Abstract

Objective Adipocyte fatty acid-binding protein (A-FABP) is a major cytoplasmic protein in adipocytes and macrophages and is closely associated with metabolic syndrome (MetS), type 2 diabetes, and atherosclerosis. Here, we investigated whether A-FABP was associated with non-alcoholic fatty liver disease (NAFLD) in type 2 diabetes.

Research design and methods We enrolled 181 type 2 diabetic patients. Clinical and biochemical metabolic parameters were measured. The severity of NAFLD was measured by ultrasound. A-FABP, adiponectin, and retinol-binding protein-4 (RBP-4) were determined by ELISA.

Results A-FABP was higher in females, patients with MetS, and patients with overt NAFLD, defined as more than a moderate degree of fatty liver, compared to males, those without MetS, and those without NAFLD. Adiponectin was decreased according to the severity of NAFLD, but RBP-4 showed no difference. Age- and sex-adjusted A-FABP showed positive correlations with body mass index (BMI), waist-to-hip ratio, waist circumference, triglycerides, γ-glutamyltransferase (GGT), fasting insulin, HOMA-IR, HbA1C, and C-reactive protein (CRP), but showed negative correlation with HDL. The odds ratio (OR) for the risk of overt NAFLD with increasing levels of sex-specific A-FABP was significantly increased [OR (95% CI) = 2.90 (1.15 - 7.29) vs. 7.87 (3.20 - 19.38)]. The OR in the highest tertile of A-FABP remained significant after adjustments for BMI, waist circumference, HbA1C, HDL, triglycerides, HOMA-IR, CRP, and hepatic enzymes.

Conclusions Our study demonstrates that serum A-FABP is significantly associated with NAFLD in type 2 diabetes independent of BMI, waist circumference, HOMA-IR, HbA1C, triglycerides, HDL cholesterol, and CRP.