الفهرس 
T YPE 1 D IABETES M ELLITUSOnly 14 pages are availabe for public view
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Abstract
ABSTRACT
Background: Diabetic nephropathy is a major cause of morbidity and mortality among young patients with type 1 diabetes mellitus (T1DM). Fatty acid binding proteins (FABP) are a family of lipid chaperone proteins that transport fatty acids and other lipophilic substances. There is increasing evidence that FABP1 and FABP2 play a role in the development and progression of chronic kidney disease including type 2 diabetes mellitus (T2DM). However, to our knowledge, these biomarkers have not been studied in patients with T1DM. Aim: We assessed serum FABP1 and FABP2 levels in children and adolescents with T1DM as potential markers for diabetic nephropathy and their relation to urinary albumin excretion, glomerular filtration rate (GFR), glycemic control and carotid intima media thickness (CIMT). Methods: Sixty patients with T1DM were divided into 2 groups according to the presence of nephropathy (microalbuminuria) and compared with 30 healthy controls. Fasting blood glucose (FBG), hemoglobin A1c (HbA1c), urinary albumin creatinine ratio (UACR), fasting lipid profile and serum FABP1 and FABP2 levels as well as CIMT were assessed. Results: FABP1 and FABP2 levels were significantly higher among type 1 diabetic patient with and without nephropathy compared with healthy controls with the highest levels among patients with nephropathy (p<0.001). CIMT was significantly higher in patients with nephropathy compared with those without (p<0.001). There were significant positive correlations between FABP1 and FABP2 and each of systolic blood pressure, CIMT, FBG, HbA1c as well as total cholesterol among type 1 diabetic patients. FABP1 was negatively correlated to estimated GFR. Both FABP1 and FABP2 were positively correlated. Multivariable linear regression analysis showed that systolic blood pressure, CIMT, FBG and HbA1c were the significant independent variables related to FABP1 levels in type 1 diabetic patients with nephropathy. ROC curve analysis revealed that the cutoff value of FABP1 at 460 ng/mL could differentiate patients with and without nephropathy with a sensitivity of 83.3% and specificity of 76.7%. Moreover, the cutoff value of FABP2 at 40 ng/mL could differentiate patients with and without nephropathy with a sensitivity of 80% and specificity of 66.7%. Conclusion: FABP1 and FABP2 levels are elevated in children and adolescents with type 1 diabetes and may be considered as early serum biomarkers for nephropathy among those patients. FABP1 and FABP2 could represent a link between diabetic nephropathy and subclinical atherosclerosis in type 1 diabetes.