Abstract

BackgroundAngiopoietin-like protein 3 (ANGPTL3) is a major lipoprotein regulator and shows positive correlation with high-density lipoprotein-cholesterol (HDL-c) in population studies and ANGPTL3 mutated subjects. However, no study has looked its correlation with HDL components nor with HDL function in patients with type 2 diabetes mellitus (T2DM).MethodsWe studied 298 non-diabetic subjects and 300 T2DM patients who were randomly recruited in the tertiary referral centre. Plasma levels of ANGPTL3 were quantified by ELISA. Plasma samples were fractionated to obtain HDLs. HDL components including apolipoprotein A-I (apoA-I), triglyceride, serum amyloid A (SAA), phospholipid and Sphingosine-1-phosphate were measured. HDLs were isolated from female controls and T2DM patients by ultracentrifugation to assess cholesterol efflux against HDLs. A Pearson unadjusted correlation analysis and a linear regression analysis adjusting for age, body mass index and lipid lowering drugs were performed in male or female non-diabetic participants or diabetic patients, respectively.ResultsWe demonstrated that plasma level of ANGPTL3 was lower in female T2DM patients than female controls although no difference of ANGPTL3 levels was detected between male controls and T2DM patients. After adjusting for confounding factors, one SD increase of ANGPTL3 (164.6 ng/ml) associated with increase of 2.57 mg/dL cholesterol and 1.14 μg/mL apoA-I but decrease of 47.07 μg/L of SAA in HDL particles of non-diabetic females (p < 0.05 for cholesterol and SAA; p < 0.0001 for apoA-I). By contrast, 1-SD increase of ANGPTL3 (159.9 ng/ml) associated with increase of 1.69 mg/dl cholesterol and 1.25 μg/mL apoA-I but decrease of 11.70 μg/L of SAA in HDL particles of female diabetic patients (p < 0.05 for cholesterol; p < 0.0001 for apoA-I; p = 0.676 for SAA). Moreover, one SD increase of ANGPTL3 associated with increase of 2.11 % cholesterol efflux against HDLs in non-diabetic females (p = 0.071) but decrease of 1.46 % in female T2DM patients (p = 0.13) after adjusting for confounding factors.ConclusionsANGPTL3 is specifically correlated with HDL-c, apoA-I, SAA and HDL function in female non-diabetic participants. The decrease of ANGPTL3 level in female T2DM patients might contribute to its weak association to HDL components and function. ANGPTL3 could be considered as a novel therapeutic target for HDL metabolism for treating diabetes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12933-016-0450-1) contains supplementary material, which is available to authorized users.

Highlights

  • Angiopoietin-like protein 3 (ANGPTL3) is a major lipoprotein regulator and shows positive correlation with high-density lipoprotein-cholesterol (HDL-c) in population studies and ANGPTL3 mutated subjects

  • Type-2 diabetic patients are always accompanied with dyslipidemia, which is featured as high plasma triglyceride concentration [11], decreased high-density lipoprotein-cholesterol (HDL-c) level [12] as well as HDL dysfunction [13]

  • We excluded one non-diabetic male and one non-diabetic female because ANGPTL3 level or serum amyloid A value deviated more than 3 SDs from the mean

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Summary

Introduction

Angiopoietin-like protein 3 (ANGPTL3) is a major lipoprotein regulator and shows positive correlation with high-density lipoprotein-cholesterol (HDL-c) in population studies and ANGPTL3 mutated subjects. No study has looked its correlation with HDL components nor with HDL function in patients with type 2 diabetes mellitus (T2DM). High-density lipoprotein (HDLs) process multiple antiatherogenic and anti-diabetic properties including reverse cholesterol transport [1], maintenance of endothelium integrity [2, 3], suppression of inflammation [4, 5], promoting pancreatic β cell survival [6] and insulin secretion in response to glucose [7, 8]. Infusion of reconstituted HDL (rHDL) containing apolipoprotein A-I (apoA-I), the major component of HDLs, stimulates glucose uptake in both insulin dependent and independent manners [9, 10]. Glycation decreases S1P content in HDLs of type-2 diabetic patients whereas adding S1P to diabetic HDLs promotes cardiomyocyte survival when challenged with oxidative stress [20]

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