A BSTRACT Objectives: Adipocyte fatty acid-binding protein (A-FABP) has been implicated in atherosclerosis, and endothelial dysfunction is a critical contributor to cardiovascular outcomes in chronic kidney disease (CKD). This study evaluated links between serum A-FABP and endothelial function among patients with CKD who were not on dialysis. Materials and Methods: Fasting serum from 151 adults with CKD not on dialysis was analyzed for A-FABP using enzyme immunoassay. Endothelial function was measured noninvasively through digital thermal monitoring (DTM), yielding vascular reactivity index (VRI) scores categorized as poor (<1.0), intermediate (1.0–1.99), or good (≥2.0) vascular reactivity. Results: Vascular reactivity categorized by DTM-derived VRI was poor in 17.9% ( n = 27), intermediate in 30.5% (n = 46), and good in 51.6% ( n = 78). Poor reactivity correlated with older age (P = 0.013), higher blood urea nitrogen ( P = 0.007), creatinine ( P = 0.009), urinary protein-to-creatinine ratio, P = 0.010, higher serum A-FABP ( P < 0.001), and lower estimated glomerular filtration rate, P = 0.007. In adjusted multivariable linear models, age ( P = 0.044), log-transformed (log-glucose, P = 0.045), and serum A-FABP ( P < 0.001) were negatively associated with VRI. Conclusion: Higher serum A-FABP independently correlated with reduced VRI, consistent with a potential modulatory role and supporting its use as a biomarker of endothelial dysfunction in nondialysis CKD patients.
Lun et al. (2026) studied this question.