Serum Angptl2 levels are independently associated with albuminuria in type 2 diabetes

Background: Elevated serum Angptl2 levels are positively associated with the development of type 2 diabetes. We investigated whether serum Angptl2 levels are associated with diabetic nephropathy in patients with type 2 diabetes. Methods: Two hundred and thirty patients with type 2 diabetes and 63 healthy controls participated in this cross-sectional study. Subjects with type 2 diabetes were divided into three groups using urinary albumin-to-creatinine ratio (ACR): a normoalbuminuric group (n = 57), a microalbuminuric group (n = 130) and a macroalbuminuria group (n = 43). Serum Angptl2 concentrations were measured by enzyme-linked immunosorbent assay. Results: Median serum (interquartile range) Angptl2 levels in control subjects and patients with type 2 diabetes with normoalbuminuria, microalbuminuria and macroalbuminuria were 24.03 (16.3-33.45), 36.14 (27.91-43.07), 44.6 (37.47-49.92), 50.19 (45.95-60.13) ng/ml (p < 0.01) respectively. Angptl2 levels correlated with urinary ACR in participants with type 2 diabetes (r = 0.38, p < 0.01). Significant intercorrelations of Angptl2 were found with age, duration of diabetes, and fasting plasma glucose. After adjustment for significant covariates, albuminuria was still significantly associated with Angptl2 levels in type 2 diabetes (r = 0.31, p < 0.01). Conclusions: Angptl2 levels are elevated in patients with type 2 diabetes with an independent association between increasing Angptl2 levels and increasing levels of albuminuria. This suggests a possible role of Angptl2 in progressive nephropathy in patients with type 2 diabetes. (C) 2013 Elsevier Ireland Ltd. All rights reserved.