title: Relationship of YKL-40 and adiponectin and subclinical atherosclerosis in asymptomatic patients with type 1 diabetes mellitus from a European Mediterranean population.
abstract: BACKGROUND
  The glycoprotein YKL-40 is a new marker of early inflammation and endothelial dysfunction. Adiponectin is a collagen-like protein with anti-atherogenic and anti-inflammatory effects. Increased concentrations of both markers have been reported in patients with type 1 diabetes (T1D).
  
  
  OBJECTIVE
  To assess the possible role of YKL-40 and adiponectin as a marker of subclinical cardiovascular disease in asymptomatic patients with type 1 diabetes with no history of ischemic or macrovascular heart disease and its relationship with other classic inflammatory biomarkers.
  
  
  METHODS
  Concentrations of YKL-40, adiponectin, IL-6, IL-1β, TNF-α, hsCRP and homocysteine were determined in 150 T1D patients (58% men, age: 38.6 ± 8.1 years, 20.4 ± 8.1 years of evolution, BMI: 25.1 ± 3.6 kg/m(2); HbA1c 8.1 ± 2.3%, 4% smokers; 26% retinopathy, microalbuminuria 9%) and 50 controls age, sex and smoke condition matched. Subclinical atherosclerosis was assessed by a carotid ultrasonography and a computed tomography for evaluation of calcium artery calcification score (CACS).
  
  
  RESULTS
  82% of T1D patients and 92% of controls had a calcium score of 0. T1D patients showed a significantly higher mean common carotid artery intima media thickness (CIMT) compared to controls (0.55 ± 0.14 vs 0.48 ± 0.14 mm, p = 0.01). Concentrations of YKL-40 and adiponectin were significantly higher in T1D [42.6 (10.4-195.0) vs ±28.7 (11.0-51.2) ng/ml, p = 0.001 and 15.8 ± 9.1 vs. 12.4 ± 5.3 mg/ml, p = 0.008], with no differences when compared to other inflammatory parameters. In T1D patients no association was found between YKL-40 and adiponectin and screening test for subclinical arterial disease (neither CACS nor CIMT). A positive correlation was found between levels of YKL-40 and age and duration of disease (r = 0.28, p = 0.003; r = 0.35, p = 0.001). There were no differences in the YKL-40 in relation to the presence or absence of retinopathy or nephropathy. Levels of adiponectin were higher in patients with nephropathy (21.84 ± 8.15 vs. 14.88 ± 8.27 mg/ml, p = 0.008).
  
  
  CONCLUSIONS
  Type 1 diabetes patients from a Mediterranean area with a longer disease evolution, although a lower degree of subclinical disease, showed significatively higher concentrations of YKL-40 and adiponectin compared with the controls. Therefore, we conclude that YKL-40 and adiponectin are early inflammatory markers in diabetic subjects even in the presence of a low atherosclerotic background.
authors.affiliation: Endocrinology and Nutrition Unit, Department of Medicine, Institute Research and Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Crta. Canyet s/n, 08916, Badalona, Barcelona, Spain. aguilerahurtado@yahoo.es.|Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabolicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. aguilerahurtado@yahoo.es.
authors.forename: Eva
authors.initials: E
authors.lastname: Aguilera
authors.affiliation: Endocrinology and Nutrition Unit, Department of Medicine, Institute Research and Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Crta. Canyet s/n, 08916, Badalona, Barcelona, Spain. enriqui@gmail.com.
authors.forename: Enric
authors.initials: E
authors.lastname: Serra-Planas
authors.affiliation: Biochemistry Unit, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain. mgranada.germanstrias@gencat.cat.
authors.forename: M Luisa
authors.initials: ML
authors.lastname: Granada
authors.affiliation: Endocrinology and Nutrition Unit, Department of Medicine, Institute Research and Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Crta. Canyet s/n, 08916, Badalona, Barcelona, Spain. spellitero.germanstrias@gencat.cat.|Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabolicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. spellitero.germanstrias@gencat.cat.
authors.forename: Silvia
authors.initials: S
authors.lastname: Pellitero
authors.affiliation: Endocrinology and Nutrition Unit, Department of Medicine, Institute Research and Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Crta. Canyet s/n, 08916, Badalona, Barcelona, Spain. reverter.germanstrias@gencat.cat.
authors.forename: Jordi L
authors.initials: JL
authors.lastname: Reverter
authors.affiliation: Endocrinology and Nutrition Unit, Department of Medicine, Institute Research and Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Crta. Canyet s/n, 08916, Badalona, Barcelona, Spain. nalonso32416@yahoo.es.|Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabolicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. nalonso32416@yahoo.es.
authors.forename: Núria
authors.initials: N
authors.lastname: Alonso
authors.affiliation: Endocrinology and Nutrition Unit, Department of Medicine, Institute Research and Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Crta. Canyet s/n, 08916, Badalona, Barcelona, Spain. bsoldevila.germanstrias@gencat.cat.|Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabolicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. bsoldevila.germanstrias@gencat.cat.
authors.forename: Berta
authors.initials: B
authors.lastname: Soldevila
authors.affiliation: Endocrinology and Nutrition Unit, Department of Medicine, Institute Research and Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Crta. Canyet s/n, 08916, Badalona, Barcelona, Spain. didacmauricio@gmail.com.|Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabolicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. didacmauricio@gmail.com.
authors.forename: Dídac
authors.initials: D
authors.lastname: Mauricio
authors.affiliation: Endocrinology and Nutrition Unit, Department of Medicine, Institute Research and Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Crta. Canyet s/n, 08916, Badalona, Barcelona, Spain. mpuigd@gmail.com.|Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabolicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. mpuigd@gmail.com.
authors.forename: Manel
authors.initials: M
authors.lastname: Puig-Domingo
mesh_terms: D054392:Adipokines / Q000097:blood*; D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood; D002340:Carotid Artery Diseases / Q000097:blood* / Q000175:diagnosis; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D000071451:Chitinase-3-Like Protein 1; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000175:diagnosis; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D037102:Lectins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D013030:Spain; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D015854:Up-Regulation; D061205:Vascular Calcification / Q000097:blood* / Q000175:diagnosis
chemical_list: C499918:ADIPOQ protein, human; D054392:Adipokines; D052242:Adiponectin; D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D018836:Inflammation Mediators; D037102:Lectins