The potential role of angiopoietin-like protein-8 in type 2 diabetes mellitus: a possibility for predictive diagnosis and targeted preventive measures?
The potential role of angiopoietin-like protein-8 in type 2 diabetes mellitus: a possibility for predictive diagnosis and targeted preventive measures?
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DOI：
10.1007/s13167-019-00180-3
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发表时间：
2019-09-01
期刊：
影响因子：
6.5
通讯作者：
Amin, Noha Gaber
中科院分区：
文献类型：
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作者：
Issa, Yasmine Amr;Abd ElHafeez, Samar Samy;Amin, Noha Gaber
背景先前的研究表明，在2型糖尿病(DM)中，血管生成素样蛋白-8(ANGPTL-8)的循环水平发生改变。目前尚不清楚ANGPTL-8水平的改变是否可以作为糖尿病风险增加的预测指标。目的探讨血管紧张素转换酶8(ANGPTL-8)作为2型糖尿病危险预测因子的作用，以及一系列可能影响ANGPTL-8水平的因素。方法入选100例新近确诊的2型糖尿病患者和100例性别、年龄匹配的健康对照。排除标准包括1型糖尿病、急性感染、慢性肾脏病史、恶性肿瘤和失血或输血。检测血清ANGPTL-8水平、血压、体重、身高、糖化血红蛋白(HbA1c)、空腹血糖、胱抑素C、血脂、肝肾功能。在未调整和多重调整的回归模型中检验DM与ANGPTL-8之间的独立关系。结果糖尿病组血清血管生成素-8水平显著高于非糖尿病组(p=0.006)，与糖化血红蛋白呈正相关(p<；0.001)，与估计肾小球滤过率呈负相关(p=0.003)，与空腹血糖水平无明显相关性。在未调整的模型中，ANGPTL-8的第三个三分位数的患者患糖尿病的风险是对照组的4倍(OR 4.03；95%CI=1.37-11.84)。校正了心血管疾病、吸烟、体重指数、收缩压、丙氨酸氨基转移酶(ALT)和低密度脂蛋白(LDL)的因素后，ANGPTL-8与DM的直接关系增加(OR 6.26；95%CI=1.21-32.50)。然而，调整慢性肾脏疾病流行病学协作(CKD-EPI)EGFR肌酐-胱抑素后，风险显著降低(OR 2.17；95%CI=0.10-49.84)。结论本研究强调了ANGPTL-8对糖尿病并发症，特别是肾病的可能预测作用。需要更大规模的预后研究来验证ANGPTL-8与肾功能恶化之间的因果关系。
Background Previous studies showed altered angiopoietin-like protein-8 (ANGPTL-8) circulating levels in type 2 diabetes mellitus (DM). Whether or not the alteration in ANGPTL-8 level can be a predictive maker for increased DM risk remains unclear. Aim Investigating possible role of ANGPTL-8 as a risk predictor of type2 DM, in addition to a set of factors likely to affect ANGPTL-8 level. Methods One hundred recently diagnosed persons with type 2 DM and 100 sex- and age-matched healthy controls were enrolled. Exclusion criteria included type 1 DM, acute infections, history of chronic kidney disease, malignancy, and blood loss or transfusion. Serum levels of ANGPTL-8, blood pressure, weight, height, glycosylated hemoglobin (HbA1c), fasting blood glucose, cystatin C, lipid profile, liver, and kidney function tests were assessed. The independent relationship between DM and ANGPTL-8 was tested in the unadjusted and multiple-adjusted regression models. Results Serum ANGPTL-8 levels showed significant elevation among persons with vs. without DM (p = 0.006), positive correlation with HbA1c (p < 0.001), and negative correlation with estimated GFR (eGFR) (p = 0.003) but no significant correlation to fasting glucose level. In the unadjusted model, patients in the third tertile of ANGPTL-8 had 4 times risk of DM (OR 4.03; 95% CI = 1.37-11.84). Data adjustment for cardiovascular diseases, smoking, body mass index, systolic blood pressure, alanine transaminase (ALT), and low-density lipoprotein (LDL) increased the direct relationship between ANGPTL-8 and DM (OR 6.26; 95% CI = 1.21-32.50). However, the risk significantly decreased after adjustment of Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) eGFR creatinine-cystatin (OR 2.17; 95% CI = 0.10-49.84). Conclusion This study highlights a possible predictive role of ANGPTL-8 in diabetic complications, particularly nephropathy. Larger prognostic studies are needed to validate the cause-effect relationship between ANGPTL-8 and deteriorated kidney functions.