title: Angiopoietin-like protein 4 and cardiovascular function in COPD.
abstract: BACKGROUND
  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.
authors.affiliation: LungClinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Grosshansdorf, Germany; Pulmonary Research Institute at LungClinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Grosshansdorf, Germany.
authors.forename: B
authors.identifier: 0000-0002-1070-3661
authors.initials: B
authors.lastname: Waschki
authors.affiliation: Pulmonary Research Institute at LungClinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research (DZL) , Grosshansdorf , Germany.
authors.forename: A M
authors.initials: AM
authors.lastname: Kirsten
authors.affiliation: Fraunhofer Institute for Toxicology and Experimental Medicine, Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL) , Hannover , Germany.
authors.forename: O
authors.initials: O
authors.lastname: Holz
authors.affiliation: Institute for Epidemiology, Social Medicine and Health System Research, Hannover Medical School , Hannover , Germany.
authors.forename: T
authors.initials: T
authors.lastname: Meyer
authors.affiliation: Institute of Clinical Chemistry, Hannover Medical School , Hannover , Germany.
authors.forename: R
authors.initials: R
authors.lastname: Lichtinghagen
authors.affiliation: LungClinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research (DZL) , Grosshansdorf , Germany.
authors.forename: K F
authors.initials: KF
authors.lastname: Rabe
authors.affiliation: Pulmonary Research Institute at LungClinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research (DZL) , Grosshansdorf , Germany.
authors.forename: H
authors.initials: H
authors.lastname: Magnussen
authors.affiliation: Department of Respiratory Medicine , Hannover Medical School, BREATH, German Center for Lung Research (DZL) , Hannover , Germany.
authors.forename: T
authors.initials: T
authors.lastname: Welte
authors.affiliation: Pulmonary Research Institute at LungClinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research (DZL) , Grosshansdorf , Germany.
authors.forename: H
authors.initials: H
authors.lastname: Watz
authors.affiliation: Department of Respiratory Medicine , Hannover Medical School, BREATH, German Center for Lung Research (DZL) , Hannover , Germany.
authors.forename: S
authors.initials: S
authors.lastname: Janciauskiene
keywords: COPD ÀÜ Mechanisms; Systemic disease and lungs