Dataset Information

Associations between High Serum Adipocyte Fatty Acid Binding Protein and First Hospitalization in Kidney Transplantation Patients: A 5-Year Follow-up Study.

ABSTRACT: Adipocyte fatty acid binding protein (A-FABP) is predictive of type 2 diabetes mellitus incidences and metabolic syndrome and is independently associated with atherosclerosis. The present study aimed to assess the association between serum A-FABP levels and future first hospitalization events in kidney transplantation (KT). We enrolled 72 KT patients from January through April 2012 and followed up on these subjects until June 2017. The first hospitalization events incidence was the primary endpoint. Using a commercially available enzyme immunoassay, serum A-FABP levels were measured from the patient's fasting blood samples. During a median 65-month follow-up, 49 first hospitalization events occurred. KT patients with first hospitalization events had greater incidences of hypertension, diabetes, and higher serum blood urea nitrogen, creatinine, triglyceride, and A-FABP levels than those without the events. Kaplan-Meier analysis showed that the cumulative incidence of first hospitalization events was greater in the high A-FABP group than in the low A-FABP group. Multivariate Cox analysis with significant variables showed that serum A-FABP (hazard ratio = 1.012; 95% confidence interval = 1.000-1.025; p = 0.044) was independently associated with first hospitalization events among KT patients. The results revealed that serum A-FABP is associated with first hospitalization events in KT patients. However, further prospective studies are needed to determine the mechanisms underlying this association.

SUBMITTER: Lee WC

PROVIDER: S-EPMC7589115 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Associations between High Serum Adipocyte Fatty Acid Binding Protein and First Hospitalization in Kidney Transplantation Patients: A 5-Year Follow-up Study.

Lee Wei-Chen WC Lee Ming-Che MC Chen Ming-Chun MC Hsu Bang-Gee BG

International journal of environmental research and public health 20201018 20

Adipocyte fatty acid binding protein (A-FABP) is predictive of type 2 diabetes mellitus incidences and metabolic syndrome and is independently associated with atherosclerosis. The present study aimed to assess the association between serum A-FABP levels and future first hospitalization events in kidney transplantation (KT). We enrolled 72 KT patients from January through April 2012 and followed up on these subjects until June 2017. The first hospitalization events incidence was the primary endpo ...[more]

PMID: 33080960

Similar Datasets

Project description:AimsAdipocyte fatty acid-binding protein (AFABP) is associated with cardiovascular diseases in type 2 diabetes. Whether circulating AFABP levels are associated with the risk of heart failure (HF) in type 2 diabetes remains undefined. We investigated the prospective association of circulating AFABP levels with incident HF hospitalization in type 2 diabetes, and its relationship to the use of sodium glucose co-transporter 2 inhibitors (SGLT2i) which reduce HF risk.Methods and resultsBaseline serum AFABP level was measured in 3322 Chinese participants without known history of cardiovascular diseases or hospitalization for HF, recruited from the Hong Kong West Diabetes Registry. Its association with incident HF hospitalization was evaluated using multivariable Cox regression analysis. Use of SGLT2i was included as a time-dependent covariate. Among these 3322 participants (52.9% men; mean age 60.0 ± 12.6), 176 (5.3%) developed HF hospitalization over a median follow-up of 8 years. Seven hundred and thirty-one (22%) were started on SGLT2i during the study period (empagliflozin 55.1%, dapagliflozin 44.2%, canagliflozin 0.4%, and ertugliflozin 0.3%). Serum AFABP levels were significantly higher in participants who developed HF hospitalization than those who did not (men: 14.8 vs. 8.3 ng/mL; women: 21.5 vs. 14.6 ng/mL; all: 18.6 vs. 10.9 ng/mL, P < 0.001). In multivariable Cox regression analysis, baseline serum AFABP level was significantly associated with incident HF hospitalization [hazard ratio (HR) 1.38, 95% confidence interval (CI) 1.06-1.80, P = 0.019] independent of the use of SGLT2i, in a model also consisting of age; sex; body mass index; smoking status; duration of diabetes; hypertension, dyslipidaemia; atrial fibrillation; presence of chronic kidney disease and albuminuria; glycated haemoglobin and high-sensitivity C-reactive protein levels; and use of metformin, insulin, aspirin, furosemide, and beta-blockers at baseline. High cumulative defined daily dose (cDDD) of SGLT2i was protective of incident HF hospitalization (HR 0.10, 95% CI 0.01-0.68, P = 0.019). The addition of circulating AFABP level to a clinical model of conventional HF risk factors provided significant improvement in the category-free net reclassification index (11.5%, 95% CI 1.6-22.1, P = 0.02) and integrated discrimination improvement (0.3%, 95% CI 0.1-1.7, P = 0.04). A dose-dependent reduction in cumulative incidence of HF hospitalization in response to SGLT2i, based on cDDD, was more clearly observed in participants with a higher baseline AFABP level above the sex-specific median (P for trend <0.01).ConclusionsCirculating AFABP level is independently associated with incident HF hospitalization in type 2 diabetes and is potentially helpful in risk stratification for the prevention of HF hospitalization.

Project description:There have been few prospective controlled studies of kidney donors. Understanding the pathophysiologic effects of kidney donation is important for judging donor safety and improving our understanding of the consequences of reduced kidney function in chronic kidney disease.Prospective, controlled, observational cohort study.3-year follow-up of kidney donors and paired controls suitable for donation at their donor's center.Kidney donation.Medical history, vital signs, glomerular filtration rate, and other measurements at 6, 12, 24, and 36 months after donation.At 36 months, 182 of 203 (89.7%) original donors and 173 of 201 (86.1%) original controls continue to participate in follow-up visits. The linear slope of the glomerular filtration rate measured by plasma iohexol clearance declined 0.36±7.55mL/min per year in 194 controls, but increased 1.47±5.02mL/min per year in 198 donors (P=0.005) between 6 and 36 months. Blood pressure was not different between donors and controls at any visit, and at 36 months, all 24-hour ambulatory blood pressure parameters were similar in 126 controls and 135 donors (mean systolic blood pressure, 120.0±11.2 [SD] vs 120.7±9.7mmHg [P=0.6]; mean diastolic blood pressure, 73.4±7.0 vs 74.5±6.5mmHg [P=0.2]). Mean arterial pressure nocturnal dipping was manifest in 11.2% ± 6.6% of controls and 11.3% ± 6.1% of donors (P=0.9). Urinary protein-creatinine and albumin-creatinine ratios were not increased in donors compared with controls. From 6 to 36 months postdonation, serum parathyroid hormone, uric acid, homocysteine, and potassium levels were higher, whereas hemoglobin levels were lower, in donors compared with controls.Possible bias resulting from an inability to select controls screened to be as healthy as donors, short follow-up duration, and dropouts.Kidney donors manifest several of the findings of mild chronic kidney disease. However, at 36 months after donation, kidney function continues to improve in donors, whereas controls have expected age-related declines in function.

Project description:Background and objectivesSurvivors of AKI are at higher risk of CKD and death, but few patients see a nephrologist after hospital discharge. Our objectives during this 2-year vanguard phase trial were to determine the feasibility of randomizing survivors of AKI to early follow-up with a nephrologist or usual care, and to collect data on care processes and outcomes.Design, setting, participants, & measurementsWe performed a randomized controlled trial in patients hospitalized with Kidney Disease Improving Global Outcomes (KDIGO) stage 2-3 AKI at four hospitals in Toronto, Canada. We randomized patients to early nephrologist follow-up (standardized basket of care that emphasized BP control, cardiovascular risk reduction, and medication safety) or usual care from July 2015 to June 2017. Feasibility outcomes included the proportion of eligible patients enrolled, seen by a nephrologist, and followed to 1 year. The primary clinical outcome was a major adverse kidney event at 1 year, defined as death, maintenance dialysis, or incident/progressive CKD.ResultsWe screened 3687 participants from July 2015 to June 2017, of whom 269 were eligible. We randomized 71 (26%) patients (34 to nephrology follow-up and 37 to usual care). The primary reason stated for declining enrollment included hospitalization-related fatigue (n=65), reluctance to add more doctors to the health care team (n=59), and long travel times (n=40). Nephrologist visits occurred in 24 of 34 (71%) intervention participants, compared with three of 37 (8%) participants randomized to usual care. The primary clinical outcome occurred in 15 of 34 (44%) patients in the nephrologist follow-up arm, and 16 of 37 (43%) patients in the usual care arm (relative risk, 1.02; 95% confidence interval, 0.60 to 1.73).ConclusionsMajor adverse kidney events are common in AKI survivors, but we found the in-person model of follow-up posed a variety of barriers that was not acceptable to many patients.Clinical trial registry name and registration numberNephrologist Follow-up versus Usual Care after an Acute Kidney Injury Hospitalization (FUSION), NCT02483039 CJASN 16: 1005-1014, 2021. doi: https://doi.org/10.2215/CJN.17331120.

Dataset Information

Associations between High Serum Adipocyte Fatty Acid Binding Protein and First Hospitalization in Kidney Transplantation Patients: A 5-Year Follow-up Study.

Publications

Associations between High Serum Adipocyte Fatty Acid Binding Protein and First Hospitalization in Kidney Transplantation Patients: A 5-Year Follow-up Study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets