Elevated circulating levels of the serum acute-phase protein YKL-40 (chitinase 3-like protein 1) are a marker of obesity and insulin resistance in prepubertal children.
YKL-40 (chitinase 3-like protein 1) is a newly recognized protein that is secreted by activated macrophages and neutrophils and expressed in a broad spectrum of inflammatory conditions and cancers. It has also been associated with endothelial dysfunction and diabetes in adults. Its role in childhood obesity has not been evaluated yet. Our aim was to evaluate the associations of serum YKL-40 levels with markers of obesity, inflammation, and insulin resistance in children. Forty-one obese prepubertal children and 41 age- and sex-matched lean controls were included, and serum YKL-40 levels were determined. Body mass index (BMI), blood pressure (BP), body fat percentage, fasting glucose, insulin, homeostasis model assessment for insulin resistance (HOMA-IR) index, whole-body insulin sensitivity index, lipids, white blood cell (WBC) count, C-reactive protein, and fibrinogen levels were also assessed. Obese children had higher YKL-40 levels compared with controls (P = .003). Insulin-resistant individuals showed higher YKL-40 compared with non-insulin-resistant individuals after adjusting for age and BMI (adjusted P = .039). Serum YKL-40 levels were positively correlated with age, BMI, body fat percentage, fasting glucose and insulin, HOMA-IR index, whole-body insulin sensitivity index, systolic BP, mean BP, and WBC count (P < .05). After adjustment for age, sex, BMI, WBC count, and systolic BP, HOMA-IR index remained significantly associated with YKL-40 levels (P < .001). The study suggests that YKL-40 levels are elevated in obese youth and represent a marker of insulin resistance even in childhood. Prospective studies are needed to determine whether children with elevated YKL-40 levels are at higher risk for future cardiovascular disease.
4th Department of Pediatrics, Faculty of Medicine, Aristotle University of Thessaloniki, Papageorgiou General Hospital, 564 03 Thessaloniki, Greece.
Ioannis
I
Kyrgios
Assimina
A
Galli-Tsinopoulou
Charilaos
C
Stylianou
Eleni
E
Papakonstantinou
Malamatenia
M
Arvanitidou
Anna-Bettina
AB
Haidich
D054392:Adipokines / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D000071451:Chitinase-3-Like Protein 1; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005951:Glucose Tolerance Test; D006801:Humans; D007249:Inflammation / Q000097:blood; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D037102:Lectins / Q000097:blood*; D007958:Leukocyte Count; D016014:Linear Models; D008297:Male; D009765:Obesity / Q000097:blood*
D054392:Adipokines; D001786:Blood Glucose; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D007328:Insulin; D037102:Lectins; D005340:Fibrinogen; D002097:C-Reactive Protein