FABP4 predicts atherogenic dyslipidemia development. The PREDIMED study.

OBJECTIVE Atherogenic dyslipidemia (AD), characterized by high plasma triglycerides and low HDL particles, is considered one of the main effectors of vascular damage associated with obesity, metabolic syndrome (MS) and type 2 diabetes. Adipocyte fatty acid-binding protein (FABP4) plasma concentrations have been linked to metabolic alterations that are associated with adiposity. The aim of the present study was to prospectively analyze the predictive value of baseline FABP4 plasma concentrations for the development of AD. METHODS In the frame of the PREDIMED study, a multicenter dietary interventional trial, we prospectively measured the baseline plasma FABP4 levels and AD incidence over a six-year follow-up period (median 4 [IQR, 3-5 years]) in 578 volunteers who visited their general practitioners because of their cardiovascular risk factors. RESULTS During follow-up, 103 participants developed AD. Baseline plasma FABP4 levels were associated with new onset AD over the follow-up period (OR 1.03 [95% IC: 1.00-1.05], p=0.020). This increased risk was observed in women but not in men. Among women, those in the highest tertile of FABP4 had a 2.54-fold increased relative risk of developing AD compared to the lowest tertile (HR 2.54 [95% CI, 1.31-4.93], p for trend=0.008). CONCLUSIONS Elevated plasma FABP4 concentrations should be considered as a potential marker of metabolic derangement, which may predict the development of AD in women.