Title:High-expression of FABP4 in Tubules is a Risk Factor for Poor
Prognosis in DKD Patients
Volume: 31
Issue: 22
Author(s): Yao Huang, Xinyuan Cui, Zheng Li, Shuguang Yuan, Yachun Han, Xiangqing Xu, Xiao Fu, Kewen Shi, Zurong Zhang, Jinying Wei, Shiyu Xia, Yang Xiao, Song Xue, Lin Sun, Hong Liu and Xuejing Zhu*
Affiliation:
- Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, Hunan,
China
- Hunan Key Laboratory of Kidney Disease and Blood Purification, Changsha, Hunan, China
Keywords:
Diabetic kidney disease, renal tubular injury, fatty acid binding protein 4, endoplasmic reticulum, obesity, renal tubules.
Abstract:
Background: Lipid metabolism imbalance is involved in the mechanism of renal
tubular injury in diabetic kidney disease (DKD). Fatty acid binding protein 4
(FABP4) has been reported to participate in cellular lipid toxicity. However, the expression
of FABP4 in renal tissues of DKD and its correlation with clinical/ pathological parameters
and prognosis have not been studied.
Methods: A retrospective cohort study was conducted in 108 hospitalized Type 2 diabetes
(T2D) patients with renal injury, including 70 with DKD and 38 with NDKD
(non-DKD). Clinical features, pathological findings, and follow-up parameters were collected.
Serum and urine FABP4 were detected by ELISA. An immunohistochemistry
stain was used to determine FABP4 in renal tubulointerstitium. A double immunofluorescence
stain was employed to assess FABP4- and CD68-positive macrophages. Correlation
analysis, logistic regression models, receiver operating characteristic (ROC), and
Kaplan-Meier survival curve were performed for statistical analysis.
Results: DKD patients had increased expression of FABP4 and ectopic fat deposition in
tubules. As shown by correlation analyses, FABP4 expression in renal tubules was positively
correlated with UNAG (r=0.589, p=0.044) and ESRD (r=0.740, p=0.004). Multivariate
regression analysis revealed that UNAG level was correlated with FABP4 expression
level above median value (odds ratio:1.154, 95% confidence interval:1.009-1.321,
p=0.037). High-expression of FABP4 in renal tubules of DKD was at an increased risk
of ESRD. Increased FABP4 expression in inflammatory cells was also associated with
ESRD in DKD.
Conclusion: High-expression of FABP4 is involved in the pathogenesis of renal tubular
lipid injury and is a risk factor for poor prognosis in DKD patients.
