High-expression of FABP4 in Tubules is a Risk Factor for Poor Prognosis in DKD Patients


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Abstract

Background::Lipid metabolism imbalance is involved in the mechanism of renal tubular injury in diabetic kidney disease (DKD). Fatty acid binding protein 4 (FABP4) has been reported to participate in cellular lipid toxicity. However, the expression of FABP4 in renal tissues of DKD and its correlation with clinical/ pathological parameters and prognosis have not been studied.

Method::A retrospective cohort study was conducted in 108 hospitalized Type 2 diabetes (T2D) patients with renal injury, including 70 with DKD and 38 with NDKD (non-DKD). Clinical features, pathological findings, and follow-up parameters were collected. Serum and urine FABP4 were detected by ELISA. An immunohistochemistry stain was used to determine FABP4 in renal tubulointerstitium. A double immunofluorescence stain was employed to assess FABP4- and CD68-positive macrophages. Correlation analysis, logistic regression models, receiver operating characteristic (ROC), and Kaplan-Meier survival curve were performed for statistical analysis.

Results::DKD patients had increased expression of FABP4 and ectopic fat deposition in tubules. As shown by correlation analyses, FABP4 expression in renal tubules was positively correlated with UNAG (r=0.589, p=0.044) and ESRD (r=0.740, p=0.004). Multivariate regression analysis revealed that UNAG level was correlated with FABP4 expression level above median value (odds ratio:1.154, 95% confidence interval:1.009-1.321, p=0.037). High-expression of FABP4 in renal tubules of DKD was at an increased risk of ESRD. Increased FABP4 expression in inflammatory cells was also associated with ESRD in DKD.

Conclusion::High-expression of FABP4 is involved in the pathogenesis of renal tubular lipid injury and is a risk factor for poor prognosis in DKD patients

About the authors

Yao Huang

Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China, Second Xiangya Hospital of Central South University

Email: info@benthamscience.net

Xinyuan Cui

Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China, Second Xiangya Hospital of Central South University

Email: info@benthamscience.net

Zheng Li

Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China, Second Xiangya Hospital of Central South University

Email: info@benthamscience.net

Shuguang Yuan

Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China, Second Xiangya Hospital of Central South University

Email: info@benthamscience.net

Yachun Han

Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China, Second Xiangya Hospital of Central South University

Email: info@benthamscience.net

Xiangqing Xu

Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China, Second Xiangya Hospital of Central South University

Email: info@benthamscience.net

Xiao Fu

Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China, Second Xiangya Hospital of Central South University

Email: info@benthamscience.net

Kewen Shi

Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China, Second Xiangya Hospital of Central South University

Email: info@benthamscience.net

Zurong Zhang

Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China, Second Xiangya Hospital of Central South University

Email: info@benthamscience.net

Jinying Wei

Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China, Second Xiangya Hospital of Central South University

Email: info@benthamscience.net

Shiyu Xia

Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China, Second Xiangya Hospital of Central South University

Email: info@benthamscience.net

Yang Xiao

National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, China., Second Xiangya Hospital of Central South University

Email: info@benthamscience.net

Song Xue

National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, China., Second Xiangya Hospital of Central South University

Email: info@benthamscience.net

Lin Sun

Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China, Second Xiangya Hospital of Central South University

Email: info@benthamscience.net

Hong Liu

Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China, Second Xiangya Hospital of Central South University

Email: info@benthamscience.net

Xuejing Zhu

Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China, Second Xiangya Hospital of Central South University

Author for correspondence.
Email: info@benthamscience.net

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