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Wu MZ, Lee CH, Chen Y, Yu SY, Yu YJ, Ren QW, Fong HYC, Wong PF, Tse HF, Lam SLK, Yiu KH. Association between adipocyte fatty acid-binding protein with left ventricular remodelling and diastolic function in type 2 diabetes: a prospective echocardiography study. Cardiovasc Diabetol 2020; 19:197. [PMID: 33234149 PMCID: PMC7687743 DOI: 10.1186/s12933-020-01167-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 10/31/2020] [Indexed: 12/25/2022] Open
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.
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Affiliation(s)
- Mei-Zhen Wu
- Division of Cardiology, Department of Medicine, the University of Hong Kong Shenzhen Hospital, Shen Zhen, China.,Division of Cardiology, Department of Medicine, the University of Hong Kong, Room 1929C, Block K, Queen Mary Hospital, Hong Kong, China
| | - Chi-Ho Lee
- Division of Endocrinology, Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Yan Chen
- Department of Ultrasound, Shenzhen Hospital, Southern Medical University, Shen Zhen, China
| | - Shuk-Yin Yu
- Division of Cardiology, Department of Medicine, the University of Hong Kong, Room 1929C, Block K, Queen Mary Hospital, Hong Kong, China
| | - Yu-Juan Yu
- Division of Cardiology, Department of Medicine, the University of Hong Kong Shenzhen Hospital, Shen Zhen, China.,Division of Cardiology, Department of Medicine, the University of Hong Kong, Room 1929C, Block K, Queen Mary Hospital, Hong Kong, China
| | - Qing-Wen Ren
- Division of Cardiology, Department of Medicine, the University of Hong Kong Shenzhen Hospital, Shen Zhen, China.,Division of Cardiology, Department of Medicine, the University of Hong Kong, Room 1929C, Block K, Queen Mary Hospital, Hong Kong, China
| | - Ho-Yi Carol Fong
- Division of Endocrinology, Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Pui-Fai Wong
- Division of Cardiology, Department of Medicine, the University of Hong Kong, Room 1929C, Block K, Queen Mary Hospital, Hong Kong, China
| | - Hung-Fat Tse
- Division of Cardiology, Department of Medicine, the University of Hong Kong Shenzhen Hospital, Shen Zhen, China.,Division of Cardiology, Department of Medicine, the University of Hong Kong, Room 1929C, Block K, Queen Mary Hospital, Hong Kong, China
| | - Siu-Ling Karen Lam
- Division of Endocrinology, Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Kai-Hang Yiu
- Division of Cardiology, Department of Medicine, the University of Hong Kong Shenzhen Hospital, Shen Zhen, China. .,Division of Cardiology, Department of Medicine, the University of Hong Kong, Room 1929C, Block K, Queen Mary Hospital, Hong Kong, China.
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