Assessment of Urinary Liver-Type Fatty Acid Binding Protein (LFABP) Levels in Type 2 Diabetes Mellitus Patients with Nephropathy

Abstract

Introduction: Diabetic Nephropathy (DN) is a micro-vascular complication of Type 2 Diabetes Mellitus (T2DM). It is known that renal tubular damage plays an important role in DN. Liver-Type Fatty Acid Binding Protein (LFABP) is found in liver and proximal tubular cells of kidney and its levels are associated with the structural and functional changes of tubular cells of kidney. Aim: The present study was carried out to estimate the levels of urinary LFABP and its potential role as a clinical biomarker for early diagnosis of nephropathy in T2DM patients with nephropathy. Materials and Methods: A hospital based cross-sectional study was conducted on 84 subjects divided into 3 groups. Group 1: (n=28) healthy controls, Group 2: (n=28) T2DM patients without nephropathy and Group 3: (n=28) T2DM patients with nephropathy. Serum and urine creatinine were carried out by alkaline picrate Jaffe’s kinetic method. Urine albumin was estimated by turbidometric method by using nephelometer. Urinary LFABP levels were measured by commercial available ELISA kit. Results: In the present study, a statistically significant difference was found in urinary Albumin Creatinine Ratio (ACR) between the study groups I and III, II and III (p=<0.001). Also, a statistically significant difference was found between the levels of urinary LFABP in groups I and II, I and III (p=0.004 and p=<0.001 respectively). Significantly increased level of urinary LFABP was found in group III as compared to group II. There was a positive correlation observed between urinary LFABP levels with urinary ACR, which indicated that LFABP can predict kidney damage even before micro-albuminuria can be detected. Also a negative correlation was observed between urinary LFABP and estimated Glomerular Filtration Rate (eGFR). Conclusion: The study suggests that the estimation of urinary LFABP could be used as a potential adjunct biomarker along with urinary ACR for early detection of DN and monitoring of progression of DN in clinical practice. This will enable the Institution for preventive strategies that could delay the onset of symptoms of full-blown DM and End Stage Renal Disease (ESRD).

Keywords

• albumin creatinine ratio
• diabetic nephropathy
• end stage renal disease
• glomerular filtration rate