YKL‐40 in type 2 diabetic patients with different levels of albuminuria

Eur J Clin Invest 2011; 41 (6): 589–596AbstractBackground  Type 2 diabetic patients with albuminuria have an increased risk for vascular complications. Albuminuria is related to endothelial dysfunction and plaque instability. YKL‐40 is also associated with both and elevated in nondiabetic vascular patients. We investigated YKL‐40 and its association with vascular disease in type 2 diabetic patients with albuminuria.Material and methods  Two hundred and four patients with type 2 diabetes were included in a cross‐sectional study: One hundred and six normo‐ (No‐A), 64 micro‐ (Mi‐A) and 34 macroalbuminuric (Ma‐A) patients that did not differ for age, diabetes duration, HbA1c, body‐mass‐index, blood pressure, lipids and creatinine. YKL‐40 was measured in serum samples and determined by ELISA.Results  YKL‐40 was significantly different in No‐A: 87 ± 57 vs. Mi‐A 119 ± 68 vs. Ma‐A 157 ± 75 ng mL−1; P < 0·001. Patients with macrovascular disease showed higher YKL‐40 than those without: 115 ± 72 vs. 87 ± 49 ng mL−1, P = 0·003. In correlation analysis, YKL‐40 was associated with urinary albumin excretion rate (AER), plasma creatinine, creatinine clearance (CC) and age. Two multivariate regression analyses were conducted: in the first one, AER and CC remained associated with YKL‐40 and in the second one AER and age.Conclusions  This is the first report of a significant elevation of YKL‐40 in type 2 diabetic patients with albuminuria. In addition, we observed a significant association with macrovascular disease. Because we detected an association between YKL‐40 with renal, micro‐ and macrovascular disease, this protein could play an important for the increased risk of type 2 diabetic patients with albuminuria for the development of cardiovascular disease.