Plasma YKL-40 predicts 10-year cardiovascular and all-cause mortality in individuals with type 2 diabetes

• Published in: Clinical endocrinology (Oxford) Vol. 79; no. 2; pp. 185 - 191
• Main Authors: Lin, Chih-Hung, Li, Hung-Yuan, Jiang, Yi-Der, Chang, Tien-Jyun, Chuang, Lee-Ming
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Publishing Ltd 01.08.2013; Blackwell; Wiley Subscription Services, Inc
• Subjects: Adipokines - blood; Aged; Biological and medical sciences; Biomarkers - blood; Cardiovascular Diseases - mortality; Chitinase-3-Like Protein 1; Coronary Disease - mortality; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - mortality; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Fundamental and applied biological sciences. Psychology; Humans; Lectins - blood; Male; Medical sciences; Middle Aged; Proportional Hazards Models; Prospective Studies; Survival Analysis; Taiwan - epidemiology; Vertebrates: endocrinology; Endocrinopathy; Type 2 diabetes; Human; Cause; Prediction; Metabolic diseases; Cardiovascular disease; Endocrinology; Blood plasma
• ISSN: 0300-0664; 1365-2265; 1365-2265
• DOI: 10.1111/cen.12015

Summary Objective Elevated YKL‐40 concentrations have been observed in both coronary heart disease (CHD) and diabetes. Thus, YKL‐40 may play a role in pathogenesis of CHD in patients with diabetes. We evaluated whether plasma YKL‐40 concentration can predict all‐cause and cardiovascular mortality in individuals with type 2 diabetes. Design This is a prospective, observational study. Patients A total of 628 subjects with type 2 diabetes were recruited between July 1996 and June 2003. Measurements Plasma YKL‐40 concentrations were measured via enzyme‐linked immunosorbent assay (ELISA). The cohort was followed up until 31 December 2008, when vital status and causes of death were obtained. Survival analysis and concordance statistics were performed. All‐cause and cardiovascular mortalities were documented. Results There were 153 (24·36%) mortalities, including 48 participants (7·64%) who died from cardiovascular diseases (CVDs). Participants with higher plasma YKL‐40 (defined with a level above the median of 87·5 μg/l) had an increased risk of mortality. After adjusting for confounding variables, the hazard ratios (HR) for all‐cause and cardiovascular mortality in participants with higher plasma YKL‐40 were 1·97 (95% CI, 1·31–2·95, P < 0·01) and 2·45 (95% CI, 1·11–5·37, P < 0·05). The results remained similar after adjustment for age. Concordance statistics revealed that plasma YKL‐40 concentration significantly increases the predictive power for both all‐cause and cardiovascular mortality in different models. Conclusions Plasma YKL‐40 concentration is an independent predictor of 10‐year all‐cause and cardiovascular mortality in subjects with type 2 diabetes. Further investigations on the role of YKL‐40 in the pathogenesis of CVD are required to elucidate the underlying mechanisms.