Clinical implication of plasma and urine YKL-40, as a proinflammatory biomarker, on early stage of nephropathy in type 2 diabetic patients.
OBJECTIVE
Chronic inflammation has emerged as being a key pathophysiology in the early stages of diabetic nephropathy. YKL-40 has been established as an inflammatory marker in chronic inflammation. The aim of this study was to evaluate the association of plasma and urine YKL-40 with albuminuria in the early stage of type 2 diabetic nephropathy.


METHODS
A total of 75 type 2 diabetic patients and 22 nondiabetic controls with estimated glomerular filtration (eGFR) ≥60 ml/min/1.73 m(2) were enrolled. Plasma and urine concentrations of YKL-40 were analyzed by ELISA kit.


RESULTS
The plasma levels of YKL-40 were significantly higher in the normoalbuminuric group with diabetes than in the control group, and increased with increasing severity of albuminuria among diabetes. However, urine YKL-40 was only increased in macroalbuminuric state. Plasma YKL-40 was positively correlated with urine YKL-40 (r=0.291, P=0.011). Urinary albumin significantly correlated with both plasma and urine YKL-40 in a univariate analysis. After adjusting for several confounding factors, plasma YKL-40 was significantly correlated with albuminuria (r=0.359; P=0.001), whereas urine YKL-40 did not show significant correlation with albuminuria (r=0.128, P=0.241).


CONCLUSIONS
Although urine YKL-40 has a limited role, plasma YKL-40, as an proinflammatory marker, was an independent factor associated with albuminuria in early stage of nephropathy in type 2 diabetes and might have an useful role as a noninvasive marker for the early diabetic nephropathy detection.
Department of Internal Medicine, Haedong Hospital, Busan, South Korea.
Jun Ho
JH
Lee
Sang Soo
SS
Kim
In Joo
IJ
Kim
Sang Heon
SH
Song
Yong Ki
YK
Kim
Ju
J
In Kim
Yun Kyung
YK
Jeon
Bo Hyun
BH
Kim
Ihm Soo
IS
Kwak
D054392:Adipokines / Q000097:blood* / Q000652:urine*; D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000097:blood / Q000209:etiology / Q000652:urine; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D000071451:Chitinase-3-Like Protein 1; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000209:etiology* / Q000378:metabolism*; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D037102:Lectins / Q000097:blood* / Q000652:urine*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index
D054392:Adipokines; D015415:Biomarkers; D001786:Blood Glucose; D000071451:Chitinase-3-Like Protein 1; D006442:Glycated Hemoglobin; D037102:Lectins; C084533:CHI3L1 protein, human