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Chronic obstructive pulmonary disease
Angiopoietin-like protein 4 and cardiovascular function in COPD
  1. B Waschki1,2,
  2. AM Kirsten2,
  3. O Holz3,
  4. T Meyer4,
  5. R Lichtinghagen5,
  6. KF Rabe1,
  7. H Magnussen2,
  8. T Welte6,
  9. H Watz2 and
  10. S Janciauskiene6
  1. 1LungClinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Grosshansdorf, Germany
  2. 2Pulmonary Research Institute at LungClinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Grosshansdorf, Germany
  3. 3Fraunhofer Institute for Toxicology and Experimental Medicine, Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
  4. 4Institute for Epidemiology, Social Medicine and Health System Research, Hannover Medical School, Hannover, Germany
  5. 5Institute of Clinical Chemistry, Hannover Medical School, Hannover, Germany
  6. 6Department of Respiratory Medicine, Hannover Medical School, BREATH, German Center for Lung Research (DZL), Hannover, Germany
  1. Correspondence to Dr B Waschki; b.waschki{at}lungenclinic.de

Abstract

Introduction The coexistence of chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) is frequent and might be inter-related through inflammation-related processes reflected by specific markers. Here, we studied angiopoietin-like protein 4 (ANGPTL4), an upcoming cardiovascular marker, in stable COPD, and its relationship to cardiovascular function with respect to well-known CVD risk factors.

Methods In a prospective COPD cohort study, we investigated serum ANGPTL4 levels, vascular status (ankle–brachial index (ABI)) and cardiac function (N-terminal pro-B-type natriuretic peptide (NT-proBNP)) as well as airflow limitation, objectively measured physical activity, the metabolic syndrome, high-sensitive C reactive protein (hs-CRP) and other CVD risk factors at 2 time points. We initially studied 74 stable COPD patients and 18 controls. For internal validation, we additionally studied 160 COPD patients of a former visit.

Results ANGPTL4 was significantly elevated in COPD patients compared with controls (p=0.026). After correction for traditional CVD risk factors, including hs-CRP, higher levels of ANGPTL4 were independently associated with lower ABI (p=0.023) and higher NT-proBNP (p<0.001). These findings were confirmed in the internal validation analysis, which included echocardiographic assessments.

Conclusions Serum ANGPTL4 is independently associated with cardiovascular function in COPD and might qualify as a biomarker reflecting a pathogenic link between COPD and CVD.

  • COPD ÀÜ Mechanisms
  • Systemic disease and lungs

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjresp-2016-000161

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    Footnotes

    • Contributors BW, HW and HM conceived and designed the cohort study, SJ and TW conceived analyses on ANGPTL4. BW, AMK, OH, RL, HW and SJ collected data. BW, TM and SJ contributed to analyses. BW, TM, KFR, HM, TW, HW and SJ interpreted the data. BW wrote the first draft. SJ and HW edited the first draft. All authors reviewed, edited and approved the final draft prior to submission.

    • Funding German Center for Lungresearch (DZL).

    • Competing interests None declared.

    • Ethics approval Ethics Committee of the Medical Association of Schleswig-Holstein, Bad Segeberg, Germany (III/EK 116/05(I); 185/08(I)).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.