YKL-40, a Marker of Inflammation and Endothelial Dysfunction, Is Elevated in Patients With Type 1 Diabetes and Increases With Levels of Albuminuria

被引:115
作者
Rathcke, Camilla Noelle [1 ]
Persson, Frederik [2 ]
Tarnow, Lise [2 ]
Rossing, Peter [2 ]
Vestergaard, Henrik [1 ,3 ]
机构
[1] Univ Copenhagen, Herlev Hosp, Dept Endocrinol, Copenhagen, Denmark
[2] Steno Diabet Ctr, DK-2820 Gentofte, Denmark
[3] Univ Copenhagen, Fac Hlth Sci, Copenhagen, Denmark
关键词
SMOOTH-MUSCLE-CELLS; HEPARIN-BINDING GLYCOPROTEIN; MICROVASCULAR COMPLICATIONS; CARDIOVASCULAR EVENTS; INSULIN-RESISTANCE; HEART-DISEASE; RISK-FACTORS; MORTALITY; MELLITUS; PROTEIN;
D O I
10.2337/dc08-1144
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE - The inflammation marker YKL-40 is elevated in patients with type 2 diabetes and is associated with atherosclerosis and increased cardiovascular mortality. In the present study, YKL-40 levels were examined in patients with type 1 diabetes with increasing levels of albuminuria, known to be associated with an increased risk of cardiovascular disease. RESEARCH DESIGN AND METHODS - A total of 149 patients with type I diabetes attending Steno Diabetes Center were examined: 58 had normoalbuminuria (urinary albumin excretion rate 30 mg/24 h), 46 had persistent microalbuminuria (urinary albumin excretion rate 30-300 mg/24 h), and 45 had persistent triacroalbuminuria/diabetic nephropathy (urinary albumin excretion rate >300 mg/24 h). The control group consisted of 55 healthy individuals. Groups were matched according to sex and duration of diabetes (>30 years). RESULTS - Median levels [interquartile range] of serum YKL-40 were significantly higher in normoalbuminuria versus Control (37 [29-52] vs. 53 [32-105] ng/ml, P < 0.01) and were increasing With increasing levels of albuminuria (microalbuminuria 74 [45-160] ng/ml and diabetic nephropathy 117 [68-215] ng/ml; P < 0.001 for all comparisons). YKL-40 levels correlated with the urinary albumin-to-creatinine ratio in the total group of participants (r(2) = P<0.001). Significant but weak intercorrelations of YKL-40 were found with age, diastolic blood pressure, A1C, and serum creatinine. After adjustment for significant covariates, albuminuria was significantly associated with YKL-40 levels (P < 0.001). CONCLUSIONS - YKL-40 levels are elevated in patients with type I diabetes With an independent association between increasing YKL-40 levels and increasing levels of albuminuria. The present study is the first to suggest a role of YKL-40 in the gradually progressing vascular complications in patients with type 1 diabetes,
引用
收藏
页码:323 / 328
页数:6
相关论文
共 25 条
[1]   Markers of endothelial dysfunction and inflammation in type 1 diabetic patients with or without diabetic nephropathy followed for 10 years - Association with mortality and decline of glomerular filtration rate [J].
Astrup, Anne Sofie ;
Tarnow, Lise ;
Pietraszek, Lotte ;
Schalkwijk, Casper G. ;
Stehouwer, Coen D. A. ;
Parving, Hans-Henrik ;
Rossing, Peter .
DIABETES CARE, 2008, 31 (06) :1170-1176
[2]   DECLINING INCIDENCE OF NEPHROPATHY IN INSULIN-DEPENDENT DIABETES-MELLITUS [J].
BOJESTIG, M ;
ARNQVIST, HJ ;
HERMANSSON, G ;
KARLBERG, BE ;
LUDVIGSSON, J .
NEW ENGLAND JOURNAL OF MEDICINE, 1994, 330 (01) :15-18
[3]   Urinary albumin excretion - An independent predictor of ischemic heart disease [J].
Borch-Johnsen, K ;
Feldt-Rasmussen, B ;
Strandgaard, S ;
Schroll, M ;
Jensen, JS .
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 1999, 19 (08) :1992-1997
[4]   ALBUMINURIA REFLECTS WIDESPREAD VASCULAR DAMAGE - THE STENO HYPOTHESIS [J].
DECKERT, T ;
FELDTRASMUSSEN, B ;
BORCHJOHNSEN, K ;
JENSEN, T ;
KOFOEDENEVOLDSEN, A .
DIABETOLOGIA, 1989, 32 (04) :219-226
[5]   Evidence of increased inflammation and microcirculatory abnormalities in patients with type 1 diabetes and their role in microvascular complications [J].
Devaraj, Sridevi ;
Cheung, Anthony T. ;
Jialal, Ishwarlal ;
Griffen, Steven C. ;
Nguyen, Danh ;
Glaser, Nicole ;
Aoki, Thomas .
DIABETES, 2007, 56 (11) :2790-2796
[6]   Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals [J].
Gerstein, HC ;
Mann, JFE ;
Yi, QL ;
Zinman, B ;
Dinneen, SF ;
Hoogwerf, B ;
Hallé, JP ;
Young, J ;
Rashkow, A ;
Joyce, C ;
Nawaz, S ;
Yusuf, S .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 286 (04) :421-426
[7]   Decreasing incidence of severe diabetic microangiopathy in type 1 diabetes [J].
Hovind, P ;
Tarnow, L ;
Rossing, K ;
Rossing, P ;
Eising, S ;
Larsen, N ;
Binder, C ;
Parving, HH .
DIABETES CARE, 2003, 26 (04) :1258-1264
[8]   C-reactive protein and soluble vascular cell adhesion molecule-1 are associated with elevated urinary albumin excretion but do not explain its link with cardiovascular risk [J].
Jager, A ;
van Hinsbergh, VWM ;
Kostense, PJ ;
Emeis, JJ ;
Nijpels, G ;
Dekker, JM ;
Heine, RJ ;
Bouter, LM ;
Stehouwer, CDA .
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 2002, 22 (04) :593-598
[9]  
Johansen JS, 2006, DAN MED BULL, V53, P172
[10]   Serum YKL-40 levels in patients with coronary artery disease [J].
Kucur, Mine ;
Isman, Ferruh K. ;
Karadag, Bilgehan ;
Vural, Vural A. ;
Tavsanoglu, Sedat .
CORONARY ARTERY DISEASE, 2007, 18 (05) :391-396