Plasma YKL-40 predicts 10-year cardiovascular and all-cause mortality in individuals with type 2 diabetes
Article first published online: 25 MAR 2013
© 2012 John Wiley & Sons Ltd
Volume 79, Issue 2, pages 185–191, August 2013
How to Cite
Lin, C.-H., Li, H.-Y., Jiang, Y.-D., Chang, T.-J. and Chuang, L.-M. (2013), Plasma YKL-40 predicts 10-year cardiovascular and all-cause mortality in individuals with type 2 diabetes. Clinical Endocrinology, 79: 185–191. doi: 10.1111/cen.12015
- Issue published online: 11 JUL 2013
- Article first published online: 25 MAR 2013
- Accepted manuscript online: 18 AUG 2012 07:19AM EST
- Manuscript Accepted: 13 AUG 2012
- Manuscript Revised: 23 JUL 2012
- Manuscript Revised: 10 JUN 2012
- Manuscript Received: 25 MAY 2012
- National Science Council
- Diabetes Research Fund of the National Taiwan University Hospital
Elevated YKL-40 concentrations have been observed in both coronary heart disease (CHD) and diabetes. Thus, YKL-40 may play a role in pathogenesis of CHD in patients with diabetes. We evaluated whether plasma YKL-40 concentration can predict all-cause and cardiovascular mortality in individuals with type 2 diabetes.
This is a prospective, observational study.
A total of 628 subjects with type 2 diabetes were recruited between July 1996 and June 2003.
Plasma YKL-40 concentrations were measured via enzyme-linked immunosorbent assay (ELISA). The cohort was followed up until 31 December 2008, when vital status and causes of death were obtained. Survival analysis and concordance statistics were performed. All-cause and cardiovascular mortalities were documented.
There were 153 (24·36%) mortalities, including 48 participants (7·64%) who died from cardiovascular diseases (CVDs). Participants with higher plasma YKL-40 (defined with a level above the median of 87·5 μg/l) had an increased risk of mortality. After adjusting for confounding variables, the hazard ratios (HR) for all-cause and cardiovascular mortality in participants with higher plasma YKL-40 were 1·97 (95% CI, 1·31–2·95, P < 0·01) and 2·45 (95% CI, 1·11–5·37, P < 0·05). The results remained similar after adjustment for age. Concordance statistics revealed that plasma YKL-40 concentration significantly increases the predictive power for both all-cause and cardiovascular mortality in different models.
Plasma YKL-40 concentration is an independent predictor of 10-year all-cause and cardiovascular mortality in subjects with type 2 diabetes. Further investigations on the role of YKL-40 in the pathogenesis of CVD are required to elucidate the underlying mechanisms.