title: YKL-40 in hemodialyzed patients with and without cardiovascular complications - the enhancement by the coexistence of the seropositivity against hepatitis C virus infection.
abstract: BACKGROUND
  YKL-40 is a new biomarker of inflammation, which is expressed by several cell types of the immune system. The aim of the present study was to evaluate plasma YKL-40 levels in hemodialysis (HD) patients and to establish its potential role as a new inflammatory biomarker of cardiovascular disease (CVD) in this population.
  
  
  METHODS
  YKL-40 and two other inflammatory markers: high sensitivity C-reactive protein (hsCRP) and neopterin levels were measured in 70 HD patients both with and without CVD and in 38 healthy controls.
  
  
  RESULTS
  Median YKL-40, hsCRP and neopterin levels were significantly elevated in HD patients, particularly those with CVD, compared to controls. YKL-40 was no associated with hsCRP, but it is strongly and independently associated with plasma neopterin levels in HD patients. The coexistence of the seropositivity against hepatitis C virus (anti-HCV) infection increased both YKL-40 and neopterin levels in these patients. This effect was particularly seen in subjects with CVD. Moreover, high neopterin levels were exclusively associated with anti-HCV seropositivity, whereas hsCRP values were only associated with the presence of CVD.
  
  
  CONCLUSIONS
  This study indicated for the first time that plasma YKL-40 level is increased in HD patients, especially in those with CVD, and it is independently associated with neopterin - an biomarker of monocyte/macrophage activation. There was no association between YKL-40 and hsCRP, the common indicator of an inflammatory state. Moreover, the coexistence of anti-HCV seropositivity had an important impact on plasma YKL-40 levels in HD patients particularly those with cardiovascular complications.
authors.affiliation: Department of Monitored Pharmacotherapy, Medical University, Bialystok, Poland. dariuszpawlak@poczta.onet.pl
authors.forename: Krystyna
authors.initials: K
authors.lastname: Pawlak
authors.forename: Dariusz
authors.initials: D
authors.lastname: Rozkiewicz
authors.forename: Michal
authors.initials: M
authors.lastname: Mysliwiec
authors.forename: Dariusz
authors.initials: D
authors.lastname: Pawlak
mesh_terms: D054392:Adipokines / Q000097:blood*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood* / Q000150:complications*; D016022:Case-Control Studies; D000071451:Chitinase-3-Like Protein 1; D005260:Female; D016174:Hepacivirus / Q000502:physiology*; D006526:Hepatitis C / Q000097:blood* / Q000150:complications*; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism; D037102:Lectins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D019798:Neopterin / Q000097:blood; D012044:Regression Analysis; D006435:Renal Dialysis
chemical_list: D054392:Adipokines; D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D018836:Inflammation Mediators; D037102:Lectins; D019798:Neopterin; D002097:C-Reactive Protein