Plasma fatty acid-binding protein 4, nonesterified fatty acids, and incident diabetes in older adults

Luc Djoussé, Owais Khawaja, Traci M. Bartz, Mary L. Biggs, Joachim H. Ix, Susan J. Zieman, Jorge R. Kizer, Russell P. Tracy, David S. Siscovick, Kenneth J. Mukamal

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


OBJECTIVE - To examine the relation of fatty acid-binding protein (FABP)4 and nonesterified fatty acids (NEFAs) to diabetes in older adults. RESEARCH DESIGN AND METHODS - We ascertained incident diabetes among 3,740 Cardiovascular Health Study participants (1992-2007) based on the use of hypoglycemic medications, fasting glucose ≥126 mg/dL, or nonfasting glucose ≥200 mg/dL. FABP4 and NEFA were measured on specimens collected between 1992 and 1993. RESULTS - Mean age of the 3,740 subjects studied was 74.8 years. For each SD increase in log FABP4, hazard ratios (HRs) for diabetes were 1.35 (95% CI 1.10-1.65) for women and 1.45 (1.13-1.85) for men controlling for age, race, education, physical activity, cystatin C, alcohol intake, smoking, self-reported health status, and estrogen use for women (P for sex-FABP4 interaction 0.10). BMI modified the FABP4-diabetes relation (P = 0.009 overall; 0.02 for women and 0.135 for men), in that statistically significant higher risk of diabetes was mainly seen inmen with BMI <25 kg/m2 (HR per SD: 1.78 [95% CI 1.13-2.81]). There was a modest and non-significant association of NEFA with diabetes (Ptrend = 0.21). However, when restricted to the first 5 years of follow-up, multivariable-adjusted HRs for diabetes were 1.0 (ref.), 1.68 (95% CI 1.12-2.53), and 1.63 (1.07-2.50) across consecutive tertiles of NEFA (Ptrend = 0.03). CONCLUSIONS - Plasma FABP4 was positively associated with incident diabetes in older adults, and such association was statistically significant in lean men only. A significant positive association between plasma NEFA and incident diabetes was observed during the first 5 years of follow-up.

Original languageEnglish (US)
Pages (from-to)1701-1707
Number of pages7
JournalDiabetes care
Issue number8
StatePublished - Aug 2012
Externally publishedYes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing


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