title: YKL-40 in type 2 diabetic patients with different levels of albuminuria.
abstract: BACKGROUND
  Type 2 diabetic patients with albuminuria have an increased risk for vascular complications. Albuminuria is related to endothelial dysfunction and plaque instability. YKL-40 is also associated with both and elevated in nondiabetic vascular patients. We investigated YKL-40 and its association with vascular disease in type 2 diabetic patients with albuminuria.
  
  
  METHODS
  Two hundred and four patients with type 2 diabetes were included in a cross-sectional study: One hundred and six normo- (No-A), 64 micro- (Mi-A) and 34 macroalbuminuric (Ma-A) patients that did not differ for age, diabetes duration, HbA1c, body-mass-index, blood pressure, lipids and creatinine. YKL-40 was measured in serum samples and determined by ELISA.
  
  
  RESULTS
  YKL-40 was significantly different in No-A: 87±57 vs. Mi-A 119±68 vs. Ma-A 157±75ng mL(-1) ; P<0·001. Patients with macrovascular disease showed higher YKL-40 than those without: 115±72 vs. 87±49ng mL(-1) , P=0·003. In correlation analysis, YKL-40 was associated with urinary albumin excretion rate (AER), plasma creatinine, creatinine clearance (CC) and age. Two multivariate regression analyses were conducted: in the first one, AER and CC remained associated with YKL-40 and in the second one AER and age.
  
  
  CONCLUSIONS
  This is the first report of a significant elevation of YKL-40 in type 2 diabetic patients with albuminuria. In addition, we observed a significant association with macrovascular disease. Because we detected an association between YKL-40 with renal, micro- and macrovascular disease, this protein could play an important for the increased risk of type 2 diabetic patients with albuminuria for the development of cardiovascular disease.
authors.affiliation: Rudolfstiftung Hospital Vienna, Medicine I, Vienna, Austria.
authors.forename: Johanna-M
authors.initials: JM
authors.lastname: Brix
authors.forename: Florian
authors.initials: F
authors.lastname: Höllerl
authors.forename: Renate
authors.initials: R
authors.lastname: Koppensteiner
authors.forename: Guntram
authors.initials: G
authors.lastname: Schernthaner
authors.forename: Gerit-H
authors.initials: GH
authors.lastname: Schernthaner
mesh_terms: D054392:Adipokines; D000368:Aged; D000419:Albuminuria / Q000150:complications*; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D000071451:Chitinase-3-Like Protein 1; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D006023:Glycoproteins / Q000097:blood* / Q000378:metabolism; D006801:Humans; D037102:Lectins / Q000097:blood* / Q000378:metabolism; D008875:Middle Aged; D012016:Reference Values; D012044:Regression Analysis; D012307:Risk Factors
chemical_list: D054392:Adipokines; D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D006023:Glycoproteins; D037102:Lectins