Potential association between coronary artery disease and the inflammatory biomarker YKL-40 in asymptomatic patients with type 2 diabetes mellitus.
BACKGROUND
Inflammation plays an important role in coronary artery disease from the initiation of endothelial dysfunction to plaque formation to final rupture of the plaque. In this study, we investigated the potential pathophysiological and clinical relevance of novel cytokines secreted from various cells including adipocytes, endothelial cells, and inflammatory cells, in predicting coronary artery disease (CAD) in asymptomatic subjects with type 2 diabetes mellitus.


METHODS
We enrolled a total of 70 asymptomatic type 2 diabetic patients without a documented history of cardiovascular disease, and determined serum levels of chemerin, omentin-1, YKL-40, and sCD26. We performed coronary computed tomographic angiography (cCTA) in all subjects, and defined coronary artery stenosis ≥ 50 % as significant CAD in this study.


RESULTS
Subjects were classified into two groups: patients with suspected coronary artery stenosis on cCTA (group I, n = 41) and patients without any evidence of stenosis on cCTA (group II, n = 29). Group I showed significantly higher YLK-40 levels and lower HDL-C levels than group II (p = 0.038, 0.036, respectively). Levels of chemerin, omentin-1, and sCD26 were not significantly different between the two groups. Serum YKL-40 levels were positively correlated with systolic/diastolic BP, fasting/postprandial triglyceride levels, and Framingham risk score. Furthermore, YKL-40 levels showed moderate correlation with the degree of coronary artery stenosis and the coronary artery calcium score determined from cCTA. In multivariate logistic analysis, after adjusting for age, gender, smoking history, hypertension, and LDL-cholesterol, YLK-40 levels showed only borderline significance.


CONCLUSIONS
YKL-40, which is secreted primarily from inflammatory cells, was associated with several CVD risk factors and was elevated in type 2 diabetic patients with suspected coronary artery stensosis on cCTA. These results suggest the possibility that the inflammatory biomarker YKL-40 might be associated with coronary artery disease in asymptomatic patients with type 2 diabetes mellitus.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Hyun Min
HM
Kim
Byung-Wan
BW
Lee
Young-Mi
YM
Song
Won Jin
WJ
Kim
Hyuk-Jae
HJ
Chang
Dong-Hoon
DH
Choi
Hee Tae
HT
Yu
Eunseok
E
Kang
Bong Soo
BS
Cha
Hyun Chul
HC
Lee
D054392:Adipokines / Q000097:blood*; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D018925:Chemokines / Q000097:blood; D000071451:Chitinase-3-Like Protein 1; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D016207:Cytokines / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D018819:Dipeptidyl Peptidase 4 / Q000097:blood; D005260:Female; D058851:GPI-Linked Proteins / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000097:blood; D036341:Intercellular Signaling Peptides and Proteins; D037102:Lectins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012307:Risk Factors
D054392:Adipokines; D015415:Biomarkers; C084533:CHI3L1 protein, human; D018925:Chemokines; D000071451:Chitinase-3-Like Protein 1; D016207:Cytokines; D058851:GPI-Linked Proteins; C432397:ITLN1 protein, human; D036341:Intercellular Signaling Peptides and Proteins; D037102:Lectins; C478630:RARRES2 protein, human; C042807:DPP4 protein, human; D018819:Dipeptidyl Peptidase 4