尿検査・腎機能検査の新しい流れ(2)

尿中肝臓型脂肪酸結合蛋白
(L-FABP)の臨床的意義

上　條　敦　子*1　菅　谷　　　健*2
樋　川　明　久*3　木　村　健二郎*4
　　　　　　　　　　　　　　　　　　　　　　
Urinary Fatty Acid Binding Protein as a New Clinical Marker
for the Progression of Chronic Renal Disease

Atsuko KAMIJO, MD*1, Takeshi SUGAYA*2,
Akihisa HIKAWA*3 and Kenjiro KIMURA, MD*4

Background
As free fatty acids are loaded into the proximal tubule during various kinds of stresses and become cytotoxic, they may play an important role in the progression of renal disease. The proximal tubular epithelial cells express liver-type fatty acid binding protein(L-FABP), an intracellular carrier protein of fatty acids. We hypothesized that urinary L-FABP reflected stresses on the proximal tubule and thus presents a new clinical marker for the progression of renal disease.
Methods
ELISA for L-FABP was established and relations between urinary L-FABP and clinical parameters from non-diabetic chronic renal disease(n＝120) were evaluated.
Results
Laboratory data revealed a correlation between urinary L-FABP and urinary protein(F＝22.7), urinary a 1-microglobulin(F＝13.9) and serum creatinine(F＝11.4). Notably only urinary L-FABP at the start of follow-up(F＝17.1) was selected as a significant clinical factor correlated with the progression rate defined as a slope of a reciprocal of serum creatinine over time. The results indicated that urinary L-FABP was correlated with the clinical prognosis of renal disease.
Conclusion
Urinary L-FABP is a new clinical marker for predicting the progression of chronic glomerular disease.
[Rinsho Byori 51 : 219〜224, 2003]

*1Internal Medicine, Nephrology and Hypertension, St. Marianna University School of Medicine, Kawasaki 216-8511

【Key Words】urinary protein(尿蛋白)，fatty acid(脂肪酸)，fatty acid binding protein(脂肪酸結合蛋白)，tubulointerstitial damage(間質尿細管障害)
　　　　　　　　　　　　　　　　　　　　　
*1,4聖マリアンナ医科大学腎臓・高血圧内科(〒216-8511 川崎市宮前区菅生2-16-1)
*2田辺製薬創薬研究所(〒335-8505 戸田市川岸2-2-50)
*3栄研化学生物化学研究所(〒329-0114 栃木県下都賀郡野木町大字野木143)

E-mail :akamijou-int@marianna-u.ac.jp