J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 9, Number 4, April 2017, pages 366-373

Current Metabolic Status Affects Urinary Liver-Type Fatty-Acid Binding Protein in Normoalbuminuric Patients With Type 2 Diabetes

Figure 1. The relationship between the changes in urinary L-FABP (ΔL-FABP) and HbA1c level (ΔHbA1c) during the 6-month observation period among (a) normoalbuminuric and (b) albuminuric patients with type 2 diabetes.

**Table 1.** The Clinical Characteristics of the Patients
	Mean ± SD/%	Number estimated
DPP-4: dipeptidyl peptidase-4; RAS: renin-angiotensin system; ACR: albumin-to-creatinine ratio; ABI: ankle-brachial pressure index; baPWV: brachial-ankle pulse wave velocity; cIMT: carotid intima-media thickness.
Age (years)	66 ± 12	788
Male (%)	58	788
Duration of diabetes (years)	12 ± 10	745
History of smoking (%)	61	452
Body mass index (kg/m²)	25.3 ± 4.5	675
Medication		788
Insulin use (%)	24
Biguanides use (%)	33
Sulfonylureas use (%)	8
DPP-4 inhibitors use (%)	27
RAS inhibitors use (%)	54
Calcium channel blockers use (%)	41
Statin use (%)	59
Systolic blood pressure (mm Hg)	131 ± 16	780
Diastolic blood pressure (mm Hg)	75 ± 12	779
Hypertension (%)	74	786
HbA1c (%)	7.4 ± 1.3	755
HbA1c ≥ 7% (%)	60	755
eGFR (mL/min/1.73 m²)	71 ± 24	788
Urinary ACR (mg/gCr)	126 ± 334	788
Albuminuria (%)	41	788
Serum uric acid (μmol/L)	307 ± 73	788
Hyperuricemia (%)	18	788
HDL-cholesterol (mmol/L)	1.36 ± 0.38	787
LDL-cholesterol (mmol/L)	2.45 ± 0.75	788
Hyper LDL-cholesterolemia (%)	63	788
ABI	1.12 ± 0.11	555
baPWV (cm/s)	1,742 ± 380	526
cIMT (mm)	1.02 ± 0.23	253
Diabetic retinopathy (%)	31	754
Diabetic peripheral neuropathy (%)	46	585
Cerebrovascular disease (%)	12	788
Coronary heart disease (%)	22	788
Peripheral artery disease (%)	4	788
Urinary L-FABP (μg/gCr)	6.6 ± 16.8	788
High urinary L-FABP (%)	18	788

Table 1. The Clinical Characteristics of the Patients

Mean ± SD/%

Number estimated

DPP-4: dipeptidyl peptidase-4; RAS: renin-angiotensin system; ACR: albumin-to-creatinine ratio; ABI: ankle-brachial pressure index; baPWV: brachial-ankle pulse wave velocity; cIMT: carotid intima-media thickness.

Age (years)

66 ± 12

788

Male (%)

788

Duration of diabetes (years)

12 ± 10

745

History of smoking (%)

452

Body mass index (kg/m²)

25.3 ± 4.5

675

Medication

788

Insulin use (%)

Biguanides use (%)

Sulfonylureas use (%)

DPP-4 inhibitors use (%)

RAS inhibitors use (%)

Calcium channel blockers use (%)

Statin use (%)

Systolic blood pressure (mm Hg)

131 ± 16

780

Diastolic blood pressure (mm Hg)

75 ± 12

779

Hypertension (%)

786

HbA1c (%)

7.4 ± 1.3

755

HbA1c ≥ 7% (%)

755

eGFR (mL/min/1.73 m²)

71 ± 24

788

Urinary ACR (mg/gCr)

126 ± 334

788

Albuminuria (%)

788

Serum uric acid (μmol/L)

307 ± 73

788

Hyperuricemia (%)

788

HDL-cholesterol (mmol/L)

1.36 ± 0.38

787

LDL-cholesterol (mmol/L)

2.45 ± 0.75

788

Hyper LDL-cholesterolemia (%)

788

ABI

1.12 ± 0.11

555

baPWV (cm/s)

1,742 ± 380

526

cIMT (mm)

1.02 ± 0.23

253

Diabetic retinopathy (%)

754

Diabetic peripheral neuropathy (%)

585

Cerebrovascular disease (%)

788

Coronary heart disease (%)

788

Peripheral artery disease (%)

788

Urinary L-FABP (μg/gCr)

6.6 ± 16.8

788

High urinary L-FABP (%)

788

**Table 2.** Comparisons of the Clinical Characteristics in the High and Normal Urinary L-FABP Groups Among Normoalbuminuric and Albuminuric Patients With Type 2 Diabetes
	Normoalbuminuric group	Albuminuric group
DPP-4: dipeptidyl peptidase-4; RAS: renin-angiotensin system; ACR: albumin-to-creatinine ratio; ABI: ankle-brachial pressure index; baPWV: brachial-ankle pulse wave velocity; cIMT: carotid intima-media thickness.
Age (years)	68 ± 10	64 ± 12	0.08	71 ± 10	67 ± 13	< 0.01
Male (%)	61	54	0.44	66	60	0.30
Duration of diabetes (years)	9 ± 8	11 ± 9	0.46	18 ± 12	12 ± 10	< 0.01
Smoking history (%)	70	58	0.27	83	58	0.04
Body mass index (kg/m²)	25.0 ± 4.5	25.3 ± 4.3	0.48	24.8 ± 4.8	25.7 ± 4.7	0.07
Medication
Insulin use (%)	22	20	0.70	33	28	0.42
Biguanides use (%)	19	37	0.03	20	34	< 0.01
Sulfonylureas use (%)	6	7	0.74	6	11	0.17
DPP-4 inhibitors use (%)	17	24	0.29	37	29	0.15
RAS inhibitors use (%)	50	49	0.94	70	56	0.01
Calcium channel blockers use (%)	44	34	0.23	61	43	< 0.01
Statin use (%)	50	62	0.17	57	55	0.72
Systolic blood pressure (mm Hg)	135 ± 20	128 ± 15	0.08	137 ± 16	132 ± 16	< 0.01
Diastolic blood pressure (mm Hg)	77 ± 15	75 ± 11	0.67	75 ± 14	75 ± 12	0.97
Hypertension (%)	77	68	0.23	91	77	< 0.01
HbA1c (%)	7.9 ± 1.6	7.3 ± 1.2	0.01	7.8 ± 1.7	7.5 ± 1.2	0.18
HbA1c ≥ 7% (%)	78	56	< 0.01	68	63	0.34
eGFR (mL/min/1.73 m²)	69 ± 22	75 ± 20	0.09	53 ± 29	72 ± 22	< 0.01
Urinary ACR (mg/gCr)	12 ± 7	12 ± 7	0.48	598 ± 752	167 ± 251	< 0.01
Serum uric acid (μmol/L)	282 ± 73	303 ± 72	0.07	316 ± 77	315 ± 74	0.92
Hyperuricemia (%)	19	14	0.36	35	19	< 0.01
HDL-cholesterol (mmol/L)	1.34 ± 0.35	1.37 ± 0.38	0.81	1.25 ± 0.33	1.39 ± 0.40	< 0.01
LDL-cholesterol (mmol/L)	2.63 ± 1.03	2.42 ± 0.70	0.33	2.40 ± 0.78	2.51 ± 0.76	0.18
Hyper LDL-cholesterolemia (%)	58	65	0.45	59	62	0.61
ABI	1.13 ± 0.09	1.13 ± 0.09	0.70	1.08 ± 0.14	1.12 ± 0.11	0.07
baPWV (cm/s)	1,811 ± 515	1,664 ± 342	0.22	1,886 ± 367	1,805 ± 402	0.05
cIMT (mm)	1.00 ± 0.23	0.99 ± 0.25	0.90	1.07 ± 0.19	1.03 ± 0.22	0.33
Diabetic retinopathy (%)	24	23	1.00	54	38	< 0.01
Diabetic peripheral neuropathy (%)	48	37	0.25	75	49	< 0.01
Cerebrovascular disease (%)	17	11	0.30	20	11	0.03
Coronary heart disease (%)	19	18	0.87	33	23	0.07
Peripheral artery disease (%)	3	3	1.00	12	3	< 0.01

Table 2. Comparisons of the Clinical Characteristics in the High and Normal Urinary L-FABP Groups Among Normoalbuminuric and Albuminuric Patients With Type 2 Diabetes

Normoalbuminuric group

Albuminuric group

High L-FABP (n = 36)

Normal L-FABP (n = 430)

High L-FABP (n = 107)

Normal L-FABP (n = 215)

Age (years)

68 ± 10

64 ± 12

0.08

71 ± 10

67 ± 13

< 0.01

Male (%)

0.44

0.30

Duration of diabetes (years)

9 ± 8

11 ± 9

0.46

18 ± 12

12 ± 10

< 0.01

Smoking history (%)

0.27

0.04

Body mass index (kg/m²)

25.0 ± 4.5

25.3 ± 4.3

0.48

24.8 ± 4.8

25.7 ± 4.7

0.07

Medication

Insulin use (%)

0.70

0.42

Biguanides use (%)

0.03

< 0.01

Sulfonylureas use (%)

0.74

0.17

DPP-4 inhibitors use (%)

0.29

0.15

RAS inhibitors use (%)

0.94

0.01

Calcium channel blockers use (%)

0.23

< 0.01

Statin use (%)

0.17

0.72

Systolic blood pressure (mm Hg)

135 ± 20

128 ± 15

0.08

137 ± 16

132 ± 16

< 0.01

Diastolic blood pressure (mm Hg)

77 ± 15

75 ± 11

0.67

75 ± 14

75 ± 12

0.97

Hypertension (%)

0.23

< 0.01

HbA1c (%)

7.9 ± 1.6

7.3 ± 1.2

0.01

7.8 ± 1.7

7.5 ± 1.2

0.18

HbA1c ≥ 7% (%)

< 0.01

0.34

eGFR (mL/min/1.73 m²)

69 ± 22

75 ± 20

0.09

53 ± 29

72 ± 22

< 0.01

Urinary ACR (mg/gCr)

12 ± 7

0.48

598 ± 752

167 ± 251

< 0.01

Serum uric acid (μmol/L)

282 ± 73

303 ± 72

0.07

316 ± 77

315 ± 74

0.92

Hyperuricemia (%)

0.36

< 0.01

HDL-cholesterol (mmol/L)

1.34 ± 0.35

1.37 ± 0.38

0.81

1.25 ± 0.33

1.39 ± 0.40

< 0.01

LDL-cholesterol (mmol/L)

2.63 ± 1.03

2.42 ± 0.70

0.33

2.40 ± 0.78

2.51 ± 0.76

0.18

Hyper LDL-cholesterolemia (%)

0.45

0.61

ABI

1.13 ± 0.09

0.70

1.08 ± 0.14

1.12 ± 0.11

0.07

baPWV (cm/s)

1,811 ± 515

1,664 ± 342

0.22

1,886 ± 367

1,805 ± 402

0.05

cIMT (mm)

1.00 ± 0.23

0.99 ± 0.25

0.90

1.07 ± 0.19

1.03 ± 0.22

0.33

Diabetic retinopathy (%)

1.00

< 0.01

Diabetic peripheral neuropathy (%)

0.25

< 0.01

Cerebrovascular disease (%)

0.30

0.03

Coronary heart disease (%)

0.87

0.07

Peripheral artery disease (%)

1.00

< 0.01

**Table 3.** ORs of Clinical Characteristics for High Urinary L-FABP in Normoalbuminuric and Albuminuric Patients With Type 2 Diabetes
	Wald χ² score	OR (95% CI)	P
RAS: renin-angiotensin system; ACR: albumin-to-creatinine ratio; OR: odds ratio; CI: confidential interval.
Normoalbuminuric group
Biguanides use (%)	3.23	0.44 (0.17 - 1.02)	0.06
Systolic blood pressure (mm Hg)	7.60	1.03 (1.01 - 1.05)	< 0.01
HbA1c (%)	8.45	1.42 (1.11 - 1.79)	< 0.01
eGFR (mL/min/1.73 m²)	6.18	0.98 (0.96 - 1.00)	0.01
Albuminuric group
RAS inhibitors use (%)	5.38	2.22 (1.16 - 4.89)	0.02
Urinary ACR (mg/gCr)	22.69	1.01 (1.00 - 1.01)	< 0.01
HDL-cholesterol (mmol/L)	4.47	0.33 (0.11 - 0.89)	0.03

Table 3. ORs of Clinical Characteristics for High Urinary L-FABP in Normoalbuminuric and Albuminuric Patients With Type 2 Diabetes

Wald χ² score

OR (95% CI)

RAS: renin-angiotensin system; ACR: albumin-to-creatinine ratio; OR: odds ratio; CI: confidential interval.

Normoalbuminuric group

Biguanides use (%)

3.23

0.44 (0.17 - 1.02)

0.06

Systolic blood pressure (mm Hg)

7.60

1.03 (1.01 - 1.05)

< 0.01

HbA1c (%)

8.45

1.42 (1.11 - 1.79)

< 0.01

eGFR (mL/min/1.73 m²)

6.18

0.98 (0.96 - 1.00)

0.01

Albuminuric group

RAS inhibitors use (%)

5.38

2.22 (1.16 - 4.89)

0.02

Urinary ACR (mg/gCr)

22.69

1.01 (1.00 - 1.01)

< 0.01

HDL-cholesterol (mmol/L)

4.47

0.33 (0.11 - 0.89)

0.03

**Table 4.** Comparison of the Clinical Characteristics of Subjects Who Were Observed for 6 Months
	Normoalbuminuric group	Albuminuric group
Urinary L-FABP (μg/gCr)	404	2.2 ± 5.0	3.3 ± 6.0	< 0.01	262	10.9 ± 22.3	11.2 ± 20.0	0.09
Systolic blood pressure (mm Hg)	400	129 ± 15	129 ± 15	0.97	259	133 ± 15	132 ± 15	0.27
HbA1c (%)	396	7.4 ± 1.2	7.3 ± 1.3	0.12	247	7.6 ± 1.3	7.6 ± 1.3	0.39
eGFR (mL/min/1.73 m²)	403	74 ± 20	75 ± 21	0.99	260	68 ± 25	66 ± 25	< 0.01
HDL-cholesterol (mmol/L)	102	1.38 ± 0.38	1.35 ± 0.36	0.50	87	1.36 ± 0.36	1.31 ± 0.34	0.25

Table 4. Comparison of the Clinical Characteristics of Subjects Who Were Observed for 6 Months

Normoalbuminuric group

Albuminuric group

0 month

6 months

0 month

6 months

Urinary L-FABP (μg/gCr)

404

2.2 ± 5.0

3.3 ± 6.0

< 0.01

262

10.9 ± 22.3

11.2 ± 20.0

0.09

Systolic blood pressure (mm Hg)

400

129 ± 15

0.97

259

133 ± 15

132 ± 15

0.27

HbA1c (%)

396

7.4 ± 1.2

7.3 ± 1.3

0.12

247

7.6 ± 1.3

0.39

eGFR (mL/min/1.73 m²)

403

74 ± 20

75 ± 21

0.99

260

68 ± 25

66 ± 25

< 0.01

HDL-cholesterol (mmol/L)

102

1.38 ± 0.38

1.35 ± 0.36

0.50

1.36 ± 0.36

1.31 ± 0.34

0.25