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Background  Serum fatty acid-binding protein 4 (FABP4), as an intracellular lipid chaperone and adipokine, was reported to be related to the incidence of type 2 diabetes (T2D) and diabetic complications, but its association with pancreatic islet β-cell and α-cell functions has not been fully elucidated. So the present study was to investigate the serum FABP4 levels and responses of islet β-cells and α-cells in patients with T2D.    Methods  115 patients with T2D and 89 healthy controls (HC), who received serum FABP4 levels test, were recruited to participate in this study. Moreover, 75-g oral glucose tolerance test (OGTT) was performed in T2D patients to evaluate islet β-cell and α-cell functions. Systemic insulin sensitivity and overall insulin secretion of islet β-cell function were assessed by Matsuda index using C peptide (ISI M-cp ) and ratio of the area under the C peptide curve to the glucose curve (AUC cp/glu ) during OGTT, respectively. Fasting glucagon (Gluca 0min ) and postchallenge glucagon assessed by the area under the glucagon curve (AUC gluca ) were determined during OGTT to evaluate islet α-cell function. And other various clinical variables were also measured in all participants. Skewed variables were natural log-transformed (ln), such as lnFABP4.    Results  The serum FABP4 levels in T2D patients were significantly higher than those in HC ( p  < 0.05). And after partially adjusting for fasting plasma glucose, serum lnFABP4 levels were negatively correlated with lnISI M-cp  ( r  =  − 0.332,  p  < 0.001) and positively correlated with lnAUC cp/glu  ( r  = 0.324,  p  < 0.001), lnGluca 0min  ( r  = 0.200,  p  = 0.040) and lnAUC gluca  ( r  = 0.311,  p  < 0.001), respectively, in patients with T2D. Furthermore, when multiple linear regression analyses were applied to adjust for other various clinical variables, serum lnFABP4 levels were found to remain associated with lnISI M-cp  ( β  =  − 0.296,  t  =  − 2.900,  p  = 0.005), lnAUC cp/glu  ( β  = 0.223,  t  = 2.038,  p  = 0.046), lnGluca 0min  ( β  = 0.272,  t  = 2.330,  p  = 0.024) and lnAUC gluca  ( β  = 0.341,  t  = 3.065,  p  = 0.004), respectively.    Conclusion  Increased serum FABP4 levels were closely associated with blunted insulin sensitivity, increased insulin secretion, and elevated fasting and postchallenge glucagon levels in patients with T2D.    Supplementary Information  The online version contains supplementary material available at 10.1186/s13098-021-00690-z.

Serum fatty acid-binding protein 4 levels and responses of pancreatic islet β-cells and α-cells in patients with type 2 diabetes