Serum Levels Of Angiopoietin-like 4 And Influencing Factors In Type 2 Diabetes Mellitus Patients With And Without Microvascular Complications

Aim: The aim of the present study was to investigate the relationship among ANGPTL4 and glucose-lipid metabolism and oxidative stress,and to explore the possible role of ANGPTL4 in the pathogenesis of T2 DM and its microvascular complications.Methods: One hundred and fifty-two subjects were enrolled and divided into three groups: normal control group(male 32/female 34),T2 DM patients without microvascular complications group(male 15/female 15),and T2 DM patients with microvascular complications group(male 29/female 27).Serum levels of ANGPTL4 were measured by enzyme-linked immunosorbent assay(ELISA).Biochemical parameters such as serum MDA,superoxide dismutase(SOD),fasting plasma glucose(FPG),glycosylated hemoglobin(Hb A1c),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),creatinine and uric acid(UA)were also measured.Results: The serum levels of MDA and FPG were significantly increased and serum levels of SOD were significantly decreased in T2 DM patients without microvascular complicatons group compared to normal control group(P <0.05).The serum levels of MDA,Hb A1 c,FPG,TC,LDL-C,creatinine were higher and serum levels of HDL-C and SOD were lower in T2 DM patients with microvascular complications group compared to T2 DM patients without microvascular complications group(P <0.05).The serum levels of ANGPTL4 significantly decreased in T2 DM patients without microvascular complications compared to normal control group(609.08±85.35 vs 926.62±70.88 pg/ml,P <0.01).And the levels of ANGPTL4 were lower in T2 DM patients with microvascular complications group compared to T2 DM patients without microvascular complications group(609.08±85.35 vs 802.29±98.76 pg/ml,P <0.01).Serum levels of ANGPTL4 were negatively correlated with BMI,FPG,Hb A1 c,TG,BUN and MDA(The r values were-0.261,-0.540,-0.458,-0.256,-0.178 and-0.596,respectively,P <0.01),but positively correlated with HDL-C,UA and SOD(The r values were 0.332,0.183 and 0.567,respectively,P < 0.01).Multiple linear regression analysis showed that Hb A1 c and HDL-C were independent factors of serum levels of ANGPTL4(regression coefficients were-30.704,1236.46,P < 0.01).Conclusions: ANGPTL4 is closely related to glucose-lipid metabolism and oxidative stress.The serum levels of ANGPTL4 decreased in type 2 diabetes mellitus patients and decreased more in T2 DM patients with microvascular complications,suggesting that low serum levels of ANGPTL4 are involved in the development of microvascular complications.Whether ANGPTL4 plays a role in the pathogenesis of type 2 diabetes and its microvascular complications remains to be elucidated.