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

  1. Camilla Noelle Rathcke, MD1,
  2. Frederik Persson, MD2,
  3. Lise Tarnow, MD, DMSC2,
  4. Peter Rossing, MD, DMSC2 and
  5. Henrik Vestergaard, MD, DMSC13
  1. 1Department of Endocrinology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
  2. 2Steno Diabetes Center, Gentofte, Denmark
  3. 3Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
  1. Corresponding author: Camilla Noelle Rathcke, cnr{at}dadlnet.dk

Abstract

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 1 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 macroalbuminuria/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 (r2 = 0.25, 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 1 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.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 28 October 2008.

    The corresponding author had full access to all data and takes full responsibility for the integrity of the data and the accuracy of the analyses.

    Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted October 22, 2008.
    • Received June 25, 2008.
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  1. Published online before print October 28, 2008, doi: 10.2337/dc08-1144 Diabetes Care February 2009 vol. 32 no. 2 323-328
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