Unmasking silent atherosclerosis in type 2 diabetes: the emerging role of adipocyte fatty acid-binding protein

Q: What are the key findings of this study?

In patients with type 2 diabetes, circulating adipocyte fatty acid-binding protein (AFABP) was the only independent factor significantly associated with increased maximum carotid intima-media thickness (β=0.004).

Q: What is the clinical evidence from this study?

Study design: Case-Control. Population: Type 2 Diabetes Mellitus (n=80). Intervention: Adipocyte fatty acid-binding protein (AFABP) levels vs. Healthy controls / low AFABP levels. Primary outcome: Association of AFABP with maximum carotid intima-media thickness (CIMT) (β=0.004, 95% CI 0.001-0.007, p=0.017).

Q: What does this research mean for the field?

Circulating adipocyte fatty acid-binding protein (AFABP) is an independent predictor of subclinical atherosclerosis, as measured by carotid intima-media thickness, in individuals with type 2 diabetes mellitus. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Magui Abdel Moneim Shalash; Noha Said Kandil; Omnia Alsaadany; Aya Fathy Radwan; Reem Mahmoud Fathalla

doi:10.2478/enr-2026-0019

January 1, 2026Endocrine RegulationsOpen Access

Unmasking silent atherosclerosis in type 2 diabetes: the emerging role of adipocyte fatty acid-binding protein

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Key result

Elevated AFABP independently links to increased carotid intima-media thickness in type 2 diabetes.

β=0.004
95% CI 0.001-0.007
P=0.017
n=80

Why the study?

Early detection of imminent atherosclerosis is critical to prevent complications in people with type 2 diabetes, but biomarkers for subclinical disease remain underexplored.

Key Points

To evaluate the association between circulating levels of adipocyte fatty acid-binding protein (AFABP) and subclinical atherosclerosis assessed by carotid intima-media thickness (CIMT) and ankle-brachial index (ABI) in individuals with type 2 diabetes mellitus.
Cross-sectional evaluation of 80 participants comprising 40 newly diagnosed patients with type 2 diabetes mellitus without prior macrovascular complications and 40 healthy controls matched for age and sex.
Assessed plasma AFABP concentrations via enzyme-linked immunosorbent assay (ELISA), subclinical atherosclerosis by Doppler ultrasound for CIMT and portable Doppler with sphygmomanometer for ABI, alongside lipid profiles and glycemic parameters.
Circulating AFABP levels were significantly higher in patients with diabetes than in healthy controls (median 51.57 ng/mL, range 42.34–60.70 vs. 43.10 ng/mL, range 32.19–50.90; p=0.007).
Maximum CIMT was significantly greater in diabetic patients than controls (1.40±0.18 mm vs. 0.51±0.12 mm, p<0.001), whereas mean ABI showed no significant difference between groups (1.12±0.08 vs. 1.11±0.09, p=0.615).
In multivariate linear regression analysis, AFABP was the only independent factor associated with maximum CIMT (β=0.004, 95% CI: 0.001–0.007, p=0.017).

Study Design

Type

Case-Control (n=80)

Multicenter

No

Structured PICO

P

Population

80 participants evenly divided into 40 newly diagnosed T2DM patients free of macrovascular complications and 40 healthy controls, evaluated for subclinical atherosclerosis.

C

Comparator

Healthy control subjects without T2DM (n=40)

O

Outcome

Subclinical atherosclerosis as measured by carotid intima-media thickness (CIMT) and ankle-brachial index (ABI), and circulating levels of adipocyte fatty acid-binding protein (AFABP)surrogate

Main Result

Effect estimate: β=0.004 (95% CI 0.001-0.007)

p-value: p=0.017

Elevated circulating AFABP levels in patients with newly diagnosed T2DM independently correlate with increased carotid intima-media thickness, suggesting AFABP may serve as a useful biomarker for identifying early silent atherosclerosis.

Limitations

The cross-sectional nature of the study limited the prediction of future atherosclerotic cardiovascular events.
More validation research is needed to explore the potential of using AFABP as a marker for CVD in clinical practice.
Lack of standardization for commercial AFABP ELISA assays.
The cross-sectional nature limits the prediction of future atherosclerotic cardiovascular events
More validation research is needed to explore potential as a CVD marker in clinical practice
Lack of standardization of commercial AFABP ELISA assays

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

AFABP merits prospective validation as atherosclerosis correlate in T2DM; leaves open utility for risk stratification.

Abstract

Objectives. Atherosclerosis contributes to higher mortality and morbidity in people with diabetes. Preventing future complications largely depends on the early detection of imminent atherosclerosis. This study aimed to explore the relationship between the subclinical atherosclerosis measured by carotid intima-media thickness (CIMT), ankle-brachial index (ABI), and circulating levels of adipocyte fatty acid-binding protein (AFABP) in individuals with type 2 diabetes mellitus (T2DM). Methods. A total of 80 participants evenly divided into two groups: 40 newly diagnosed patients with T2DM and 40 healthy controls. Patients with T2DM had no prior history or clinical signs of macrovascular complications, such as coronary artery disease, cerebrovascular stroke or peripheral artery disease. Serum total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), and glycated hemoglobin (HbA1c) were measured. Plasma AFABP levels were determined using a human enzyme-linked immunosorbent assay (ELISA) kit. ABI was assessed using a sphygmomanometer with a cuff that fits the limb’s circumference and a portable Doppler device. Doppler ultrasound of the carotid artery was used to measure CIMT. Results. In patients with T2DM, circulating AFABP levels were significantly higher than those in healthy subjects (p=0.007). Multivariate regression analysis indicated that AFABP is the only independent factor influencing the maximum CIMT (β=0.004, 95% CI: 0.001–0.007, p=0.017). Conclusion. Plasma AFABP level could serve as a biomarker for early diagnosis of atherosclerosis in patients with T2DM.

Discussion

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Cite This Study

Shalash et al. (2026) conducted a case-control in Type 2 Diabetes Mellitus (n=80). Adipocyte fatty acid-binding protein (AFABP) levels vs. Healthy controls / low AFABP levels was evaluated on Association of AFABP with maximum carotid intima-media thickness (CIMT) (β=0.004, 95% CI 0.001-0.007, p=0.017). In patients with type 2 diabetes, circulating adipocyte fatty acid-binding protein (AFABP) was the only independent factor significantly associated with increased maximum carotid intima-media thickness (β=0.004).

synapsesocial.com/papers/6ad0fce415427f6a84040364 https://doi.org/10.2478/enr-2026-0019

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Unmasking silent atherosclerosis in type 2 diabetes: the emerging role of adipocyte fatty acid-binding protein

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Unmasking silent atherosclerosis in type 2 diabetes: the emerging role of adipocyte fatty acid-binding protein

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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