*Purpose: Adipocyte fatty acid-binding protein (A-FABP) is abundantly found in mature adipocytes, activated macrophages, and dendritic cells and is involved in lipid metabolism, metabolic and inflammatory responses and can accelerate cardiovascular disease. It is interesting to investigate a potential association between serum A-FABP levels and endothelial function among kidney transplant (KT) patients.

*Methods: Fasting blood samples were obtained from 80 KT patients. The endothelial function and vascular reactivity index (VRI) were measured using digital thermal monitoring (DTM) test (VENDYS). Serum A-FABP levels were measured using a commercially available enzyme immunoassay kit. In this study, VRI < 1.0 was used as the poor vascular reactivity, 1.0 ≤ VRI < 2.0 was used as the intermediate vascular reactivity, and VRI ≥ 2.0 was used as the good vascular reactivity.

*Results: Twelve KT patients (15.0%) were categorized as poor vascular reactivity (VRI < 1.0), thirty KT patients (37.5%) were categorized as intermediate vascular reactivity (1.0 ≤ VRI < 2.0), and 38 KT patients had good vascular reactivity. Increase serum alkaline phosphatase (ALP, P = 0.012) and serum A-FABP level (P < 0.001) was associated with poor vascular reactivity. Advanced age (r = -0.305, P = 0.006), serum ALP level (r = -0.347, P = 0.002), and serum logarithmically transformed A-FABP level (log-A-FABP, r = -0.526, P < 0.001) were negatively correlated with VRI values in KT patients. After multivariable forward stepwise linear regression analysis noted that serum log-A-FABP level (β = -0.514, adjusted R² change = 0.268; P < 0.001) and age (β = -0.283, adjusted R² change = 0.072; P = 0.003) were significantly and independently associated with VRI values in KT patients.

*Conclusions: Serum fasting A-FABP level was negatively associated with VRI values and positively associated with endothelial function among KT patients.

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