YKL-40, a marker of inflammation and endothelial dysfunction, is elevated in patients with Type 1 Diabetes and increases with levels of albuminuria.

Abstract

Objective. The inflammation marker YKL-40 is elevated in patients with type 1 diabetes and is associated with atherosclerosis and an increased cardiovascular mortality. In the present study, YKL-40 levels are 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. One-hundred-fourty-nine patients with type 1 diabetes attending Steno Diabetes Center were examined: 58 with normoalbuminuria (N, U-albumin<30mg/24h), 46 with persistent microalbuminuria (MA, 30-300 mg/24h) and 45 with persistent macroalbuminuria/diabetic nephropathy (DN, >300 mg/24h). Control group consisted of 55 healthy individuals (C). Groups were matched according to gender and duration of diabetes (>30 years).

Results. Median levels (interquartile range) of serum YKL-40 were significantly higher in N vs. C (37 (29-52) ng/ml vs. 53 (32-105) ng/ml, p<0.01) and were increasing with increasing levels of albuminuria: MA, 74 (45-160) ng/ml; DN, 117 (68-215) ng/ml, p<0.001 for all comparisons. YKL-40 levels correlated with urinary albumin/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, hemoglobin 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.