Association between adipocyte fatty acid-binding protein with left ventricular remodelling and diastolic function in type 2 diabetes: a prospective echocardiography study

Abstract

Background The relationship between adipocyte fatty acid-binding protein (AFABP) and cardiac remodelling has been reported in cross-sectional studies, although with conflicting results. Type 2 diabetes mellitus (T2DM) is associated with left ventricular (LV) hypertrophy and diastolic dysfunction, as well as elevated circulating AFABP levels. Here we investigated prospectively the association between AFABP with the longitudinal changes of cardiac remodelling and diastolic dysfunction in T2DM. Methods Circulating AFABP levels were measured in 176 T2DM patients without cardiovascular diseases (CVD) at baseline. All participants received detailed transthoracic echocardiography both at baseline and after 1 year. Multivariable linear and Cox regression analyses were used to evaluate the associations of circulating AFABP levels with changes in echocardiography parameters and incident major adverse cardiovascular events (MACE), respectively. Results The median duration between baseline and follow-up echocardiography assessments was 28 months. Higher sex-specific AFABP quartiles at baseline were associated with increase in LV mass and worsening of average E/e′ (all P < 0.01). Multivariable linear regression demonstrated that AFABP in the highest quartile was independently associated with both increase in LV mass (β = 0.89, P < 0.01) and worsening of average E/e′ (β = 0.57, P < 0.05). Moreover, multivariable Cox regression analysis showed that elevated baseline circulating AFABP level independently predicted incident MACE (HR 2.65, 95% CI 1.16–6.05, P < 0.05) after adjustments for age, sex, body mass index, glycated haemoglobin, hypertension, dyslipidemia and presence of chronic kidney disease. Conclusion Circulating AFABP level at baseline predicted the development of LV hypertrophy, diastolic dysfunction and MACE in T2DM patients without CVD.

Sex-specific differences in left ventricular mass and myocardial energetic efficiency in non-diabetic, pre-diabetic and newly diagnosed type 2 diabetic subjects

“…Indeed, it has been reported that myocardial volume increased with higher age and BSA, with an additional gender dependency both gender and body surface area were associated with left ventricle volumes, and myocardial volume [ 45 ]. Moreover, it has been shown that increased levels of adipocyte fatty acid-binding protein (AFABP), a lipid chaperone protein linked to obesity, is associated with a significant longitudinal increase in left ventricular mass, and is an independent predictor of incident major adverse cardiovascular events in patients with T2DM [ 46 ].…”

Prospective associations of circulating thrombospondin-2 level with heart failure hospitalization, left ventricular remodeling and diastolic function in type 2 diabetes

“…In Part 2, all participants were recruited from the Chinese Diabetic Heart Study (CDHS), which consisted of Chinese patients who had type 2 diabetes but without CVD or severe structural heart disease and were regularly followed up in the medical specialist clinics of Queen Mary Hospital, Hong Kong between July 2011 and August 2014 [ 21 , 22 ]. All CDHS participants received blood tests and transthoracic echocardiography (ECHO) at baseline to investigate the cardiovascular manifestations and underlying pathophysiology of Chinese patients with type 2 diabetes.…”

Prospective association of serum adipocyte fatty acid‐binding protein with heart failure hospitalization in diabetes

“…30 Indeed, a recent prospective ECHO study in patients with type 2 diabetes demonstrated that circulating AFABP level was associated not only with left ventricular remodelling and diastolic dysfunction at baseline but also with the longitudinal increase in left ventricular mass, E/e' ratio, and the development of major adverse cardiovascular events. 31 Therefore, in contrast to our cohort with exclusively individuals with type 2 diabetes, variations in the percentage of patients having type 2 diabetes in the study populations in previous studies could have led to their observed differences in the association between circulating AFABP level and LV remodelling. Moreover, our findings have extended the understanding of the prospective associations between circulating AFABP level and HF hospitalization, reported previously in the Cardiovascular Health Study.…”