TY - JOUR
T1 - Urinary fatty acid and retinol binding protein-4 predict CKD progression in severe NAFLD patients with hypertension
T2 - 4-year study with clinical and experimental approaches
AU - Tsai, Yu Lien
AU - Liu, Chih Wei
AU - Huang, Shiang Fen
AU - Yang, Ying Ying
AU - Lin, Ming Wei
AU - Huang, Chia Chang
AU - Li, Tzu Hao
AU - Huang, Yi Hsiang
AU - Hou, Ming Chih
AU - Lin, Han Chieh
N1 - Publisher Copyright:
© 2020 the Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Detection of the chronic kidney disease (CKD) progression can begin early intervention to improve the prognosis of severe non-alcoholic fatty liver disease (NAFLD). This bi-directional cross-sectional study evaluates the roles of fatty acid-binding protein (FABP) and retinol binding protein (RBP4), which are produced from inflamed liver, adipose tissue and immune cells, for the prediction of CKD progression in severe NAFLD. Ninety severe NAFLD patients with hypertension and proteinuria (NAFLD+HTN+) were enrolled and divided into CKD (n = 39) and non-CKD groups (n = 51). Among 39 NAFLD+HTN+ patients, 18 cases were categorized as CKD progression group. In comparison with CKD stable group (n = 21), the positive correlation between fold change values of hepatic fibrotic score (KPa), urinary FABP4 or urinary RBP4 versus severity of albuminuria were noted among CKD progression group. On multivariate analysis, high body mass index (BMI, >25 kg/m2), high hepatic fibrosis score (>9.5 KPa), high urinary level of vascular cell adhesion molecule-1 (VCAM-1, >2239 μg/g cr), high urinary level of FABP4 (>115 ng/g cr) and high urinary level of RBP4 (>33.5 mg/g cr) are 5 independent predictors for progressive CKD during 24 months of follow-up. Synergetic effect was noted among these 5 risk factors for the prediction of CKD progression in NAFLD+HTN+ patients. The in vitro experiments revealed that both FABP4 and RBP4 directly enhanced albumin-induced ER stress and apoptosis of human renal tubular epithelial cell line HK-2 cells and human podocytes cell lines. Through clinical and experimental approaches, this study revealed new 5 synergetic predictors including high BMI, hepatic fibrosis score, urinary level of VCAM-1, urinary level of FABP4 and RBP4, for the CKD progression in severe NAFLD patients with hypertension and proteinuria.
AB - Detection of the chronic kidney disease (CKD) progression can begin early intervention to improve the prognosis of severe non-alcoholic fatty liver disease (NAFLD). This bi-directional cross-sectional study evaluates the roles of fatty acid-binding protein (FABP) and retinol binding protein (RBP4), which are produced from inflamed liver, adipose tissue and immune cells, for the prediction of CKD progression in severe NAFLD. Ninety severe NAFLD patients with hypertension and proteinuria (NAFLD+HTN+) were enrolled and divided into CKD (n = 39) and non-CKD groups (n = 51). Among 39 NAFLD+HTN+ patients, 18 cases were categorized as CKD progression group. In comparison with CKD stable group (n = 21), the positive correlation between fold change values of hepatic fibrotic score (KPa), urinary FABP4 or urinary RBP4 versus severity of albuminuria were noted among CKD progression group. On multivariate analysis, high body mass index (BMI, >25 kg/m2), high hepatic fibrosis score (>9.5 KPa), high urinary level of vascular cell adhesion molecule-1 (VCAM-1, >2239 μg/g cr), high urinary level of FABP4 (>115 ng/g cr) and high urinary level of RBP4 (>33.5 mg/g cr) are 5 independent predictors for progressive CKD during 24 months of follow-up. Synergetic effect was noted among these 5 risk factors for the prediction of CKD progression in NAFLD+HTN+ patients. The in vitro experiments revealed that both FABP4 and RBP4 directly enhanced albumin-induced ER stress and apoptosis of human renal tubular epithelial cell line HK-2 cells and human podocytes cell lines. Through clinical and experimental approaches, this study revealed new 5 synergetic predictors including high BMI, hepatic fibrosis score, urinary level of VCAM-1, urinary level of FABP4 and RBP4, for the CKD progression in severe NAFLD patients with hypertension and proteinuria.
KW - albuminuria
KW - chronic kidney disease
KW - fatty acid-binding protein
KW - non-alcoholic fatty liver disease
KW - retinol binding protein
UR - http://www.scopus.com/inward/record.url?scp=85077755917&partnerID=8YFLogxK
U2 - 10.1097/MD.0000000000018626
DO - 10.1097/MD.0000000000018626
M3 - Article
C2 - 31914044
AN - SCOPUS:85077755917
SN - 0025-7974
VL - 99
JO - Medicine (United States)
JF - Medicine (United States)
IS - 2
M1 - e18626
ER -