Diagnostic Value of Serum ANGPTL8 and FGF21 Levels in Type 2 Diabetes Mellitus Complicated with Coronary Atherosclerotic Heart Disease

FENG Wei; WANG Xin; JI Chunrui; CAI Jianing

doi:10.12102/j.issn.1672-1349.2025.09.017

Abstract：Objective: To explore the diagnostic value of serum angiopoietin-like protein 8 (ANGPTL8) and fibroblast growth factor 21 (FGF21) levels in patients with type 2 diabetes mellitus (T2DM) combined with coronary atherosclerotic heart disease (CHD). Methods: A total of 156 T2DM patients admitted to our hospital from November 2021 to November 2023 were selected as the study subjects. According to the results of coronary angiography, T2DM patients with CHD were enrolled into the T2DM+CHD group (74 cases), while those without CHD were enrolled into the T2DM group (82 cases). Additionally, 98 healthy individuals who underwent physical examination at the same time were selected as the control group. Clinical data were collected, and serum ANGPTL8 and FGF21 levels were detected using enzyme-linked immunosorbent assay (ELISA). Pearson's correlation analysis was used to evaluate the relationship between ANGPTL8 and FGF21 levels and related laboratory indicators. Logistic regression analysis was performed to identify the risk factors for CHD in T2DM patients. Receiver operating characteristic (ROC) curves were used to analyze the diagnostic value of serum ANGPTL8 and FGF21 levels in T2DM combined with CHD. Results: The levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), fasting blood glucose (FBG), and serum ANGPTL8 and FGF21 were significantly higher in the T2DM+CHD group compared to the control group and T2DM group, while lipoprotein lipase (LPL) levels were lower than those in the T2DM group (P < 0.05). Serum ANGPTL8 and FGF21 levels showed positive correlations with TC, TG, LDL-C, TNF-α, IL-6, and FBG (P < 0.05), while LPL levels showed a negative correlation with ANGPTL8 (P < 0.05) but no correlation with FGF21 (P > 0.05). Elevated serum ANGPTL8 and FGF21 levels were identified as risk factors for CHD in T2DM patients (P < 0.05). The area under the curve (AUC) for the diagnosis of T2DM combined with CHD by serum ANGPTL8 and FGF21 levels alone were 0.828, 0.855, and 0.939 when combined, respectively. The combined diagnosis was superior to individual diagnosis (Z for ANGPTL8 combined = 3.578, P < 0.001; Z for FGF21 combined = 2.618, P = 0.009). Conclusion: Serum ANGPTL8 and FGF21 levels are elevated in patients with T2DM combined with CHD, and they have high diagnostic value for T2DM combined with CHD. Combined detection can serve as a serum biomarker for early diagnosis of T2DM combined with CHD.