Female
• Glucose (metabolism)
• Hemoglobins (analysis)
• Hepatitis A Virus Cellular Receptor 1
• Humans
• Kidney Failure, Chronic (epidemiology, urine)
• Kidney Function Tests
• Male
• Membrane Glycoproteins (urine)
• Middle Aged
• Multivariate Analysis
• Neoplasm Proteins (urine)
• Receptors, Virus