Angiopoietin-like 2 (ANGPTL2) is a proinflammatory protein belonging to the angiopoietin-like family. ANGPTL2 is secreted and detected in the systemic circulation. Serum levels of ANGPTL2 increase significantly in various chronic inflammatory diseases and show associations between ANGPTL2 levels and diagnosis and/or prognosis of cardiovascular diseases, diabetes, chronic kidney disease, and various types of cancers. However, no data regarding the relationship between ANGPTL2 and diabetic foot are available. Here, we explored the potential link between ANGPTL2 and diabetic foot. We recruited 66 participants, including 16 patients with diabetic foot and 50 patients with type 2 diabetes mellitus without diabetic foot. Serum ANGPTL2, CRP, VEGF, ICAM-1 and TNF-α were measured using enzyme-linked immunosorbent assay (ELISA) kits. We demonstrated that serum levels of ANGPTL2 in diabetic foot patients were higher than those in diabetes controls (6.696±0.6759 vs. 4.444±0.2135, p<0.0001). In the spearman correlation analysis, serum ANGPTL2 level had strong positive correlation with CRP (r=0.4924, p<0.0001), VEGF(r=0.4116, p=0.0006), ESR (r=0.5282, p<0.0001) among all subjects. After adjusted for age, sex, smoking and duration of diabetes, ANGPTL2 was demonstrated to be an independent risk factor for diabetic foot (OR, 3.835, 95% CI 1.608-14.81, p=0.0002). In addition, serum ANGPTL2 was still positively correlated diabetic foot stage after adjusting age, sex, smoking, HbA1c, duration of diabetes and use of drugs (β=0.3838, p=0.002).
In conclusion, serum ANGPTL2 acted as a contributor for diabetic foot and had strong association with diabetic foot progression in all stages. Blockade of ANGPTL2 may postpone the onset and development of diabetic foot.
Y. Wang: None. L. Yang: None. Z. Zheng: None. X. Wang: None. D. Zhao: None.
National Natural Science Foundation of China; National Science Funding in China