Huang Chi-Lun, Wu Yen-Wen, Wu Chih-Cheng, Hwang Juey-Jen, Yang Wei-Shiung
Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Nuclear Medicine and Cardiovascular Medical Center (Cardiology), Far Eastern Memorial Hospital, New Taipei City, Taiwan; National Yang-Ming University School of Medicine, Taipei, Taiwan.
PLoS One. 2015 Sep 23;10(9):e0138678. doi: 10.1371/journal.pone.0138678. eCollection 2015.
Angiopoietin-like protein 2 (ANGPTL2), which is mainly expressed from adipose tissue, is demonstrated to be involved in obesity, metabolic syndrome, and atherosclerosis. Because several adipocytokines are known to be associated with heart failure (HF), here we investigated the association of ANGPTL2 and HF in Taiwanese subjects.
A total of 170 symptomatic HF patients and 130 age- and sex-matched controls were enrolled from clinic. The echocardiography was analyzed in each patient, and stress myocardial perfusion study was performed for clinical suspicion of coronary artery disease. Detailed demographic information, medications, and biochemical data were recorded. Circulating adipocytokines, including tumor necrosis factor-alpha (TNF-α), adiponectin, adipocyte fatty acid-binding protein (A-FABP) and ANGPTL2, were analyzed. Compared with the control group subjects, serum ANGPTL2 concentrations were significantly higher in HF group patients. In correlation analyses, ANGPTL2 level was positively correlated to creatinine, fasting glucose, triglyceride, hsCRP, TNF-α, NT-proBNP and A-FABP levels, and negatively correlated with HDL-C and left ventricular ejection fraction. In multiple regression analysis, A-FABP, hsCRP, and HDL-C levels remained as independent predictors for ANGPTL2 level. To determine the association between serum ANGPTL2 concentrations and HF, multivariate logistic regression analyses were performed with subjects divided into tertiles by ANGPTL2 levels. For the subjects with ANGPTL2 levels in the highest tertile, their risk of HF was about 2.97 fold (95% CI = 1.24-7.08, P = 0.01) higher than those in the lowest tertile.
Our results demonstrate a higher circulating ANGPTL2 level in patients with HF, and the upregulating ANGPTL2 levels might be associated with metabolic derangements and inflammation.
血管生成素样蛋白2（ANGPTL2）主要由脂肪组织表达，已被证明与肥胖、代谢综合征和动脉粥样硬化有关。由于已知几种脂肪细胞因子与心力衰竭（HF）相关，因此我们在此研究了台湾受试者中ANGPTL2与HF的关联。
从诊所招募了总共170例有症状的HF患者和130例年龄和性别匹配的对照。对每位患者进行超声心动图分析，并对临床怀疑有冠状动脉疾病的患者进行负荷心肌灌注研究。记录详细的人口统计学信息、药物治疗和生化数据。分析了循环脂肪细胞因子，包括肿瘤坏死因子-α（TNF-α）、脂联素、脂肪细胞脂肪酸结合蛋白（A-FABP）和ANGPTL2。与对照组受试者相比，HF组患者的血清ANGPTL2浓度显著更高。在相关性分析中，ANGPTL2水平与肌酐、空腹血糖、甘油三酯、hsCRP、TNF-α、NT-proBNP和A-FABP水平呈正相关，与HDL-C和左心室射血分数呈负相关。在多元回归分析中，A-FABP、hsCRP和HDL-C水平仍然是ANGPTL2水平的独立预测因子。为了确定血清ANGPTL2浓度与HF之间的关联，对按ANGPTL2水平分为三分位数的受试者进行了多变量逻辑回归分析。对于ANGPTL2水平处于最高三分位数的受试者，其发生HF的风险比最低三分位数的受试者高约2.97倍（95%CI = 1.24-7.08，P = 0.01）。
我们的结果表明HF患者的循环ANGPTL2水平较高，并且ANGPTL2水平的上调可能与代谢紊乱和炎症有关。
