OBJECTIVETo investigate the values of combination of urinary liver-type fatty acid-binding protein (L-FABP) and neutrophil gelatinase-associated lipocalin (NGAL) in early diagnosis of acute kidney injury (AKI) after cardiac surgery in children.

METHODSA total of 97 children with congenital heart disease undergoing cardiopulmonary bypass surgery were enrolled. Serum and urine samples were collected before and after surgery. Levels of serum creatinine (Scr), urinary L-FABP, and urinary NGAL from AKI group (n=18) and non-AKI group (n=79) were measured, and the postoperative dynamic changes in these markers were compared between the two groups. The receiver operating characteristic (ROC) curve and the area under ROC curve (AUC) were used to assess the values of these markers alone or in combination in the prediction of postoperative AKI.

RESULTSThe levels of urinary L-FABP and NGAL in the AKI group were significantly higher than those in the non-AKI group at 2 and 6 hours after surgery, and the changes in their concentrations were earlier than Scr. The AUCs of urinary L-FABP alone in predicting AKI at 2 and 6 hours after surgery were 0.921 and 0.896 respectively, and those of urinary NGAL alone were 0.908 and 0.928 respectively. Those of their combination were 0.942 and 0.929 respectively.

CONCLUSIONSUrinary L-FABP and NGAL significantly increase in the early stage of AKI after cardiac surgery in children, which are significantly earlier than the changes in Scr. They can be used to predict the occurrence of AKI in the early stage. A combination of the two biomarkers can further improve the accuracy of diagnosis.

Acute Kidney Injury ; diagnosis ; urine ; Cardiac Surgical Procedures ; adverse effects ; Cardiopulmonary Bypass ; Child ; Child, Preschool ; Creatinine ; blood ; Fatty Acid-Binding Proteins ; urine ; Female ; Humans ; Infant ; Lipocalin-2 ; urine ; Male

BACKGROUND: Amino-terminal pro-B type natriuretic peptide (NT-proBNP) is a well-established prognostic factor in heart failure (HF). However, numerous causes may lead to elevations in NT-proBNP, and thus, an increased NT-proBNP level alone is not sufficient to predict outcome. The aim of this study was to evaluate the utility of two acute response markers, high sensitivity C-reactive protein (hsCRP) and heart-type fatty acid binding protein (H-FABP), in patients with an increased NT-proBNP level. METHODS: The 278 patients were classified into three groups by etiology: 1) acute coronary syndrome (ACS) (n=62), 2) non-ACS cardiac disease (n=156), and 3) infectious disease (n=60). Survival was determined on day 1, 7, 14, 21, 28, 60, 90, 120, and 150 after enrollment. RESULTS: H-FABP (P<0.001), NT-proBNP (P=0.006), hsCRP (P<0.001) levels, and survival (P<0.001) were significantly different in the three disease groups. Patients were divided into three classes by using receiver operating characteristic curves for NT-proBNP, H-FABP, and hsCRP. Patients with elevated NT-proBNP (≥3,856 pg/mL) and H-FABP (≥8.8 ng/mL) levels were associated with higher hazard ratio for mortality (5.15 in NT-proBNP and 3.25 in H-FABP). Area under the receiver operating characteristic curve analysis showed H-FABP was a better predictor of 60-day mortality than NT-proBNP. CONCLUSIONS: The combined measurement of H-FABP with NT-proBNP provides a highly reliable means of short-term mortality prediction for patients hospitalized for ACS, non-ACS cardiac disease, or infectious disease.
Acute Coronary Syndrome/blood/*diagnosis/mortality ; Aged ; Area Under Curve ; Biomarkers/blood ; C-Reactive Protein/*analysis ; Fatty Acid-Binding Proteins/*blood ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Natriuretic Peptide, Brain/*blood ; Peptide Fragments/*blood ; Prognosis ; Proportional Hazards Models ; ROC Curve

It has been reported that fatty acid binding proteins (FABPs) do not act only as intracellular mediators of lipid responses but also have extracellular functions. This study aimed to investigate whether extracellular liver type (L)-FABP has a biological activity and to determined serum L-FABP levels in patients with end-stage renal disease (ESRD). We isolated L-FABP complementary deoxyribonucleic acid (cDNA) from the Huh7 human hepatocarcinoma cell line and expressed the recombinant L-FABP protein in Escherichia coli. A549 lung carcinoma and THP-1 monocytic cells were stimulated with the human recombinant L-FABP. Human whole blood cells were also treated with the human recombinant L-FABP or interleukin (IL)-1α. IL-6 levels were measured in cell culture supernatants using IL-6 enzyme-linked immunosorbent assay (ELISA). Human recombinant L-FABP induced IL-6 in a dose-dependent manner in A549, THP-1 cells, and whole blood cells. The blood samples of healthy volunteers and patients with ESRD were taken after an overnight fast. The serum levels of L-FABP in healthy volunteers and ESRD patients were quantified with L-FABP ELISA. The values of L-FABP in patients with ESRD were significantly lower than those in the control group. Our results demonstrated the biological activity of L-FABP in human cells suggesting L-FABP can be a mediator of inflammation.
Blood Cells ; Carrier Proteins* ; Cell Culture Techniques ; Cell Line ; DNA ; Enzyme-Linked Immunosorbent Assay ; Escherichia coli ; Fatty Acid-Binding Proteins ; Healthy Volunteers ; Humans ; Inflammation ; Interleukin-6* ; Interleukins ; Kidney Failure, Chronic ; Liver* ; Lung

OBJECTIVETo study the change in serum intestinal fatty acid binding protein (IFABP) in children with pneumonia and its correlation with gastrointestinal injury.

METHODSA total of 82 children with community-acquired pneumonia who were treated from January to October, 2015 were enrolled, among whom 34 had mild pneumonia and 48 had severe pneumonia. According to pediatric critical illness score (PCIS), the children with severe pneumonia were further divided into non-critical group (25 patients) and critical group (23 patients). Thirty healthy children who underwent physical examination at outpatient service were enrolled as the control group. ELISA was used to measure serum IFABP level, and the acute gastrointestinal injury (AGI) grade was determined for children with severe pneumonia. Serum IFABP level was compared between groups, and the correlations of IFABP with AGI grade and PCIS were analyzed.

RESULTSThe severe pneumonia group showed a significantly higher serum IFABP level than the control group and the mild pneumonia group (P<0.01), and the mild pneumonia group also showed a significantly higher serum IFABP level than the control group (P<0.01). The critical group showed a significantly higher serum IFABP level than the non-critical group (P<0.01). The patients with grade I-IV AGI had significantly higher serum IFABP levels than the control group (P<0.01), and the serum IFABP level increased significantly with the increasing AGI grade (P<0.01). Serum IFABP level was positively correlated with AGI grade (P<0.01) but negatively correlated with PCIS (P<0.01).

CONCLUSIONSChildren with pneumonia experience an increased serum IFABP level which can be used as a sensitive indicator for the early diagnosis of gastrointestinal injury and the evaluation of conditions in children with pneumonia.

Acute Disease ; Child, Preschool ; Community-Acquired Infections ; blood ; Fatty Acid-Binding Proteins ; blood ; Female ; Gastrointestinal Diseases ; blood ; Humans ; Male ; Pneumonia ; blood

OBJECTIVETo study the value of combined measurement of intestinal fatty acid-binding protein (I-FABP) and fecal calprotectin (FC) in the diagnosis of necrotizing enterocolitis (NEC) in full-term neonates.

METHODSA total of 36 full-term neonates with NEC (case group) and 39 neonates without digestive system diseases (control group) were enrolled as study subjects. ELISA was used to measure the serum I-FABP level and fecal FC level, and the clinical value of I-FABP combined with FC in the diagnosis of NEC was evaluated.

RESULTSThe case group had significantly higher I-FABP and FC levels than the control group (P<0.05). In the case group, serum I-FABP level was positively correlated with fecal FC level (r=0.71, P<0.05). In the diagnosis of NEC, I-FABP alone, FC alone, and I-FABP/FC combination had sensitivities of 83.3%, 81.5%, and 79.5%, specificities of 72.5%, 75.8%, and 86.3%, and areas under the ROC curve (AUCs) of 0.82, 0.81, and 0.88. The combined measurement showed significantly higher specificity and AUC than single measurement (P<0.05).

CONCLUSIONSChildren with NEC have significant increases in I-FABP and FC levels, and there is a correlation between them. Combined measurement of I-FABP and FC can increase the specificity of the diagnosis of NEC.

Enterocolitis, Necrotizing ; diagnosis ; Fatty Acid-Binding Proteins ; blood ; Feces ; chemistry ; Female ; Humans ; Infant, Newborn ; Leukocyte L1 Antigen Complex ; analysis ; Male

OBJECTIVE: To explore the eff ect of silibinin on β cells in C57BL/6J mice fed a high-fat diet and the possible mechanisms. METHODS: A total of 18 male C57BL/6J mice at 3 weeks old were divided into a normal chow group (n=6), a high-fat diet group (n=6) and a high-fat diet plus silibinin group (n=6). Aft er intervention for 10 weeks, fasting blood glucose (FBG), fasting insulin (FINS), triglycerides (TG), alanine aminotransferase (ALT), creatinine (Cr) and blood urea nitrogen (BUN), lipid metabolism, antioxidant enzyme activities and apoptosis were evaluated. Pancreatic tissues were isolated to examine insulin-induced gene-1 (Insig-1), sterol regulatory element binding protein-1c (SREBP-1c) and fatty acid synthetase (FAS) mRNA and protein expression. RESULTS: Compared with the high-fat diet group, the function of insulin secretion was improved, and the level of blood glucose was decreased in the high-fat diet plus silibinin group (P<0.05). The levels of lipid content and oxidative stress and the rates of β cell apoptosis were lower in high-fat diet plus silibinin group than those in the high-fat diet group (both P<0.05). Simultaneously, the silibinin could promote the expression of Insig-1 and depress the expression of SREBP-1c and FAS (all P<0.05). Moreover, there was no significant difference in the levels of serum ALT, Cr and BUN among the 3 groups (all P>0.05). CONCLUSION Silibinin can protect β cells of mice fed a high-fat diet, and this effect might be related to, at least partially, increase in its antioxidative ability through regulation of insig-1/SREBP-1c pathway. Moreover, silibinin is safe for long-term treatment.
Alanine Transaminase ; blood ; Animals ; Apoptosis ; Blood Glucose ; analysis ; Blood Urea Nitrogen ; Creatinine ; blood ; Diet, High-Fat ; Fatty Acid Synthases ; metabolism ; Insulin ; blood ; Insulin-Secreting Cells ; cytology ; drug effects ; Lipid Metabolism ; Lipids ; Male ; Membrane Proteins ; metabolism ; Mice ; Mice, Inbred C57BL ; Oxidative Stress ; Silybin ; Silymarin ; pharmacology ; Sterol Regulatory Element Binding Protein 1 ; metabolism ; Triglycerides ; blood

OBJECTIVETo evaluate the clinical value of intestinal fatty acid-binding protein (I-FABP) in full-term newborn infants with necrotizing enterocolitis (NEC).

METHODSForty-one full-term infants with a confirmed diagnosis of NEC from February 2012 to January 2014 were recruited as case group (stage I: 24 cases; stage II-III: 17 cases). Sixty-two children diagnosed with non-digestive diseases in the same period were recruited as the control group. Serum levels of I-FABP and C-reactive protein (CRP) were determined by enzyme-linked immunosorbent assay. The diagnostic value of I-FABP for NEC was assessed using the receiver operating characteristic (ROC) curve.

RESULTSStage I and stage II-III cases in the case group had significantly higher serum I-FABP levels than the control group (P<0.05), and stage II-III cases had significantly higher serum I-FABP levels than stage I cases (P<0.05). The area under the ROC curve for serum I-FABP was 0.85 (95% CI: 0.78-0.92), with the optimal cut-off point of 2.25 ng/mL. Under this cut-off point, the sensitivity and specificity were 80.49% and 70.19%, respectively. There was no significant difference in serum CRP level between the case and control groups (P>0.05).

CONCLUSIONSIn newborn infants with NEC, serum I-FABP level increases significantly in stage I , and it is correlated with the disease severity. Therefore, serum I-FABP can be used as a biomarker for the diagnosis of NEC.

C-Reactive Protein ; analysis ; Enterocolitis, Necrotizing ; blood ; diagnosis ; Fatty Acid-Binding Proteins ; blood ; Humans ; Infant ; ROC Curve

OBJECTIVETo study the value of the biochemical markers heart fatty acid binding protein (H-FABP), creatine kinase isoenzyme-MB (CK-MB), myocardial troponin T (cTnT) in early diagnosis of acute myocardial infarction (AMI).

METHODSSerum levels of H-FABP, CK-MB, and cTNT were detected in 95 patients with confirmed AMI at different time points following the onset in comparison with the data from 43 patients without AMI. The sensitivity and specificity of H-FABP in different phases following the onset were compared between those of CK-MB and cTnT.

RESULTSSerum H-FABP activities increased significantly within 3 h after the onset of AMI (P<0.01) and continued to increase at 3-6 h and 6-12 h (P<0.001). Serum level of CK-MB within 6 h and cTnT level within 3 h after AMI onset did not show obvious changes (P<0.05). Both the diagnostic sensitivity and specificity of H-FABP within 3 h and within 3-6 h were higher than those CK-MB and cTnT (P<0.05).

CONCLUSIONH-FABP is superior to CK-MB and cTnT in early diagnosis (within 3 h and 3-6 h following the onset) of AMI.

Acute Disease ; Biomarkers ; blood ; Creatine Kinase, MB Form ; blood ; Early Diagnosis ; Fatty Acid Binding Protein 3 ; Fatty Acid-Binding Proteins ; blood ; Humans ; Myocardial Infarction ; diagnosis ; Sensitivity and Specificity ; Troponin T ; blood

Whether supplementation of curcuminoids decreases serum adipocyte-fatty acid binding protein (A-FABP) level and whether this decrease benefits glucose control is unclear. One-hundred participants (n=50 administered curcuminoids, n=50 administered placebo) from our previous report on the effect of curcuminoids on type 2 diabetes in a 3-month intervention were assessed for levels of serum A-FABP, oxidative stress, and inflammatory biomarkers. Curcuminoids supplementation led to significant decreases in serum A-FABP, C-reactive protein (CRP), tumor necrosis factor-α, and interleukin-6 levels. Curcuminoids supplementation also significantly increased serum superoxide dismutase (SOD) activity. The change in serum A-FABP levels showed positive correlations with changes in levels of glucose, free fatty acids (FFAs), and CRP in subjects supplemented with curcuminoids. Further stepwise regression analysis showed that A-FABP was an independent predictor for levels of FFAs, SOD, and CRP. These results suggest that curcuminoids may exert anti-diabetic effects, at least in part, by reductions in serum A-FABP level. A-FABP reduction is associated with improved metabolic parameters in human type 2 diabetes.
Biomarkers ; blood ; Blood Glucose ; analysis ; Curcumin ; administration & dosage ; pharmacology ; therapeutic use ; Diabetes Mellitus, Type 2 ; blood ; complications ; drug therapy ; immunology ; Fatty Acid-Binding Proteins ; blood ; Humans ; Hypoglycemic Agents ; administration & dosage ; pharmacology ; therapeutic use ; Obesity ; blood ; complications ; drug therapy ; immunology ; Oxidative Stress ; drug effects ; immunology ; Treatment Outcome

Acute kidney injury (AKI) is closely associated with the mortality of hospitalized patients and long-term development of chronic kidney disease, especially in children. The purpose of our study was to assess the evidence of contrast-induced AKI after cardiac catheterization in children with heart disease and evaluate the clinical usefulness of candidate biomarkers in AKI. A total of 26 children undergoing cardiac catheterization due to various heart diseases were selected and urine and blood samples were taken at 0 hr, 6 hr, 24 hr, and 48 hr after cardiac catheterization. Until 48 hr after cardiac catheterization, there was no significant increase in serum creatinine level in all patients. Unlike urine kidney injury molecule-1, IL-18 and neutrophil gelatinase-associated lipocalin, urine liver-type fatty acid-binding protein (L-FABP) level showed biphasic pattern and the significant difference in the levels of urine L-FABP between 24 and 48 hr. We suggest that urine L-FABP can be one of the useful biomarkers to detect subclinical AKI developed by the contrast before cardiac surgery.
Acute Kidney Injury/blood/*chemically induced/*urine ; Biological Markers/urine ; Cardiac Catheterization/*adverse effects ; Child ; Contrast Media/adverse effects/diagnostic use ; Fatty Acid-Binding Proteins/*urine ; Female ; Heart Defects, Congenital/complications/*radiography ; Humans ; Iohexol/adverse effects/*analogs & derivatives/diagnostic use ; Male ; Radiography, Interventional/adverse effects ; Reproducibility of Results ; Sensitivity and Specificity