Issa Yasmine Amr, Abd ElHafeez Samar Samy, Amin Noha Gaber
1Department of Medical Biochemistry, Alexandria Faculty of Medicine, University of Alexandria, Alexandria, Egypt.
2Department of Epidemiology, High Institute of Public Health, University of Alexandria, Alexandria, Egypt.
EPMA J. 2019 Aug 6;10(3):239-248. doi: 10.1007/s13167-019-00180-3. eCollection 2019 Sep.
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.
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.
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.
Serum ANGPTL-8 levels showed significant elevation among persons with vs. without DM ( = 0.006), positive correlation with HbA1c ( < 0.001), and negative correlation with estimated GFR (eGFR) ( = 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).
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.
先前的研究表明，2型糖尿病（DM）患者循环血管生成素样蛋白8（ANGPTL-8）水平发生改变。ANGPTL-8水平的改变是否可作为DM风险增加的预测指标仍不清楚。
研究ANGPTL-8作为2型DM风险预测指标的可能作用，以及一组可能影响ANGPTL-8水平的因素。
纳入100例新诊断的2型DM患者和100例性别及年龄匹配的健康对照者。排除标准包括1型DM、急性感染、慢性肾脏病病史、恶性肿瘤以及失血或输血史。评估血清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、血脂谱、肝功能和肾功能检查。在未调整和多重调整回归模型中检验DM与ANGPTL-8之间的独立关系。
与无DM者相比，DM患者血清ANGPTL-8水平显著升高（P = 0.006），与HbA1c呈正相关（P < 0.001），与估计肾小球滤过率（eGFR）呈负相关（P = 0.003），但与空腹血糖水平无显著相关性。在未调整模型中，ANGPTL-8处于第三个三分位数的患者患DM的风险为4倍（OR 4.03；95%CI = 1.37 - 11.84）。对心血管疾病、吸烟、体重指数、收缩压、丙氨酸转氨酶（ALT）和低密度脂蛋白（LDL）进行数据调整后，ANGPTL-8与DM之间的直接关系增强（OR 6.26；95%CI = 1.21 - 32.50）。然而，在调整慢性肾脏病流行病学协作组（CKD-EPI）eGFR肌酐-胱抑素后，风险显著降低（OR 2.17；95%CI = 0.10 - 49.84）。
本研究强调了ANGPTL-8在糖尿病并发症尤其是肾病中的可能预测作用。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。
