# Increased Serum Angiopoietin-like Peptide 4 in Impaired Glucose Tolerance and Diabetes Subjects with or Without Hepatic Steatosis

## TL;DR

This study found that higher levels of a protein called ANGPTL4 are linked to prediabetes and diabetes, regardless of whether participants had fatty liver.

## Contribution

The study identifies ANGPTL4 as a potential biomarker for impaired glucose tolerance and diabetes, independent of hepatic steatosis.

## Key findings

- IGT and NDD were associated with significantly higher serum ANGPTL4 concentrations compared to NGT.
- ANGPTL4 levels were not influenced by the presence of hepatic steatosis.
- BMI and insulin resistance were independently associated with ANGPTL4 levels.

## Abstract

Objectives: Although angiopoietin-like 4 (ANGPTL4) is highly associated with glucose hemostasis and lipid metabolism, the relationships between the serum ANGPTL4 level, glucose status and hepatic steatosis remain unclear. Therefore, this study aimed to quantify the independent effects of glucose intolerance and hepatic steatosis on circulating ANGPTL4 concentrations. Methods: A total of 348 age- and sex-matched participants with normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and newly diagnosed diabetes (NDD) with or without hepatic steatosis were recruited for this cross-sectional study. Serum ANGPTL4 levels were measured, and multivariate linear regression analysis was used to evaluate the relationship between ANGPTL4, glycemic status and hepatic steatosis. Results: Compared with NGT, both IGT and NDD were associated with significantly higher serum ANGPTL4 concentrations, irrespective of hepatic steatosis status. Serum ANGPTL4 did not differ by the presence versus absence of hepatic steatosis. In multiple regression analysis, body mass index, homeostasis model assessment of insulin resistance, NGT vs. IGT, and NGT vs. NDD were independently associated with ANGPTL4 levels after adjustment for cardiovascular risk factors and adiponectin, whereas hepatic steatosis was not. Conclusions: Elevated serum ANGPTL4 concentrations were independently associated with prediabetes and diabetes, irrespective of hepatic steatosis.