Angiopoietin-like protein 2 is associated with chronic kidney disease in a general Japanese population: The Hisayama Study

Abstract

Background: Angiopoietin-like protein 2 (Angptl2) is an adipokine that promotes inflammation and endothelial dysfunction of the vessels. The aim of this study was to investigate the relationship between serum Angptl2 level and chronic kidney disease (CKD). Methods and Results: A total of 3,169 community-dwelling subjects aged ≥40 years were divided into quintiles by Angptl2 level. CKD was defined as the presence of albuminuria (urine albumin-creatinine ratio ≥30.0 mg/g) or decreased estimated glomerular filtration rate (eGFR <60 ml · min-1 · 1.73 m-2). The odds ratio (OR) for the presence of CKD was calculated using a logistic regression model. The overall prevalence of CKD was 37.5%. The age- and sex-adjusted ORs for the presence of CKD increased with higher serum Angptl2 level. This trend remained significant after adjusting for known cardiovascular risk factors (<2.01 ng/ml: OR, 1.00 (reference); 2.01-2.48 ng/ml: OR, 1.67, 95% confidence interval [CI]: 1.24-2.24; 2.49-2.99 ng/ml: OR, 1.70, 95% CI: 1.27-2.28; 3.00-3.65 ng/ml: OR, 1.78, 95% CI: 1.32-2.39; ≥3.66 ng/ml: OR, 1.79, 95% CI: 1.32-2.43; P-value for trend=0.001). Multivariate-adjusted ORs for the presence of albuminuria increased significantly with elevated serum Angptl2 (P-value for trend=0.004), while there was no evidence of a significant relationship between serum Angptl2 level and decreased eGFR (P-value for trend=0.08). Conclusions: Elevated serum Angptl2 is associated with the likelihood of CKD in the general population.