Evaluation of urinary L-FABP as an early marker for diabetic nephropathy in type 2 diabetic patients

Abstract

Summary Background Albuminuria is the standard biomarker for the diagnosis of diabetic nephropathy (DN). However, some patients with persistent microalbuminuria still progress to chronic kidney disease, raising the question of finding a better biomarker. This study aimed to evaluate the correlation of urinary liver-type fatty acid-binding protein (L-FABP) levels with renal function and to compare the role of urinary albumin-to-creatinine ratio (ACR) with urinary L-FABP in early detection of DN in type 2 diabetic patients. Methods The cross-sectional study was done on 106 type 2 diabetic patients and 30 non-diabetic people. L-FABP was measured with the Latex enhanced immunoturbidimetric technique. Results There was a strong and negative correlation between the urine L-FABP levels and eGFR (r = -0.606, p<0.001). The urinary L-FABP levels were significantly higher (p<0.001) in the normoalbuminuria diabetic group than the non-diabetic control group. The ROC-curve analyses in the diabetic patients and the normoalbuminuria diabetic patients showed that the AUCL-FABP was remarkably higher (p<0.001) than the AUCACR. An optimal cutoff value of 5 mg L-FABP/g Cr (with the sensitivity of 98.1% and specificity of 90%) and of 4.3 mg L-FABP/g Cr (with the sensitivity of 100% and specificity of 86.67%) was set to detect DN in the diabetic patients and the normoalbuminuria diabetic patients, respectively. Conclusions The change in urinary L-FABP levels happened earlier than in urinary albumin during renal function impairment. Urinary L-FABP can be used as a better indicator than ACR for early detection of DN in type 2 diabetes.

Predictive value of novel biomarkers for chronic kidney disease among workers occupationally exposed to silica

“…An optimal cutoff value of 138 L-FABP was set with a sensitivity of 93% and specificity of 86%. This is in agreement with Ngan et al (2019), who found that urinary L-FABP was better used to detect renal dysfunction in the absence of albuminuria compared with the albumin-to-creatinine ratio.…”

Serum Albumin in Health and Disease: Esterase, Antioxidant, Transporting and Signaling Properties

“…Therefore, from the point of view of diagnostics, the level of albumin characterizes not just the level of one protein, but its integrative characteristics assess the state of the whole organism. The relationship between the integrity of the endothelium and the level of albumin in urine is the most studied phenomenon in medical practice, indicating primarily kidney pathology, but also the state of other components of the blood and cardiovascular system [ 278 , 279 , 280 ]. Among these components, the vascular endothelium of the brain is of the greatest interest, since on the other side of the barrier there is the brain parenchyma, the “holy of holies” of the whole organism.…”

Plasma and urinary concentrations of arachidonic acid-derived eicosanoids are associated with diabetic kidney disease

“…Interestingly, these differences were still evident for DHETs when filtration impairment was taken out of the equation and only the diabetic disease was considered. These findings taken together suggest AA-derived metabolites in plasma and/or urine might be useful in DKD diagnosis, a pathology still needed of reliable biomarkers (Thi et al, 2020[ 35 ]). Notwithstanding, the analysis of larger cohorts of DKD patients is warranted in order to confirm the results presented herein.…”