1610-P: Fatty Acid–Binding Protein 4 as a Biomarker for Remission of Type 2 Diabetes

Elevated levels of circulating Fatty Acid Binding Protein 4 (FABP4), also named adipocyte FABP (A-FABP), are associated with obesity, diabetes mellitus, insulin resistance, hypertension, and cardiovascular risk. FABP4 is a protein found in high levels in both macrophages and adipocytes. Release of FABP4 from adipocytes via lipolysis, and release from macrophages during inflammation, plays a key role in development of insulin resistance and diabetes mellitus. We studied the effect of a high protein (HP; 30% protein, 40% carbohydrate, 30% fat) diet vs high carbohydrate (HC;15% protein, 55% carbohydrate, 30% fat) diet in patients recently diagnosed with Type 2 Diabetes (T2D). We determined the levels of circulating FABP4 and metabolic parameters in the HP vs HC groups at baseline and 6 months after consuming the respective diets. Participants (14) were randomized to a HP or HC diet for 6 months. All food was provided and designed for weight loss. After 6 months on the HP diet, 100% of the subjects had remission of T2D to Normal Glucose Tolerance (NGT), whereas only 16.6% of subjects on HC diet had remission of T2D. The HP diet group exhibited significant improvement in a) insulin sensitivity (p=0.001), b) inflammatory cytokines (p=0.001), C) cardiovascular risk factors (p=0.004) compared to the HC diet group at 6 months. Although weight loss in both groups was around 10% at 6 months, the HP group lost % fat mass, whereas, the HC group lost both % muscle and fat mass. Average level of FABP4 decrease after 6 months was 12,831 pg/ml in the 8 participants on the HP diet, compared to only a 1183 pg/ml average decrease after 6 months for the 6 HC participants. Conclusions: These data showed a significant decrease of circulating FABP4 in the HP but not HC diet group and suggests that a high protein diet could be an optimal way to reduce FABP4 levels in the blood. This could subsequently lower the risk of development/progression of insulin resistance, T2D, inflammation and cardiovascular risk conditions and serve as a biomarker.