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CARDIOVASCULAR PREVENTION / CLINICAL RESEARCH
Plasma angiopoietin-like protein 4 as a novel biomarker predicting 10-year mortality in a community-based population: a longitudinal cohort study
1
Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
2
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
3
Department of Internal Medicine, Taipei City Hospital Renai Branch, Taipei, Taiwan
4
Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
5
School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
6
Department of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan
7
Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
8
Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
9
Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
10
Department of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan
Submission date: 2024-02-14
Final revision date: 2024-04-24
Acceptance date: 2024-05-30
Online publication date: 2024-06-06
Corresponding author
Hung-Yuan Li
Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan, South Road, Taipei, Taiwan, Phone: +886-2-23123456 ext. 63540
Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan, South Road, Taipei, Taiwan, Phone: +886-2-23123456 ext. 63540
KEYWORDS
all-cause mortalitybiomarkercancer mortalityangiopoietin-like protein 4 (ANGPTL4)cardiovascular or cancer-related mortality
TOPICS
ABSTRACT
Introduction:
Angiopoietin-like protein 4 (ANGPTL4) is a hepatokine implicated in fat metabolism regulation. Its genetic inactivation has been associated with improved glucose homeostasis, while elevated plasma ANGPTL4 levels are observed in diabetic and obese individuals. However, the potential link between ANGPTL4 and diabetes- or obesity-related complications remains uncertain. This study aimed to explore whether plasma ANGPTL4 level could serve as a predictor of cancer mortality, cardiovascular mortality, and all-cause mortality in a community-based cohort.
Material and methods:
A community-based cohort study was conducted, where fasting plasma ANGPTL4 concentrations were measured at baseline, and vital status was ascertained through linkage with the National Health Insurance Research Database in Taiwan.
Results:
During a 10.46-year follow-up period, 29 (2.49%) of the 1163 participants died. Subjects within the highest tertile of plasma ANGPTL4 levels exhibited the lowest survival rate. In unadjusted models, plasma ANGPTL4 significantly predicted all-cause mortality, cancer mortality, and cardiovascular or cancer-related mortality. Upon adjustment for confounders including age, sex, smoking, body mass index (BMI), hypertension, diabetes mellitus (DM), and renal function, each standard deviation increase in plasma ANGPTL4 was associated with HRs of 1.35 (95% CI: 1.01–1.80, p < 0.05) for all-cause mortality, 1.41 (95% CI: 0.94–2.10, p = 0.094) for cancer mortality, and 1.40 (95% CI: 1.02–1.94, p < 0.05) for cardiovascular or cancer-related mortality. Additionally, plasma ANGPTL4 contributed more significantly to predicting cardiovascular or cancer-related mortality and all-cause mortality compared to other predictors, such as sex, smoking, BMI, history of hypertension, history of diabetes, and eGFR.
Conclusions:
Plasma ANGPTL4 emerges as a promising biomarker capable of predicting 10-year mortality and enhancing risk prediction beyond established risk factors.
Angiopoietin-like protein 4 (ANGPTL4) is a hepatokine implicated in fat metabolism regulation. Its genetic inactivation has been associated with improved glucose homeostasis, while elevated plasma ANGPTL4 levels are observed in diabetic and obese individuals. However, the potential link between ANGPTL4 and diabetes- or obesity-related complications remains uncertain. This study aimed to explore whether plasma ANGPTL4 level could serve as a predictor of cancer mortality, cardiovascular mortality, and all-cause mortality in a community-based cohort.
Material and methods:
A community-based cohort study was conducted, where fasting plasma ANGPTL4 concentrations were measured at baseline, and vital status was ascertained through linkage with the National Health Insurance Research Database in Taiwan.
Results:
During a 10.46-year follow-up period, 29 (2.49%) of the 1163 participants died. Subjects within the highest tertile of plasma ANGPTL4 levels exhibited the lowest survival rate. In unadjusted models, plasma ANGPTL4 significantly predicted all-cause mortality, cancer mortality, and cardiovascular or cancer-related mortality. Upon adjustment for confounders including age, sex, smoking, body mass index (BMI), hypertension, diabetes mellitus (DM), and renal function, each standard deviation increase in plasma ANGPTL4 was associated with HRs of 1.35 (95% CI: 1.01–1.80, p < 0.05) for all-cause mortality, 1.41 (95% CI: 0.94–2.10, p = 0.094) for cancer mortality, and 1.40 (95% CI: 1.02–1.94, p < 0.05) for cardiovascular or cancer-related mortality. Additionally, plasma ANGPTL4 contributed more significantly to predicting cardiovascular or cancer-related mortality and all-cause mortality compared to other predictors, such as sex, smoking, BMI, history of hypertension, history of diabetes, and eGFR.
Conclusions:
Plasma ANGPTL4 emerges as a promising biomarker capable of predicting 10-year mortality and enhancing risk prediction beyond established risk factors.
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| ISSN: | 1734-1922 |
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