Article

High YKL-40 levels predict mortality in patients with type 2 diabetes.

Steno Diabetes Center, Niels Steensenvej 2,Gentofte, Denmark.
Diabetes research and clinical practice (impact factor: 2.16). 12/2011; 96(1):84-9. DOI:10.1016/j.diabres.2011.12.008 pp.84-9
Source: PubMed

ABSTRACT We determined levels of the inflammatory marker YKL-40 in a population of patients with type 2 diabetes (T2D) and investigated the association with mortality.
In a prospective observational follow-up study, 290 patients with T2D, normoalbuminuria (n=177), microalbuminuria (n=71) and macroalbuminuria (n=42) were followed for a median (range) of 17.2 (0.2-23.0) years. Serum YKL-40 concentration was determined at baseline.
Baseline median (IQR) YKL-40 level was 46ng/ml (36-67) in patients with normoalbuminuria, 61ng/ml (43-114) in microalbuminuric patients, and 81.5ng/ml (60-157) in patients with macroalbuminuria, p<0.001. During follow-up 189 patients (65.2%) died, 119 (41.0%) from cardiovascular causes. All-cause mortality was increased in patients with YKL-40 levels in the second and third tertile (hazard ratios (95% CI) compared with the first tertile, (1.50 (1.03-2.19), p=0.034, and 2.88 (2.01-4.12), p<0.001). This association persisted after adjustment for cardiovascular risk factors but was attenuated after additional adjustment for urinary albumin excretion rate and glomerular filtration rate. Cardiovascular mortality was increased with YKL-40 levels in the third tertile compared with the first tertile, (2.70 (1.78-4.08)), p<0.001. This association was diminished after adjustment for covariates.
In patients with T2D and increasing albuminuria high YKL-40 levels predict all-cause mortality.

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Keywords

additional adjustment
 
All-cause mortality
 
Baseline median
 
cardiovascular causes
 
Cardiovascular mortality
 
cardiovascular risk factors
 
covariates
 
first tertile
 
follow-up 189 patients
 
glomerular filtration rate
 
hazard ratios
 
inflammatory marker YKL-40
 
microalbuminuria
 
microalbuminuric patients
 
prospective observational follow-up study
 
Serum YKL-40 concentration
 
third tertile
 
type 2 diabetes
 
urinary albumin excretion rate
 
YKL-40 levels