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Song M, Zhang G, Shi H, Zhu E, Deng L, Shen H. Serum YKL-40 in coronary heart disease: linkage with inflammatory cytokines, artery stenosis, and optimal cut-off value for estimating major adverse cardiovascular events. Front Cardiovasc Med 2023; 10:1242339. [PMID: 38028459 PMCID: PMC10644235 DOI: 10.3389/fcvm.2023.1242339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/22/2023] [Indexed: 12/01/2023] Open
Abstract
Objective YKL-40, previously known as chitinase-3-like protein 1 (CHI3L1), is an inflammation-related glycoprotein that promotes atherosclerosis, but its application and optimal cut-off value as a prognostic biomarker in coronary heart disease (CHD) require more clinical evidence. Thus, this prospective study aimed to evaluate the linkage of serum YKL-40 with disease features, inflammatory cytokines, and major adverse cardiovascular events (MACEs) in CHD patients. Methods A total of 410 CHD patients were enrolled for serum YKL-40 determination via enzyme-linked immunosorbent assay. Meanwhile, serum YKL-40 levels in 100 healthy controls (HCs) were also quantified. Results YKL-40 level was higher in CHD patients compared with that in HCs (P < 0.001). YKL-40 was positively linked with hyperlipidemia (P = 0.014), diabetes mellitus (P = 0.001), fasting blood glucose (P = 0.045), C-reactive protein (P < 0.001), the Gensini score (P < 0.001), and stenosis degree (graded by the Gensini score) (P < 0.001) in CHD patients. In addition, an elevated YKL-40 level was associated with increased levels of tumor necrosis factor alpha (P = 0.001), interleukin (IL)-1β (P = 0.001), IL-6 (P < 0.001), and IL-17A (P = 0.002) in CHD patients. The 1-/2-/3-year cumulative MACE rates of CHD patients were 5.5%, 14.4%, and 25.0%, respectively. Regarding the prognostic capability, YKL-40 ≥100 ng/ml (the median cut-off value) (P = 0.003) and YKL-40 ≥150 ng/ml (the third interquartile cut-off value) (P = 0.021) reflected an elevated accumulating MACE rate, whereas accumulating MACE was not different between CHD patients with YKL-40 ≥80 and <80 ng/ml (the first interquartile cut-off value) (P = 0.083). Conclusion Serum YKL-40 is positively linked with inflammatory cytokines and the Gensini score, whose high expression cut-off by 100 and 150 ng/ml estimates a higher MACE risk in CHD patients.
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Affiliation(s)
- Mowei Song
- Department of Cardiology, The First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Guofu Zhang
- Department of Cardiovascular Surgery, The First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Hang Shi
- Department of Cardiovascular Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Erjun Zhu
- Department of Cardiovascular Surgery, The First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Li Deng
- Department of Extracorporeal Life Support, The People’s Hospital of Gaozhou, Gaozhou, China
| | - Hongtao Shen
- Department of Orthopedic Surgery, The First Affiliated Hospital, Harbin Medical University, Harbin, China
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Vasquez-Rios G, Katz R, Levitan EB, Cushman M, Parikh CR, Kimmel PL, Bonventre JV, Waikar SS, Schrauben SJ, Greenberg JH, Sarnak MJ, Ix JH, Shlipak MG, Gutierrez OM. Urinary Biomarkers of Kidney Tubule Health and Mortality in Persons with CKD and Diabetes Mellitus. KIDNEY360 2023; 4:e1257-e1264. [PMID: 37533144 PMCID: PMC10547219 DOI: 10.34067/kid.0000000000000226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/24/2023] [Indexed: 08/04/2023]
Abstract
Key Points Among adults with diabetes and CKD, biomarkers of kidney tubule health were associated with a greater risk of death, independent of eGFR, albuminuria, and additional risk factors. Higher urine levels of YKL-40 and KIM-1 were associated with a greater risk of death. For cause-specific death, UMOD was independently and inversely associated with the risk of cardiovascular death. Background Kidney disease assessed by serum creatinine and albuminuria are strongly associated with mortality in diabetes. These markers primarily reflect glomerular function and injury. Urine biomarkers of kidney tubule health were recently associated with the risk of kidney failure in persons with CKD and diabetes. Associations of these biomarkers with risk of death are poorly understood. Methods In 560 persons with diabetes and eGFR ≤60 ml/min per 1.73 m2 from the Reasons for Geographic and Racial Differences in Stroke study (47% male, 53% Black), we measured urine biomarkers of kidney tubule health at baseline: monocyte chemoattractant protein-1 (MCP-1), alpha-1-microglobulin, kidney injury molecule-1 (KIM-1), EGF, chitinase-3-like protein 1 (YKL-40), and uromodulin (UMOD). Cox proportional hazards regression was used to examine the associations of urine biomarkers with all-cause and cause-specific mortality in nested models adjusted for urine creatinine, demographics, mortality risk factors, eGFR, and urine albumin. Results The mean (SD) age was 70 (9.6) years, and baseline eGFR was 40 (3) ml/min per 1.73 m2. There were 310 deaths over a mean follow-up of 6.5 (3.2) years. In fully adjusted models, each two-fold higher urine concentration of KIM-1 and YKL-40 were associated with all-cause mortality (hazard ratio [HR] 1.15, 95% confidence interval [CI], 1.01 to 1.31 and 1.13, 95% CI, 1.07 to 1.20, respectively). When examining cause-specific mortality, higher UMOD was associated with a lower risk of cardiovascular death (adjusted HR per two-fold higher concentration 0.87, 95% CI, 0.77 to 0.99), and higher MCP-1 was associated with higher risk of cancer death (HR per two-fold higher concentration 1.52, 95% CI, 1.05 to 2.18). Conclusion Among persons with diabetes and CKD, higher urine KIM-1 and YKL-40 were associated with a higher risk of all-cause mortality independently of established risk factors. Urine UMOD and MCP-1 were associated with cardiovascular and cancer-related death, respectively.
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Affiliation(s)
- George Vasquez-Rios
- Division of Nephrology , Department of Internal Medicine , Icahn School of Medicine at Mount Sinai , Manhattan , New York
| | - Ronit Katz
- Department of Obstetrics and Gynecology , University of Washington , Seattle , Washington
| | - Emily B Levitan
- Department of Epidemiology , University of Alabama at Birmingham , Birmingham , Alabama
| | - Mary Cushman
- Departments of Medicine and Pathology and Laboratory Medicine , Larner College of Medicine at the University of Vermont , Burlington , Vermont
| | - Chirag R Parikh
- Section of Nephrology , Department of Internal Medicine , Johns Hopkins School of Medicine , Baltimore , Maryland
| | - Paul L Kimmel
- National Institute of Diabetes and Digestive and Kidney Diseases , Bethesda , Maryland
| | - Joseph V Bonventre
- Division of Nephrology , Department of Medicine , Brigham and Women's Hospital , Boston , Massachusetts
| | - Sushrut S Waikar
- Section of Nephrology , Department of Medicine , Boston Medical Center , Boston , Massachusetts
| | - Sarah J Schrauben
- Department of Medicine , Perelman School of Medicine , Center for Clinical Epidemiology and Biostatistics at the Perelman School of Medicine at the University of Pennsylvania , Philadelphia , Pennsylvania
| | - Jason H Greenberg
- Section of Nephrology , Department of Pediatrics , Program of Applied Translational Research , Yale University School of Medicine , New Haven , Connecticut
| | - Mark J Sarnak
- Division of Nephrology , Department of Medicine , Tufts Medical Center , Boston , Massachusetts
| | - Joachim H Ix
- Division of Nephrology-Hypertension , Department of Medicine , University of California San Diego , San Diego , California
- Veterans Affairs San Diego Healthcare System , San Diego , California
| | - Michael G Shlipak
- Kidney Health Research Collaborative , San Francisco Veterans Affairs Healthcare System and University of California , San Francisco , California
| | - Orlando M Gutierrez
- Departments of Medicine and Epidemiology , University of Alabama at Birmingham , Birmingham , Alabama
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Fang C, Li J, Wang W, Wang Y, Chen Z, Zhang J. Establishment and validation of a clinical nomogram model based on serum YKL-40 to predict major adverse cardiovascular events during hospitalization in patients with acute ST-segment elevation myocardial infarction. Front Med (Lausanne) 2023; 10:1158005. [PMID: 37283624 PMCID: PMC10239942 DOI: 10.3389/fmed.2023.1158005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/02/2023] [Indexed: 06/08/2023] Open
Abstract
Objective This study aimed to investigate the predictive value of a clinical nomogram model based on serum YKL-40 for major adverse cardiovascular events (MACE) during hospitalization in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods In this study, 295 STEMI patients from October 2020 to March 2023 in the Second People's Hospital of Hefei were randomly divided into a training group (n = 206) and a validation group (n = 89). Machine learning random forest model was used to select important variables and multivariate logistic regression was included to analyze the influencing factors of in-hospital MACE in STEMI patients; a nomogram model was constructed and the discrimination, calibration, and clinical effectiveness of the model were verified. Results According to the results of random forest and multivariate analysis, we identified serum YKL-40, albumin, blood glucose, hemoglobin, LVEF, and uric acid as independent predictors of in-hospital MACE in STEMI patients. Using the above parameters to establish a nomogram, the model C-index was 0.843 (95% CI: 0.79-0.897) in the training group; the model C-index was 0.863 (95% CI: 0.789-0.936) in the validation group, with good predictive power; the AUC (0.843) in the training group was greater than the TIMI risk score (0.648), p < 0.05; and the AUC (0.863) in the validation group was greater than the TIMI risk score (0.795). The calibration curve showed good predictive values and observed values of the nomogram; the DCA results showed that the graph had a high clinical application value. Conclusion In conclusion, we constructed and validated a nomogram based on serum YKL-40 to predict the risk of in-hospital MACE in STEMI patients. This model can provide a scientific reference for predicting the occurrence of in-hospital MACE and improving the prognosis of STEMI patients.
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Affiliation(s)
- Caoyang Fang
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
- Graduate School, Bengbu Medical College, Bengbu, Anhui, China
| | - Jun Li
- Department of Cardiology, The Lu’an Hospital Affiliated to Anhui Medical University, Lu’an, Anhui, China
- Department of Cardiology, The Lu’an People's Hospital, Lu’an, Anhui, China
| | - Wei Wang
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Yuqi Wang
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
- Graduate School, Bengbu Medical College, Bengbu, Anhui, China
| | - Zhenfei Chen
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Jing Zhang
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
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Johnson MJ, Tommerdahl KL, Vinovskis C, Waikar S, Reinicke T, Parikh CR, Obeid W, Nelson RG, van Raalte DH, Pyle L, Nadeau KJ, Bjornstad P. Relationship between biomarkers of tubular injury and intrarenal hemodynamic dysfunction in youth with type 1 diabetes. Pediatr Nephrol 2022; 37:3085-3092. [PMID: 35286453 PMCID: PMC9470783 DOI: 10.1007/s00467-022-05487-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/29/2022] [Accepted: 01/31/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Early identification of youth with type 1 diabetes (T1D) at risk for diabetic kidney disease may improve clinical outcomes. We examined the cross-sectional relationship between kidney biomarkers neutrophil gelatinase-associated lipocalin (NGAL), copeptin, interleukin-18 (IL-18), kidney injury molecule-1 (KIM-1), chitinase-3-like protein-1 (YKL-40), and monocyte chemoattractant protein-1 (MCP-1) and intrarenal hemodynamic function in adolescents with T1D. METHODS Urine albumin-to-creatinine ratio (UACR), renal vascular resistance (RVR), glomerular filtration rate (GFR), intraglomerular pressure (PGLO), efferent arteriole resistance (RE), afferent arteriolar resistance (RA), and renal plasma flow (RPF), and the above indicated biomarkers were assessed in youth aged 12-21 years with and without T1D of < 10 years duration. RESULTS Fifty adolescents with T1D (16.1 ± 3.0 years, HbA1c 8.6 ± 1.2%) and 20 adolescents of comparable BMI without T1D (16.1 ± 2.9 years, HbA1c 5.2 ± 0.2%) were enrolled. Adolescents with T1D demonstrated significantly higher GFR, RPF, RE, and PGLO than controls (39%, 33%, 74%, and 29%, respectively, all p < 0.0001). Adolescents with T1D also exhibited significantly lower RVR and RA than controls (25% and 155%, respectively, both p < 0.0001). YKL-40 and KIM-1 concentrations, respectively, were positively associated with GFR (r: 0.43, p = 0.002; r: 0.41, p = 0.003), RPF (r: 0.29, p = 0.08; r: 0.34, p = 0.04), UACR (r: 0.33, p = 0.02; r: 0.50, p = 0.0002), and PGLO (r: 0.45, p = 0.006; r: 0.52, p = 0.001) in adolescents with T1D. CONCLUSIONS Higher concentrations of biomarkers YKL-40 and KIM-1 may help define the risk for intraglomerular hemodynamic dysfunction in youth with T1D. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Melissa J Johnson
- Department of Pediatrics, Section of Pediatric Endocrinology, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kalie L Tommerdahl
- Department of Pediatrics, Section of Pediatric Endocrinology, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO, USA
- Ludeman Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Carissa Vinovskis
- Department of Pediatrics, Section of Pediatric Endocrinology, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sushrut Waikar
- Section of Nephrology, Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Trenton Reinicke
- Department of Pediatrics, Section of Pediatric Endocrinology, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Chirag R Parikh
- Division of Nephrology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Wassim Obeid
- Division of Nephrology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Robert G Nelson
- Chronic Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - Daniel H van Raalte
- Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Centers, location VUMC, Amsterdam, The Netherlands
| | - Laura Pyle
- Department of Biostatistics, Colorado School of Public Health, Aurora, CO, USA
| | - Kristen J Nadeau
- Department of Pediatrics, Section of Pediatric Endocrinology, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Ludeman Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Petter Bjornstad
- Department of Pediatrics, Section of Pediatric Endocrinology, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
- Ludeman Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, 13123 E. 16th AveBox B265, Aurora, CO, USA.
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Piani F, Melena I, Severn C, Chung LT, Vinovskis C, Cherney D, Pyle L, Roncal-Jimenez CA, Lanaspa MA, Rewers A, van Raalte DH, Obeid W, Parikh C, Nelson RG, Pavkov ME, Nadeau KJ, Johnson RJ, Bjornstad P. Tubular injury in diabetic ketoacidosis: Results from the diabetic kidney alarm study. Pediatr Diabetes 2021; 22:1031-1039. [PMID: 34435718 PMCID: PMC8957478 DOI: 10.1111/pedi.13259] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 08/07/2021] [Accepted: 08/16/2021] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Glomerular injury is a recognized complication of diabetic ketoacidosis (DKA), yet the tubular lesions are poorly understood. The aim of this prospective study was to evaluate the presence and reversibility of tubular injury during DKA in children with type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS Blood and urine samples were collected from 40 children with DKA (52% boys, mean age 11 ± 4 years, venous pH 7.2 ± 0.1, glucose 451 ± 163 mg/dL) at three timepoints: 0-8 and 12-24 h after starting insulin, and 3 months after discharge. Mixed-effects models evaluated the changes in tubular injury markers over time (neutrophil gelatinase-associated lipocalin [NGAL], kidney injury molecule 1 [KIM-1], and interleukin 18 [IL-18]). We also evaluated the relationships among the tubular injury biomarkers, copeptin, a vasopressin surrogate, and serum uric acid (SUA). RESULTS Serum NGAL, KIM-1, and IL-18 were highest at 0-8 h (306.5 ± 45.9 ng/mL, 128.9 ± 10.1 pg/mL, and 564.3 ± 39.2 pg/mL, respectively) and significantly decreased over 3 months (p = 0.03, p = 0.01, and p < 0.001, respectively). There were strong relationships among increases in copeptin and SUA and rises in tubular injury biomarkers. At 0-8 h, participants with acute kidney injury (AKI) [17%] showed significantly higher concentrations of tubular injury markers, copeptin, and SUA. CONCLUSIONS DKA was characterized by tubular injury, and the degree of injury associated with elevated copeptin and SUA. Tubular injury biomarkers, copeptin and SUA may be able to predict AKI in DKA.
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Affiliation(s)
- Federica Piani
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Isabella Melena
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Cameron Severn
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Linh T. Chung
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Carissa Vinovskis
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - David Cherney
- Department of Medicine, Division of Nephrology, University of Toronto School of Medicine, Toronto, Ontario, Canada
| | - Laura Pyle
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Biostatistics and Informatics, Colorado School of Public Health, Colorado, USA
| | - Carlos A. Roncal-Jimenez
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Miguel A. Lanaspa
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Arleta Rewers
- Department of Pediatrics, Section of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Daniël H. van Raalte
- Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands
| | - Wassim Obeid
- Department of Medicine, Division of Nephrology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Chirag Parikh
- Department of Medicine, Division of Nephrology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Robert G. Nelson
- Chronic Kidney Disease Section, Phoenix Epidemiology and Clinical Research Branch, NIDDK, Phoenix, Arizona, USA
| | - Meda E. Pavkov
- Division of Diabetes Translation, Center for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kristen J. Nadeau
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Richard J. Johnson
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Petter Bjornstad
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, Colorado, USA
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Retinol-Binding Protein-4-A Predictor of Insulin Resistance and the Severity of Coronary Artery Disease in Type 2 Diabetes Patients with Coronary Artery Disease. BIOLOGY 2021; 10:biology10090858. [PMID: 34571734 PMCID: PMC8468650 DOI: 10.3390/biology10090858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/29/2021] [Accepted: 08/29/2021] [Indexed: 12/25/2022]
Abstract
(1) Background: Insulin resistance (IR) is the fundamental cause of type 2 diabetes (T2D), which leads to endothelial dysfunction and alters systemic lipid metabolism. The changes in the endothelium and lipid metabolism result in atherosclerotic coronary artery disease (CAD). In insulin-resistant and atherosclerotic CAD states, serum cytokine retinol-binding protein-4 (RBP-4) levels are elevated. The adipocyte-specific deletion of glucose transporter 4 (GLUT4) results in higher RBP-4 expression and IR and atherosclerotic CAD progression. (2) Aim: This study aimed to investigate the association of RBP-4 and clinical factors with IR and the severity of CAD. (3) Methods: Patients were recruited from diabetes and cardiology clinics and divided into three subgroups, namely (i) T2D patients with CAD, (ii) T2D-only patients, and (iii) CAD-only patients. The severity of CAD was classified as either single-vessel disease (SVD), double-vessel disease (DVD), or triple-vessel disease (TVD). An enzyme-linked immunosorbent assay was conducted to assess the concentration of serum RBP-4. Univariate (preliminary analysis) and multivariate (secondary analysis) logistic regressions were applied to assess the associations of RBP-4 and clinical factors with IR and the severity of CAD. (4) Results: Serum RBP-4 levels were associated with IR and the severity of CAD in all the three groups (all p-values are less than 0.05). Specifically, serum RBP-4 levels were associated with IR (p = 0.030) and the severity of CAD (SVD vs. DVD, p = 0.044; SVD vs. TVD, p = 0.036) in T2D patients with CAD. The clinical factors fasting plasma glucose (FPG) and angiotensin-converting-enzyme inhibitor (ACEI) were also associated with both IR and the severity of CAD in T2D patients with CAD. (5) Conclusion: RBP-4, FPG, and ACEI are predictors of IR and severity of CAD in T2D patients with CAD.
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Wilczyńska K, Waszkiewicz N. Diagnostic Utility of Selected Serum Dementia Biomarkers: Amyloid β-40, Amyloid β-42, Tau Protein, and YKL-40: A Review. J Clin Med 2020; 9:jcm9113452. [PMID: 33121040 PMCID: PMC7692800 DOI: 10.3390/jcm9113452] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/16/2020] [Accepted: 10/16/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction: Dementia is a group of disorders that causes dysfunctions in human cognitive and operating functions. Currently, it is not possible to conduct a fast, low-invasive dementia diagnostic process with the use of peripheral blood biomarkers, however, there is a great deal of research in progress covering this subject. Research on dementia biomarkers in serum validates anticipated health and economic benefits from early screening tests. Biomarkers are also essential for improving the process of developing new drugs. Methods: The result analysis, of current studies on selected biomarker concentrations (Aβ40, Aβ42, t-tau, and YKL-40) and their combination in the serum of patients with dementia and mild cognitive disorders, involved a search for papers available in Medline, PubMed, and Web of Science databases published from 2000 to 2020. Results: The results of conducted cross-sectional studies comparing Aβ40, Aβ42, and Aβ42/Aβ40 among people with cognitive disorders and a control group are incoherent. Most of the analyzed papers showed an increase in t-tau concentration in diagnosed Alzheimer’s disease (AD) patients’ serum, whereas results of mild cognitive impairment (MCI) groups did not differ from the control groups. In several papers on the concentration of YKL-40 and t-tau/Aβ42 ratio, the results were promising. To date, several studies have only covered the field of biomarker concentrations in dementia disorders other than AD. Conclusions: Insufficient amyloid marker test repeatability may result either from imperfection of the used laboratorial techniques or inadequate selection of control groups with their comorbidities. On the basis of current knowledge, t-tau, t-tau/Aβ42, and YKL-40 seem to be promising candidates as biomarkers of cognitive disorders in serum. YKL-40 seems to be a more useful biomarker in early MCI diagnostics, whereas t-tau can be used as a marker of progress of prodromal states in mild AD. Due to the insignificant number of studies conducted to date among patients with dementia disorders other than AD, it is not possible to make a sound assessment of their usefulness in dementia differential diagnostics.
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YKL-40 as a novel biomarker in cardio-metabolic disorders and inflammatory diseases. Clin Chim Acta 2020; 511:40-46. [PMID: 33002471 DOI: 10.1016/j.cca.2020.09.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/25/2020] [Accepted: 09/25/2020] [Indexed: 02/07/2023]
Abstract
Dyslipidaemia is associated with numerous health problems that include the combination of insulin resistance, hypertension and obesity, ie, metabolic syndrome. Although the use of statins to decrease serum low density lipoprotein cholesterol (LDL-C) has been an effective therapeutic in treating atherosclerosis, the persistence of high atherosclerotic risk, ie, residual risk, is notable and is not simply explained as a phenomenon of dyslipidaemia. As such, it is imperative that we identify new biomarkers to monitor treatment and more accurately predict future cardiovascular events. This athero-protective strategy includes the assessment of novel inflammatory biomarkers such as YKL-40. Recent evidence has implicated YKL-40 in patients with inflammatory diseases and cardio-metabolic disorders, making it potentially useful to evaluate disease severity, prognosis and survival. In this review, we summarize role of YKL-40 in the pathogenesis of cardio-metabolic disorders and explore its use as a novel biomarker for monitoring athero-protective therapy.
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Çetin M, Erdoğan T, Kırış T, Özer S, Çinier G, Emlek N, Durak H, Şatıroğlu Ö. Elevated serum YKL40 level is a predictor of MACE during the long-term follow up in hypertensive patients. Clin Exp Hypertens 2019; 42:271-274. [PMID: 31204510 DOI: 10.1080/10641963.2019.1632342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: YKL-40 (human cartilage glycoprotein 39, chitinase-3-like protein 1) is an inflammatory marker secreted mainly by macrophages and has distinctive roles on extracellular matrix remodeling, macrophage maturation, adhesion, and migration. Despite the presence of robust data suggesting the association of YKL-40 with variety of cardiovascular diseases (CV), there is no study up to date evaluating the role of YKL-40 on the long-term prognosis in patients with hypertension (HT).Methods: A single center, prospective, observational cohort study that included 327 consecutive hypertensive patients which were presented to a cardiology outpatient clinic. Patients were followed up for 7.89 ± 0.12 years. Primary outcome of the study was the occurrence of major cardiovascular outcomes (MACE) defined as all-cause mortality, new onset heart failure (HF), and coronary artery disease (CAD) requiring revascularization.Results: A total of 135 patients constituted the final study population [mean age: 52.4 ± 10.2, female: 63 (46%)]. A total of 28 (20.7%) patients had MACE during the follow up. Cox regression analysis revealed that age (HR: 1.046, 1.016-1.093 CI 95%, p = .026), diabetes (HR: 2.278, 1.026-5.057 CI 95%, p = .043), and YKL-40 level (HR: 1.019, 1.013-1.026 CI 95%, p = .005) significantly predicted MACE. We found that sensitivity and specificity of YKL-40 > 93.5 for predicting MACE was 71.4% and 65%, respectively with an area under curve (AUC) 0.723 (0.617-0.828 CI 95%, p < .001)Conclusion: Elevated serum YKL-40 level predicted MACE in hypertensive patients during a long-term follow up.
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Affiliation(s)
- Mustafa Çetin
- Department of Cardiology, Rize Recep Tayyip Erdoğan University Faculty of Medicine, Rize, Turkey
| | - Turan Erdoğan
- Department of Cardiology, Rize Recep Tayyip Erdoğan University Faculty of Medicine, Rize, Turkey
| | - Tuncay Kırış
- Department of Cardiology, Katip Çelebi University Atatürk Research and Training Hospital, Izmir, Turkey
| | - Savaş Özer
- Department of Cardiology, Rize Recep Tayyip Erdoğan University Training and Research Hospital, Rize, Turkey
| | - Göksel Çinier
- Department of Cardiology, Kaçkar State Hospital, Rize, Turkey
| | - Nadir Emlek
- Department of Cardiology, Rize Recep Tayyip Erdoğan University Faculty of Medicine, Rize, Turkey
| | - Hüseyin Durak
- Department of Cardiology, Rize Recep Tayyip Erdoğan University Faculty of Medicine, Rize, Turkey
| | - Ömer Şatıroğlu
- Department of Cardiology, Rize Recep Tayyip Erdoğan University Training and Research Hospital, Rize, Turkey
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Plasma YKL-40 Elevation on Admission and Follow-Up Is Associated with Diastolic Dysfunction and Mortality in Patients with Acute Myocardial Infarction. Cardiol Res Pract 2018; 2018:8701851. [PMID: 29686891 PMCID: PMC5852852 DOI: 10.1155/2018/8701851] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 01/11/2018] [Indexed: 11/18/2022] Open
Abstract
Objective The aim of the study was to determine an association between the plasma YKL-40 level and echocardiographic left ventricle systolic and diastolic function parameters in patients with acute myocardial infarction. Subjects and Methods The study included 46 patients with acute myocardial infarction. Serum brain natriuretic protein (BNP) and YKL-40 levels were analyzed on admission and after one month. Left ventricle systolic and diastolic functions and Tei index were computed by transthoracic echocardiography. Results Plasma YKL-40 was significantly higher in patients with acute myocardial infarction (AMI) (101.7 μg/L versus 34 μg/L, resp., p < 0.001) and remained higher than in healthy subjects after one month. The levels of YKL-40 on admission were correlated with log BNP on admission (r=0.41, p=0.004), Tei index (r=0.44, p=0.002), left atrium volume index (r=0.32, p=0.02), and mitral septal annular E/e′ (r=0.44, p=0.003). Death was more frequently observed in patients with plasma YKL-40 above the median value than in those with plasma YKL-40 below the median value (p=0.001; OR = 13.6 (2.5–72.3)). Conclusion YKL-40 elevations in patients with AMI remain at least one month and are associated with serum BNP elevations, diastolic dysfunction, and long-term increased overall mortality. It has prognostic importance in patients with AMI.
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