Abstract
Background: Hyperglycemia, insulin resistance and hypertriglyceridesmia are risk factors for albuminuria in type 2 diabetes. Angiopoietin-like Protein 8(ANGPTL8) is a newly identified liver-derived hormone related to these risk factors. Hence, we aimed to explore the relationship between ANGPTL8 and albuminuria in type 2 diabetes.Methods: Serum ANGPTL8 levels were determined in groups of control (n = 50) and type 2 diabetic patients with normoalbuminuria (A1, n = 100), microalbuminuria (A2, n = 45), and macroalbuminuria (A3, n = 33).Results: Serum levels of ANGPTL8 and triglycerides were significantly increased in type 2 diabetic patients with albuminuria as compared with controls (P < 0.001). ANGPTL8 levels were positively correlated with triglycerides, duration of diabetes, and urine albumin-to-creatinine ratio (ACR) and negatively correlated with estimated glomerular filtration rate in type 2 diabetic patients with A2 and A3 (all P < 0.05). Logistic regression analysis indicated that ANGPTL8 had higher odds of having A2 (OR = 2.52, 95% CI 1.16–5.48, P = 0.019) and A3 (OR = 4.89, 95% CI 2.10–11.39, P < 0.001) in type 2 diabetes. Mediation analysis indicated that triglycerides might act as a partial mediator in the relationship between ANGPTL8 and ACR.Conclusions: Triglycerides might partially mediate the correlation between ANGPTL8 and ACR. Our data provide the evidence for a strong link between ANGPTL8 and albuminuria, indicating that ANGPTL8 may be a new biomarker for diabetic kidney disease in type 2 diabetes.Trial Registration Number: ChiCTR-EPC-14005273
Highlights
Diabetic kidney disease is one of the most common microvascular complications of diabetes, which results in chronic kidney disease in diabetic patients
Our data provide the evidence for a strong link between Angiopoietin-like protein 8 (ANGPTL8) and albuminuria, indicating that ANGPTL8 may be a new biomarker for diabetic kidney disease in type 2 diabetes
Significant differences were found in statin use, NSAID use, systolic blood pressure (SBP), diastolic blood pressure (DBP), TG, fasting plasma glucose, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), duration of diabetes, HbA1c, estimated glomerular filtration rate (eGFR) and urinary albumin-tocreatinine ratio (ACR) between the diabetic patients and the control subjects
Summary
Diabetic kidney disease is one of the most common microvascular complications of diabetes, which results in chronic kidney disease in diabetic patients. Angiopoietin-like protein 8 (ANGPTL8), known as betatrophin, lipasin, TD26 and refeeding-induced fat and liver (RIFL), is a secreted protein of 198 amino acids primarily expressed in liver and adipose tissues [3] It is a newly identified endocrine regulator associated with insulin resistance, lipid and glucose metabolism, all of which are thought to be involved in the pathogenesis of diabetic kidney disease in type 2 diabetes [4]. Some studies have reported a positive relationship between blood glucose, homeostasis model assessment of insulin resistance (HOMA-IR) and ANGPTL8 in type 2 diabetic patients [10, 11] These findings above motivated us to speculate that increased circulating levels of ANGPTL8 might be positively related to urine albumin-tocreatinine ratio (ACR) and serve as a novel biomarker for diabetic kidney disease in type 2 diabetes. We aimed to explore the relationship between ANGPTL8 and albuminuria in type 2 diabetes
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