Fatty Acid-Binding Protein 4 in Patients with and without Diabetic Retinopathy

Huang, Ping; Zhao, Xiaoqin; Sun, Yi; Wang, Xinlei; Ouyang, Rong; Jiang, Yanqiu; Zhang, Xiaoquan; Hu, Renyue; Tang, Zhuqi; Gu, Yunjuan

doi:10.4093/dmj.2021.0195

Cited by 2 publications

(1 citation statement)

References 46 publications

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“…There is a positive association of FABP4 with obesity [ 27 ] and T2DM [ 28 ]. The results in our study were consistent with the previous study [ 29 ], displaying that FABP4 was positively related to DR severity in patients with T2DM. A 5-year prospective cohort study demonstrated a positive association of baseline FABP4 with DR, and its severity developed in the future [ 10 ].…”

Section: Discussionsupporting

confidence: 93%

A Prediction Model for Sight-Threatening Diabetic Retinopathy Based on Plasma Adipokines among Patients with Mild Diabetic Retinopathy

An,

Cao,

et al. 2023

Journal of Diabetes Research

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Background. Accumulating evidence has suggested a link between adipokines and diabetic retinopathy (DR). This study is aimed at investigating the risk factors for sight-threatening DR (STDR) and establishing a prognostic model for predicting STDR among a high-risk population of patients with type 2 diabetes mellitus (T2DM). Methods. Plasma concentrations of adipokines were determined by enzyme-linked immunosorbent assay. In the case-control set, principal component analysis (PCA) was performed to select optimal predictive cytokines for STDR, involving severe nonproliferative DR (NPDR) and proliferative DR. Support vector machine (SVM) was used to examine the possible combination of baseline plasma adipokines to discriminate the patients with mild NPDR who will later develop STDR. An individual prospective cohort with a follow-up period of 3 years was used for the external validation. Results. In both training and testing sets, involving 306 patients with T2DM, median levels of plasma adiponectin (APN), leptin, and fatty acid-binding protein 4 (FABP4) were significantly higher in the STDR group than those in mild NPDR. Except for adipsin, the other three adipokines, FABP4, APN, and leptin, were selected by PCA and integrated into SVM. The accuracy of the multivariate SVM classification model was acceptable in both the training set ( AUC = 0.81 , sensitivity = 71 % , and specificity = 91 % ) and the testing set ( AUC = 0.77 , sensitivity = 61 % , and specificity = 92 % ). 110 T2DM patients with mild NPDR, the high-risk population of STDR, were enrolled for external validation. Based on the SVM, the risk of each patient was calculated. More STDR occurred in the high-risk group than in the low-risk group, which were grouped by the median value of APN, FABP4, and leptin, respectively. The model was validated in an individual cohort using SVM with the AUC, sensitivity, and specificity reaching 0.77, 64%, and 91%, respectively. Conclusions. Adiponectin, leptin, and FABP4 were demonstrated to be associated with the severity of DR and maybe good predictors for STDR, suggesting that adipokines may play an important role in the pathophysiology of DR development.

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Section: Discussionsupporting

confidence: 93%

A Prediction Model for Sight-Threatening Diabetic Retinopathy Based on Plasma Adipokines among Patients with Mild Diabetic Retinopathy

An,

Cao,

et al. 2023

Journal of Diabetes Research

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Circulating AFABP, FGF21, and PEDF Levels as Prognostic Biomarkers of Sight-threatening Diabetic Retinopathy

Lee

Lui

Cheung

et al. 2023

The Journal of Clinical Endocrinology &Amp; Metabolism

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Background Adipocyte fatty acid-binding protein (AFABP), fibroblast growth factor 21 (FGF21) and pigment epithelium-derived factor (PEDF) are three diabetes-related biomarkers whose circulating levels had been shown to associate with nephropathy progression in Chinese patients with type 2 diabetes. Here, we evaluated and compared their prospective associations with the development of sight-threatening diabetic retinopathy (STDR), another important diabetic micro-vascular complication. Methods Baseline serum AFABP, PEDF and FGF21 levels were measured in 4760 Chinese individuals with type 2 diabetes and without STDR at baseline. The associations of these biomarkers with incident STDR were analyzed using Cox regression analysis. Results Among these 4760 participants (mean diabetes duration of 11 years and ≥50% with non-proliferative diabetic retinopathy at baseline), 172 participants developed STDR over a median follow-up of 8.8 years. Participants with incident STDR had comparable baseline serum FGF21 levels but significantly higher baseline serum AFABP and PEDF levels (both p<0.001) than those without. However, in multivariable Cox regression analysis, only serum AFABP remained independently associated with incident STDR (HR 1.28, 95%CI 1.05–1.55, p=0.013). The addition of serum AFABP to a clinical model of conventional STDR risk factors including diabetes duration, glycemic control, albuminuria and baseline diabetic retinopathy status significantly improved the c-statistics (p<0.001), net reclassification index (p=0.0027) and integrated discrimination index (p=0.033) in predicting incident STDR among participants without DR or with mild DR at baseline. Conclusion Among the three diabetes-related biomarkers, serum AFABP level appeared to be a more clinically useful biomarker for predicting incident STDR in type 2 diabetes.

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Fatty Acid-Binding Protein 4 in Patients with and without Diabetic Retinopathy

Cited by 2 publications

References 46 publications

A Prediction Model for Sight-Threatening Diabetic Retinopathy Based on Plasma Adipokines among Patients with Mild Diabetic Retinopathy

A Prediction Model for Sight-Threatening Diabetic Retinopathy Based on Plasma Adipokines among Patients with Mild Diabetic Retinopathy

Circulating AFABP, FGF21, and PEDF Levels as Prognostic Biomarkers of Sight-threatening Diabetic Retinopathy

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