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24-05-2012 | Internal medicine | Article

Fat-binding protein linked to diabetes risk


Free abstract

MedWire News: A protein secreted by adipose tissue is positively associated with the risk for diabetes, research shows.

Having high levels of plasma fatty acid-binding protein 4 (FABP4), a carrier protein for fatty acids and other lipophilic substances between the extracellular and intracellular membranes, was found to be associated with an increased risk for developing diabetes in older men, although it was modified by body mass index (BMI).

As a result, the association with diabetes risk was observed in lean men only, report Luc Djoussé (Harvard Medical School, Boston, Maryland, USA) and colleagues in Diabetes Care.

The study included 3740 men and women, aged 65 years or older, who participated in the Cardiovascular Health Study. The mean plasma FABP4 level was 29.5 ng/mL, with higher concentrations observed in women. Nonesterified fatty acid (NEFA) concentrations were also measured, with the median plasma level 0.46 mEq/L.

During a mean follow up of 9.5 years, 305 cases of diabetes occurred. For each standard deviation (SD) increase in FABP4, there was a 39% higher risk for diabetes in the overall population (hazard ratio=1.39), with the increased risk observed in both men and women.

As noted, there was a significant interaction between BMI and the FABP4-diabetes relationship, such that the increased risk was mainly seen in individuals with lower BMI (<25 kg/m2), with a 1.78-fold increased hazard per SD increase in FABP-4.

In terms of the underlying mechanism, Djoussé and colleagues explain that as a "lipid chaperone," FABP4 might play a mediating role in the obesity-diabetes connection. Previous studies have linked FABP4 with a higher risk for stroke, mortality, and metabolic syndrome, they note.

There was also a nonsignificant trend towards an increased risk for diabetes with each SD increase in NEFA concentrations. In an analysis with shorter follow up, each SD increase was associated with a 15% higher risk for incident diabetes in the first 5 years. BMI did not alter the association.

By MedWire Reporters

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