Associations Between High Serum Adipocyte Fatty Acid Binding Protein and First Hospitalization in Kidney Transplantation Patients
Ming-Che Lee1,3, Yen-Cheng Chen1,3, Guan-Jin Ho1,3, Bang-Gee Hsu2,3.
1Department of Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; 2Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; 3School of Medicine, Tzu Chi University, Hualien, Taiwan
Introduction: Adipocyte fatty acid-binding protein (A-FABP) is an adipokine and predicts the incidence of metabolic syndrome and type 2 diabetes mellitus and is an independent association with atherosclerosis. This study was evaluated the association between serum A-FABP levels and future first hospitalization events in patients with kidney transplantation (KT).
Materials and Methods: A total of 72 KT patients were enrolled in this study from January through April 2012. The primary end point was the incidence of first hospitalization. All patients are follow-up until June 2017.Fasting blood samples were obtained from 74 KT patients. Serum A-FABP levels were determined using a commercially available enzyme immunoassay.
Results: During a median 65-month follow-up, Forty-nine first hospitalization events occurred. Compared with serum median A-FABP levels, female KD patient had higher A-FABP levels(P = 0.033) and serum A-FABP level was positively associated with body mass index (P = 0.036), body fat mass (P = 0.004), systolic blood pressure (P = 0.003), total cholesterol (P = 0.014), triglyceride (P = 0.010), blood urea nitrogen (P = 0.001), creatinine (P = 0.032), while negatively associated with height (P = 0.029), glomerular filtration rate (P = 0.008), respectively. KT patients with first hospitalization events and higher prevalence of diabetes (P = 0.027), hypertension (P = 0.049), higher body fat mass (P = 0.024), and higher serum A-FABP levels (P = 0.011) compared to subjects without first hospitalization events. The Kaplan–Meier analysis showed that the cumulative incidence of the first hospitalization events in the high A-FABP group (median A-FABP concentration of ≥ 29.05 ng/mL) was greater than that in the low A-FABP group (log-rank P = 0.018). By multivariate Cox analysis showed that hypertension (hazard ratio (HR): 2.134, 95% confidence interval (CI): 1.190–3.828, P = 0.011) and serum A-FABP levels (HR: 1.010, 95% CI: 1.000–1.019, P = 0.047) was independently associated with first hospitalization events in KT patients.
Conclusion: The results of our study showed that the serum A-FABP level is a biomarker for future first hospitalization events in KT patients. Further prospective studies are needed to confirm the mechanisms underlying this association.
