Objective To investigate the value of serum Fetuin-A and fatty acid binding protein 4 (FABP4) in the prediction of nephropathy risk in patients with type 2 diabetes mellitus. Methods A total of 107 patients with type 2 diabetes mellitus admitted to Xi'an Trade Union Hospital from August 2021 to July 2023 were selected, including 55 males and 52 females who were (61.69±9.05) years old; they were divided into a normal albuminuria group (48 cases), a microalbuminuria group (39 cases), and a macroalbuminuria group (20 cases) according to their urinary albuminuria/creatinine ratios. Fifty healthy examinees were selected as a healthy control group, including 26 males and 24 females who were (60.87±8.24) years old. The basic data and levels of FABP4, Fetuin-A, C-reactive protein (CRP), adiponectin, and blood lipids and glucose related indicators were compared. Analysis of variance, LSD-t test, and χ2 test were applied. Results The body mass indexes (BMI) of the normal albuminuria group, the microalbuminuria group, and the macroalbuminuria group were (24.35±3.04) kg/m2, (25.06±3.12) kg/m2, and (24.88±2.83) kg/m2, which were higher than that in the healthy control group [(22.48±2.83) kg/m2] (all P<0.05) . The levels of FABP4, Fetuin-A, and CRP of the normal albuminuria group, the microalbuminuria group, and the macroalbuminuria group were (7.92±1.76) μg/L, (8.46±1.98) μg/L, and (9.23±2.05) μg/L, (330.67±44.32) mg/L, (385.38±49.15) mg/L, and (413.10±56.28) mg/L, and (4.77±1.34) mg/L, (5.83±1.96) mg/L, and (6.59±2.17) mg/L, respectively, which were higher than those in the healthy control group [(6.77±1.32) μg/L, (224.56±31.93) mg/L, and (2.36±1.11) mg/L] (all P<0.05) ; the levels of adiponectin of the normal albuminuria group, the microalbuminuria group, and the macroalbuminuria group were (7.56±2.31) mg/L, (5.21±2.09) mg/L, and (4.33±1.95) mg/L, respectively, which were lower than that in the healthy control group [(11.12±2.43) mg/L] (all P<0.05) . The levels of fasting blood glucose (FBG), glycosylated hemoglobin, type A1C (HbA1c), low density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triacylglycerol (TG) of the normal albuminuria group, the microalbuminuria group, and the macroalbuminuria group were (8.23±2.79) mmol/L, (8.48±3.18) mmol/L, and (8.51±3.26) mmol/L, (8.79±1.35)%, (8.96±1.47)%, and (9.04±1.52)%, (3.35±0.71) mmol/L, (3.26±0.72) mmol/L, and (3.51±0.77) mmol/L, (5.15±0.97) mmol/L, (5.08±0.95) mmol/L, and (5.18±0.97) mmol/L, and (1.69±0.73) mmol/L, (1.82±0.85) mmol/L, and (1.84±0.79) mmol/L, respectively, which were higher than those in the healthy control group [(4.52±0.67) mmol/L, (5.18±1.03)%, (2.28±0.57) mmol/L, (4.52±0.85) mmol/L, and (1.24±0.42) mmol/L] (P<0.001, P<0.001, P<0.001, P=0.003, and P<0.001) ; the levels of high density lipoprotein cholesterol (HDL-C) of the normal albuminuria group, the microalbuminuria group, and the macroalbuminuria group were (1.12±0.47) mmol/L, (1.15±0.50) mmol/L, and (1.17±0.48) mmol/L, respectively, which were lower than that in the healthy control group [(1.36±0.28) mmol/L] (P=0.030) . There was no statistical difference in 2 h postprandial blood glucose between the normal albuminuria group, the microalbuminuria group, and the macroalbuminuria group (P>0.05). The nephropathy risk in the patients increased with the serum levels of Fetuin-A and FABP4 (both P<0.001). The area under the curve (AUC) of Fetuin-A combined with FABP4 in the prediction of nephropathy in the patients was 0.873 (95%CI 0.782-0.963, P<0.001); the sensitivity was 85.17%; specificity was 84.44%. Conclusion Serum Fetuin-A combined with FABP4 has high specificity and sensitivity in predicting the nephropathy risk in patients with type 2 diabetes mellitus, and has certain predictive value.
