LIVER-TYPE FATTY-ACID BINDING PROTEIN AS A BIOCHEMICAL MARKER IN EGYPTIAN PATIENTS WITH DIABETIC NEPHROPATHY

Background: Liver-type fatty-acid binding protein (L-FABP) is a 14 kDa small molecule that is expressed in the cytoplasm of human proximal tubules. Studies of patients with type 1 or type 2 diabetes demonstrated that urinary excretion of L-FABP derived from proximal tubules is a suitable biomarker for predicting and monitoring deterioration of renal function in diabetic nephropathy.

Aim: We investigate the urinary level of L-FABP as biochemical marker that can determine the severity of tissue injury resulting from diabetic nephropathy; also we investigate other three parameters – albumin in urine, albumin/creatinine ratio and eGFR as markers of chronic kidney disease progression.

Methods: This study was carried out on 66 patients (35 males & 31 female) and classified into three groups; Normal albuminuria, Micro-albuminuria and Macro-albuminuria. We assessed urinary levels of LFABP, urinary albumin, urinary creatinine, Albumin/creatinine ratio, serum creatinine, urea, HbA1c and eGFR.

Results: We found that increase in the level of urinary L-FABP and positive correlation with the progression of kidney disease, a significant positive correlation between L-FABP and both HbA1c (P < 0.05) and urinary albumin. urinary L-FABP is a highly significant marker in diagnosing of micro-albuminuric group (AUC=0.62), (P<0.001) and macro-albuminuric group (AUC=0.80), (P<0.001).

Conclusion: Measurement of L-FABP in urine provides a suitable biomarker for the early detection of diabetic nephropathy.