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May 24, 2026Journal of EpidemiologyOpen Access

Serum levels of angiopoietin-like protein 2 and the risk of cause-specific mortality in a general population: the Hisayama Study

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Why the study?

Few studies have investigated the relationship between circulating ANGPTL2 concentrations and cause-specific mortality risk in the general population.

Are elevated serum ANGPTL2 concentrations associated with an increased risk of all-cause and cause-specific mortality in a general population?

Population

2,912 community-dwelling Japanese adults aged ≥40 years without cardiovascular diseases or cancer

Comparison

Serum ANGPTL2 concentrations

Design

Prospective cohort study

Follow-up

Median of 15.2 years

Key result

Higher baseline serum ANGPTL2 concentrations were associated with an increased risk of all-cause mortality (HR 1.34; 95% CI 1.23-1.47 per 1-SD increment) over a median follow-up of 15.2 years.

Authors

JHJun HataSSSatoko SakataYFYoshihiko Furuta

Discussion

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Overview

May flag higher mortality risk in community adults; hypothesis-generating for ANGPTL2 in risk models.

Key Points

  • This research aims to explore the association between serum levels of ANGPTL2 and risk of cause-specific mortality in a general population.
  • Conducted a prospective cohort study with 2,912 Japanese adults aged ≥40 years.
  • Measured baseline serum ANGPTL2 concentrations from 2002–2003 and followed participants for a median of 15.2 years.
  • Used Cox proportional hazards models to estimate hazard ratios for mortality outcomes.
  • Higher serum ANGPTL2 levels corresponded to a HR of 1.34 (95% CI: 1.23–1.47) for all-cause mortality.
  • For cardiovascular death, HR was 1.28 (95% CI: 1.06–1.55); for cancer death, HR was 1.31 (95% CI: 1.12–1.53); and for infectious disease mortality, HR was 1.27 (95% CI: 1.05–1.54).
  • Associations were slightly reduced after adjustments for insulin resistance and chronic inflammation mediators.

Study Design

Type

Cohort (n=2,912)

Structured PICO

Are elevated serum ANGPTL2 concentrations associated with an increased risk of all-cause and cause-specific mortality in a general population?

P
Population
2,912 community-dwelling Japanese adults aged ≥40 years with no prior history of cardiovascular diseases or cancer.
I
Intervention
Higher baseline serum ANGPTL2 concentrations (collected in 2002–2003)
C
Comparator
Lower baseline serum ANGPTL2 concentrations
O
Outcome
All-cause and cause-specific mortality (cardiovascular death, cancer death, infectious diseases death, and other causes)hard clinical

Main Result

Effect estimate: HR 1.34 (95% CI 1.23-1.47)

Elevated serum ANGPTL2 concentrations are an independent risk factor for all-cause and cause-specific mortality, including cardiovascular death, in the general population.

Cite This Study

Hata et al. (2026) conducted a cohort in General population (n=2,912). Serum ANGPTL2 concentrations was evaluated on all-cause mortality (HR 1.34, 95% CI 1.23-1.47). Higher baseline serum ANGPTL2 concentrations were associated with an increased risk of all-cause mortality (HR 1.34; 95% CI 1.23-1.47 per 1-SD increment) over a median follow-up of 15.2 years.

synapsesocial.com/papers/6a129af248a0ea1665674094https://doi.org/10.2188/jea.je20250491
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Plasma Angiopoietin-Like Protein 2 Levels and Mortality Risk Among Younger-Old Japanese People: A Population-Based Case–Cohort Study2022 · 5 citations
  2. 2Serum Angiopoietin–Like Protein 2 Is a Novel Risk Factor for Cardiovascular Disease in the Community2016 · 40 citations
  3. 3Angiopoietin‐like protein 2 and mortality in patients with heart failure—Results from an observational study2025
  4. 4Angiopoietin-Like Protein 2 and Risk of Type 2 Diabetes in a General Japanese Population2012 · 78 citations
  5. 5Circulating angiopoietin-like protein 2 levels and mortality risk in patients receiving maintenance hemodialysis: a prospective cohort study2019 · 12 citations