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Clinical Significance of Urinary Liver-Type Fatty Acid–Binding Protein in Patients With Diabetic Nephropathy

¹ Division of Nephrology and Hypertension, Diabetes Center, Tokyo Women’s Medical University School of Medicine, Tokyo, Japan
² Department of Medicine, Diabetes Center, Tokyo Women’s Medical University School of Medicine, Tokyo, Japan

Address correspondence and reprint requests to Tetsuya Babazono, MD, PhD, Division of Nephrology and Hypertension, Diabetes Center, Tokyo Women’s, Medical University School of Medicine, 8-1 Kawadacho, Shinjukuku, Tokyo 162-8666, Japan. E-mail: babazono@dmc.twmu.ac.jp

Abbreviations: ACR, albumin-to-creatinine ratio • FABP, fatty acid–binding protein • FFA, free fatty acid • GFR, glomerular filtration rate • L-FABP, liver-type FABP

The first 20% of the full text of this article appears below.

	INTRODUCTION

 
Tubulointerstitial damage plays a crucial role in the progression of kidney diseases, including diabetic nephropathy (1). Among several distinct types of fatty acid–binding protein (FABP), liver-type FABP (L-FABP) is abundantly expressed in hepatocytes and constitutively expressed in proximal tubular cells of the kidney (2). L-FABP incorporates albumin-bound free fatty acids (FFAs) that are filtered through the glomeruli into proximal tubular cells and transports FFAs from the cytosol to the nucleus (3). In transgenic mice expressing human L-FAPB, protein overload, resulting in massive proteinuria, upregulated renal L-FABP expression and increased its urinary excretion (4), suggesting that urinary L-FABP may reflect tubulointerstitial damage. Recently, in patients with nondiabetic glomerular disease, urinary excretion of L-FABP increased in parallel with the severity of tubulointerstitial injury and correlated with proteinuria and the rate of progression of renal disease, suggesting that L-FABP may be a useful indicator for the progression of nondiabetic kidney disease (4,5). To determine the clinical significance of L-FABP in patients with diabetic nephropathy, we conducted a cross-sectional study comparing urinary L-FABP excretion in diabetic patients with serial stages of kidney disease.

	RESEARCH DESIGN AND METHODS

 
Adult patients with type 2 diabetes were recruited from the outpatient clinic of the Division of Nephrology and Hypertension, Diabetes . . . [Full Text of this Article]

	RESULTS

 

	CONCLUSIONS

 

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