Integrating fatty acid-binding proteins and vascular cell adhesion molecule-1 as novel diagnostic biomarkers for peripheral artery disease in diabetic populations

Background: Peripheral artery disease (PAD) is a major vascular complication in diabetic patients, associated with high morbidity and mortality. Despite its clinical significance, early diagnosis remains challenging due to atypical symptoms and limitations in current diagnostic tools. the study aimed to evaluate the diagnostic potential of serum fatty acid-binding proteins (FABP3, FABP4) and vascular cell adhesion molecule-1 (VCAM1) as biomarkers for PAD in diabetic patients.Methods: This case-control study included 60 diabetic patients with PAD and 30 age-matched diabetic controls. Serum levels of FABP3, FABP4, VCAM1, and lipid profiles were measured using enzyme linked immunosorbent assay (ELISA) and automated assays. Statistical analyses compared biomarker levels, assessed diagnostic accuracy via Receiver Operating Characteristic (ROC) curves, and identified predictors using logistic regression.Results: The PAD group exhibited significantly elevated FABP3 (28.2 ± 7.6 vs. 18.9 ± 4.5 ng/mL), FABP4 (7723 ± 1062 vs. 5729 ± 1246 ng/L), and VCAM-1 (219 ± 60.1 vs. 132.4 ± 31.6 ng/mL) compared to controls (p < 0.001). ROC analysis demonstrated robust diagnostic accuracy performance for FABP4 (AUC = 93%, sensitivity = 93%, specificity = 80%) and VCAM-1 (AUC = 92%, sensitivity = 90%, specificity = 83%). Logistic regression confirmed these biomarkers as independent predictors of PAD (model AUC = 98.5%, overall accuracy = 95.5%).Conclusion: FABP3, FABP4, and VCAM-1 are robust biomarkers for PAD detection in diabetic patients, reflecting metabolic dysregulation, inflammation, and endothelial dysfunction. Their integration into clinical practice could enhance early diagnosis and risk stratification.