2023年 新着論文 62 糖尿病診療分野から論文が発表されました

Cross-Sectional and Longitudinal Associations between Skin Autofluorescence and Tubular Injury Defined by Urinary Excretion of Liver-Type Fatty Acid-Binding Protein in People with Type 2 Diabetes

Biomedicines. 2023 Nov 10;11(11):3020. doi: 10.3390/biomedicines11113020.

Authors

Hiroki Yamagami  1   2 Tomoyo Hara  1 Saya Yasui  2 Minae Hosoki  2 Taiki Hori  1   2 Yousuke Kaneko  2 Yukari Mitsui  1 Kiyoe Kurahashi  3 Takeshi Harada  1 Sumiko Yoshida  1 Shingen Nakamura  4 Toshiki Otoda  4 Tomoyuki Yuasa  4 Akio Kuroda  5 Itsuro Endo  6 Munehide Matsuhisa  5 Masahiro Abe  7 Ken-Ichi Aihara  2   4

Affiliations

  • 1 Department of Hematology, Endocrinology and Metabolism, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan.
  • 2 Department of Internal Medicine, Anan Medical Center, 6-1 Kawahara Takarada-cho, Tokushima 774-0045, Japan.
  • 3 Department of Community Medicine for Respirology, Hematology and Metabolism, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan.
  • 4 Department of Community Medicine and Medical Science, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan.
  • 5 Diabetes Therapeutics and Research Center, Institute of Advanced Medical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan.
  • 6 Department of Bioregulatory Sciences, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan.
  • 7 Department of Hematology, Kawashima Hospital, 6-1 Kitasakoichiban-cho, Tokushima 770-8548, Japan.

Abstract

It has previously been unclear whether the accumulation of advanced glycation end products, which can be measured using skin autofluorescence (SAF), has a significant role in diabetic kidney disease (DKD), including glomerular injury and tubular injury. This study was therefore carried out to determine whether SAF correlates with the progression of DKD in people with type 2 diabetes (T2D). In 350 Japanese people with T2D, SAF values were measured using an AGE Reader®, and both urine albumin-to-creatinine ratio (uACR), as a biomarker of glomerular injury, and urine liver-type fatty acid-binding protein (uLFABP)-to-creatinine ratio (uL-FABPCR), as a biomarker of tubular injury, were estimated as indices of the severity of DKD. Significant associations of SAF with uACR (p < 0.01), log-transformed uACR (p < 0.001), uL-FABPCR (p < 0.001), and log-transformed uL-FABPCR (p < 0.001) were found through a simple linear regression analysis. Although SAF was positively associated with increasing uL-FABPCR (p < 0.05) and increasing log-transformed uL-FABPCR (p < 0.05), SAF had no association with increasing uACR or log-transformed uACR after adjusting for clinical confounding factors. In addition, the annual change in SAF showed a significant positive correlation with annual change in uL-FABPCR regardless of confounding factors (p = 0.026). In conclusion, SAF is positively correlated with uL-FABP but not with uACR in people with T2D. Thus, there is a possibility that SAF can serve as a novel predictor for the development of diabetic tubular injury.

Keywords: L-FABP; albuminuria; diabetic kidney disease; skin autofluorescence; tubular injury; type 2 diabetes.