Angiopoietin-like protein 2 level linked to incident diabetes

By Sally Robertson, B.Sc.Sep 12 2012

Elevated angiopoietin-like protein (ANGPTL) 2 levels are associated with the development of Type 2 diabetes, show findings from a Japanese study.

"To our knowledge, this is the first report to indicate that serum ANGPTL2 levels are an independent risk factor for developing T2DM [Type 2 diabetes] in a general population," write Yasufumi Doi (Kyushu University, Fukuoka) and colleagues in Diabetes Care.

Although the protein has previously been shown to be closely related to adiposity and inflammation in humans, the association of ANGPTL2 with incident diabetes has not been investigated until now, says the team.

In a follow-up study of 2164 community-dwelling Japanese individuals (mean age 58.6 years) who underwent a baseline oral glucose tolerance test in 2002, diabetes had developed in 221 participants by 2009.

On stratifying the patients by quartiles of ANGPTL2, the team found that the age- and gender-adjusted incidence of diabetes increased significantly with elevating quartiles, and that the risk was significantly higher in the second (2.16-2.71 ng/mL), third (2.72-3.40 ng/mL), and fourth quartile (≥3.41 ng/mL), than in the first quartile (≤2.15 ng/mL).

In multivariate analysis, this association remained unchanged after further adjustment for family history of diabetes, fasting insulin, high-molecular-weight adiponectin, body mass index (BMI), triglycerides, high-density lipoprotein cholesterol, hypertension, alcohol intake, smoking habits, and regular exercise.

Prospective observational studies have shown that several non-specific indicators of inflammation are predictive of Type 2 diabetes and, among them, C-reactive protein (CRP) was the most commonly measured circulating marker for subclinical inflammation, notes the team.

However, even after further adjustment for high-sensitivity CRP, the risk for incident diabetes was significantly higher in the highest ANGPTL2 quartile than in the lowest quartile, at a hazard ratio of 1.80.

Furthermore, the findings remained unchanged when waist circumference was used in place of BMI in the models.

"The association between serum baseline ANGPTL2 levels and incident T2DM was found to be independent of the hs-CRP levels," remark Doi and colleagues. "Nevertheless further studies would be required to reveal whether the association is truly independent of other established inflammatory markers."

Future research is needed to examine the role of the protein in inflammation in human adipose tissue and the development of Type 2 diabetes, concludes the team.

Sally Robertson, medwireNews Reporter

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