title: Significant association of elevated concentration of plasma YKL-40 with disease severity in patients with pelvic inflammatory disease.
abstract: BACKGROUND
  To date, no study reports the implication of YKL-40 in pelvic inflammatory disease (PID). Therefore, we investigate the levels of plasma YKL-40 in patients with PID and further associate its expression with the severity of disease.
  
  
  METHODS
  We designed a hospital-based case-control study with approximate 1:1 ratio and consecutively recruited 64 patients with PID and 70 control women. We collected blood samples from 64 women with PID before and after they received treatment and 70 control women to detect levels of plasma YKL-40 and C-reactive protein (CRP) as well as white blood cell and neutrophil counts.
  
  
  RESULTS
  The results revealed that levels of plasma YKL-40 were significantly elevated in patients with PID as compared to those in controls (38.36 vs. 21.69 ng/ml, P = 0.001) but the significant difference was restricted to women aged 30 years or old after age stratification (56.75 vs. 23.61 ng/ml, P ≤ 0.001). It declined significantly after they received treatment (median: 38.36 vs. 27.54 ng/ml; P ≤ 0.001). Although both plasma YKL-40 and CRP were elevated in patients with tubo-ovarian abscess, PID patients with surgery exhibited higher YKL-40 concentration than those without surgery (median: 82.05 vs. 30.19 ng/ml, P = 0.005) and only plasma YKL-40 was significantly associated with the length of the hospital stay (P ≤ 0.001, R = 0.604).
  
  
  CONCLUSIONS
  We conclude that once individuals are diagnosed to have PID, YKL-40 may act as a biomarker to predict the severity and clinical outcome of the disease.
authors.affiliation: Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Shu-Hsin
authors.initials: SH
authors.lastname: Lee
authors.forename: Ching-Yi
authors.initials: CY
authors.lastname: Lin
authors.forename: Po-Hui
authors.initials: PH
authors.lastname: Wang
authors.forename: Chih-Ping
authors.initials: CP
authors.lastname: Han
authors.forename: Shun-Fa
authors.initials: SF
authors.lastname: Yang
authors.forename: Jinghua Tsai
authors.initials: JT
authors.lastname: Chang
authors.forename: Meng-Chih
authors.initials: MC
authors.lastname: Lee
authors.forename: Long-Yau
authors.initials: LY
authors.lastname: Lin
authors.forename: Maw-Sheng
authors.initials: MS
authors.lastname: Lee
mesh_terms: D054392:Adipokines / Q000097:blood*; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D000071451:Chitinase-3-Like Protein 1; D005260:Female; D006801:Humans; D037102:Lectins / Q000097:blood*; D007958:Leukocyte Count; D016015:Logistic Models; D016017:Odds Ratio; D000292:Pelvic Inflammatory Disease / Q000097:blood*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D054392:Adipokines; D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D037102:Lectins; D002097:C-Reactive Protein