Department of Laboratory Medicine, Collegium Medicum, Bydgoszcz, Nicolaus Copernicus University, 87-110 Torun, Poland.
Nutrients. 2021 Nov 30;13(12):4339. doi: 10.3390/nu13124339.
Hypertriglyceridemia is an independent risk factor for coronary artery disease. Lipoprotein lipase (LPL) plays an essential role in the metabolism of triglyceride-rich lipoproteins (TRLs). Angiopoietin-like proteins ANGPTL3 and ANGPTL8 are shown to be important regulators of LPL activity. Increased concentrations of these proteins may reflect cardiovascular risk, and the treatment of patients with dyslipidemia with ANGPTLs inhibitors may decrease this risk. We assessed the gender-specific relationships of serum ANGPTL3 and ANGPTL8 with atherogenic lipid biomarkers and obesity in non-diabetic adults. The study comprised 238 participants aged 25-74 [122 with triglycerides (TG) <150 mg/dL (<1.7 mmol/L) and 116 with hypertriglyceridemia]. Total cholesterol, HDL-cholesterol, LDL-cholesterol, TG, C-reactive protein (CRP), glycated hemoglobin, apolipoprotein B, small dense LDL-C (sd-LDL-C), ANGPTL3, and ANGPTL8 were measured. Non-HDL-cholesterol, remnant cholesterol (remnant-C) concentrations, and body mass index (BMI) were calculated. Results: Women and men did not differ in terms of age, CRP levels, the percentage of obese subjects, and concentrations of atherogenic lipid biomarkers, except higher TG in males and higher ANGPTL3 concentrations in females. Positive correlations of both ANGPTLs with TG, remnant-C, and sdLDL-C levels were found in females. In males, only ANGPTL3 correlated positively with atherogenic biomarkers, but there were no correlations with ANGPTL8. Concentrations of ANGPTL3 were higher in obese men, whereas ANGPTL8 levels were higher in obese women. In women alone, ANGPTL8 showed very good discrimination power to identify subjects with hypertriglyceridemia (AUC = 0.83). Contrary to this, ANGPTL3 was a better discriminator of hypertriglyceridemia (AUC = 0.78) in male subjects. Regression models, adjusted for age, sex, and BMI showed a weak but significant effect of ANGPTL8 to increase the risk of hypertriglyceridemia. Conclusions: In females, ANGPTL8 is more strongly associated with TRLs metabolism, whereas in males, ANGPTL3 plays a more important role. We suggest sex differences be taken into consideration when applying new therapies with angiopoietin-like proteins inhibitors in the treatment of dyslipidemia.
高甘油三酯血症是冠心病的独立危险因素。脂蛋白脂肪酶(LPL)在富含甘油三酯脂蛋白(TRL)的代谢中起重要作用。血管生成素样蛋白 ANGPTL3 和 ANGPTL8 被证明是 LPL 活性的重要调节剂。这些蛋白质浓度的增加可能反映了心血管风险,用 ANGPTLs 抑制剂治疗血脂异常的患者可能会降低这种风险。我们评估了血清 ANGPTL3 和 ANGPTL8 与非糖尿病成人致动脉粥样硬化脂质生物标志物和肥胖的性别特异性关系。该研究包括 238 名年龄在 25-74 岁的参与者[122 名甘油三酯(TG)<150mg/dL(<1.7mmol/L)和 116 名高甘油三酯血症]。测量总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯、C 反应蛋白(CRP)、糖化血红蛋白、载脂蛋白 B、小而密低密度脂蛋白胆固醇(sd-LDL-C)、ANGPTL3 和 ANGPTL8。计算非高密度脂蛋白胆固醇、残余胆固醇(remnant-C)浓度和体重指数(BMI)。结果:女性和男性在年龄、CRP 水平、肥胖患者比例和致动脉粥样硬化脂质生物标志物浓度方面没有差异,除了男性的甘油三酯较高和女性的 ANGPTL3 浓度较高。在女性中,两种 ANGPTLs 均与 TG、残余-C 和 sdLDL-C 水平呈正相关。在男性中,只有 ANGPTL3 与致动脉粥样硬化生物标志物呈正相关,但与 ANGPTL8 无相关性。肥胖男性的 ANGPTL3 浓度较高,而肥胖女性的 ANGPTL8 水平较高。仅在女性中,ANGPTL8 对识别高甘油三酯血症患者具有很好的判别能力(AUC=0.83)。与此相反,在男性中,ANGPTL3 是高甘油三酯血症的更好判别器(AUC=0.78)。调整年龄、性别和 BMI 的回归模型显示,ANGPTL8 对增加高甘油三酯血症的风险有微弱但显著的影响。结论:在女性中,ANGPTL8 与 TRLs 代谢的相关性更强,而在男性中,ANGPTL3 则发挥更重要的作用。我们建议在应用新的血管生成素样蛋白抑制剂治疗血脂异常时,考虑性别差异。