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Serum Adipocyte Fatty Acid–Binding Protein as a New Biomarker Predicting the Development of Type 2 Diabetes

A 10-year prospective study in a Chinese cohort

¹ Department of Medicine, University of Hong Kong, Hong Kong, China
² Research Centre of Heart, Brain, Hormone and Healthy Aging, University of Hong Kong, Hong Kong, China
³ Genome Research Centre, University of Hong Kong, Hong Kong, China
⁴ Department of Clinical Biochemistry, Queen Mary Hospital, Hong Kong, China

Address correspondence and reprint requests to Prof. Karen S.L. Lam, Department of Medicine, University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong. E-mail: ksllam{at}hkucc.hku.hk

OBJECTIVE— Adipocyte fatty acid–binding protein (A-FABP) is abundantly expressed in adipocytes and plays a role in glucose homeostasis in experimental animals. We have previously shown that circulating A-FABP levels are associated with the metabolic syndrome, which confers an increased risk of type 2 diabetes. Here we investigated whether serum A-FABP levels could predict the development of diabetes in a 10-year prospective study.

RESEARCH DESIGN AND METHODS— Baseline serum A-FABP levels were measured with an enzyme-linked immunosorbent assay in 544 nondiabetic subjects, recruited from the Hong Kong Cardiovascular Risk Factor Prevalence Study cohort, who were followed prospectively to assess the development of type 2 diabetes. The role of A-FABP in predicting the development of type 2 diabetes over 10 years was investigated using Cox regression analysis.

RESULTS— At baseline, serum sex-adjusted A-FABP levels were higher in subjects with impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) (P < 0.00001 versus normal glucose tolerance) and correlated positively with adverse cardiometabolic risk factors. Over 10 years, 96 subjects had developed type 2 diabetes. High baseline A-FABP was predictive of type 2 diabetes, independent of obesity, insulin resistance, or glycemic indexes (relative risk [RR] 2.25 [95% CI 1.40–3.65]; P = 0.001; above versus below sex-specific median). High A-FABP levels remained an independent predictor of type 2 diabetes in the high-risk IGT/IFG subgroup (adjusted RR 1.87 [1.12–3.15]; P = 0.018).

CONCLUSIONS— Serum A-FABP was associated with glucose dysregulation and predicted the development of type 2 diabetes in a Chinese cohort.

Abbreviations: A-FABP, adipocyte fatty acid–binding protein • FPG, fasting plasma glucose • HOMA-IR, homeostasis model assessment index of insulin resistance • hsCRP, high-sensitivity C-reactive protein • IFG, impaired fasting glucose • IGT, impaired glucose tolerance • NGT, normal glucose tolerance • OGTT, oral glucose tolerance test

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