Significance of Serum Angiopoietin-Like Protein 2 in the Occurrence and Progression of Diabetic Kidney Disease: A Cross-Sectional Study

Abstract

Background: Diabetic kidney disease (DKD), a microvascular complication of type 2 diabetes mellitus (T2DM), contributes to chronic kidney disease and end-stage renal disease. Angiopoietin-like protein 2 (ANGPTL2) is a glycoprotein secreted by a variety of cells, especially visceral adipocytes. However, the relationship of ANGPTL2 and DKD remains unknown. The aim of this study was to explore the value of serum ANGPTL2 as a molecular biomarker for the prevention and management of DKD. Methods: An age and gender matched cross-sectional study was carried out, looking at patients with T2DM and healthy population. The study looked for risk factors for DKD and assessed the diagnostic value of ANGPTL2 for DKD. Results: A total of 140 cases and 140 control participants were included in the study. Serum ANGPTL2 level was significantly higher in T2DM patients than in healthy subjects, and significantly rose during DKD progression (p < 0.0001). Serum ANGPTL2, diabetic retinopathy (DR), and age over 65 years were independent predictors of DKD progression. In T2DM patients, ANGPTL2 level was positively correlated with age. The synergy of serum ANGPTL2 and DR was superior to a single index (ANGPTL2) in diagnosing DKD, especially for non-elderly T2DM patients (<65 years old) (p < 0.001). Conclusions: ANGPTL2 has a close association with the occurrence and progression of DKD. Serum ANGPTL2 had higher diagnostic value for the younger T2DM patients (<65 years old), and might serve as a potential biomarker for diagnosing DKD.