1. Division of Endocrinology and Metabolism, E-Da Hospital, Kaohsiung, 82445 Taiwan
2. Division of Cardiology, E-Da Hospital, Kaohsiung, 82445 Taiwan
3. Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, 82445 Taiwan
4. Department of Obstetrics & Gynecology, E-Da Hospital, Kaohsiung, 82445 Taiwan
5. Departmen of Emergency, E-Da Hospital, Kaohsiung, 82445 Taiwan
6. Division of General Surgery, Department of Surgery, E-Da Hospital, Kaohsiung, 82445 Taiwan
7. Lee's Endocrinology Clinic, Pingtung, 90000 Taiwan
8. School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 82445 Taiwan
9. The School of Chinese Medicine for Post Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, 82445 Taiwan
10. Division of Cardiology, Department of Internal Medicine, E-Da Cancer Hospital, Kaohsiung 82445 Taiwan
11. Department of Obstetrics & Gynecology, E-Da Dachang Hospital, Kaohsiung 80794 Taiwan
12. Health Examination Center, E-Da Dachang Hospital, Kaohsiung, Taiwan
#These authors contributed equally to this work.
Background: Fatty acid-binding protein 1 (FABP1) (also known as liver-type fatty acid-binding protein or LFABP) is a protein that is mainly expressed in the liver, and is associated with hepatocyte injury in acute transplant rejection. Reduced levels of FABP1 in mice livers have been shown to be effective against nonalcoholic fatty liver disease (NAFLD). In this study, we investigated the association between plasma FABP1 levels and NAFLD in patients with type 2 diabetes mellitus (T2DM).
Methods: We enrolled 267 T2DM patients. Clinical and biochemical parameters were measured. The severity of NAFLD was assessed by ultrasound. FABP1 levels were determined using by enzyme-linked immunosorbent assays.
Results: FABP1 levels were higher in patients with overt NAFLD, defined as more than a moderate degree of fatty liver compared to those without NAFLD. Age- and sex-adjusted analysis of FABP1 showed positive associations with body mass index (BMI), waist circumference, homeostasis model assessment estimate of β-cell function, creatinine, and fatty liver index, but showed negative associations with albumin and estimated glomerular filtration rate (eGFR). The odds ratio (OR) for the risk of overt NAFLD with increasing levels of sex-specific FABP1 was significantly increased (OR 2.63 [95% CI 1.30-5.73] vs. 4.94 [2.25-11.48]). The OR in the second and third tertiles of FABP1 remained significant after adjustments for BMI, triglycerides, high-density lipoprotein cholesterol, HbA1C, homeostasis model assessment estimate of insulin resistance, white blood cell count, hepatic enzymes, and eGFR.
Conclusion: Our results indicate that FABP1 may play a role in the pathogenesis of NAFLD in patients with T2DM.
Keywords: Fatty acid-binding protein 1, nonalcoholic fatty liver disease, type 2 diabetes mellitus