TY - JOUR
T1 - YKL-40, cardiovascular events, and mortality in individuals recently diagnosed with type 2 diabetes
T2 - A Danish cohort study
AU - Kjaergaard, Alisa D
AU - Vaag, Allan
AU - Jensen, Verena H
AU - Olsen, Michael H
AU - Højlund, Kurt
AU - Vestergaard, Peter
AU - Hansen, Torben
AU - Thomsen, Reimar Wernich
AU - Jessen, Niels
N1 - Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.
PY - 2025/1
Y1 - 2025/1
N2 - AIMS: We investigated the association of the inflammatory biomarker YKL-40 with cardiovascular events (CVEs) and mortality in individuals with type 2 diabetes.METHODS: We followed 11,346 individuals recently diagnosed with type 2 diabetes for up to 14 years. Baseline YKL-40 levels (measured in 9,010 individuals) were grouped into percentiles (0-33 %, 34-66 %, 67-90 %, and 91-100 %) and analyzed continuously (per 1 SD log increment), with comparisons to CRP (measured in 9,644 individuals). Cox regression assessed associations with atrial fibrillation (AF), ischemic stroke (IS), venous thromboembolism (VTE), myocardial infarction (MI), heart failure (HF), peripheral artery disease (PAD), and all-cause, cardiovascular, and cancer mortality.RESULTS: Adjusted HRs (95% CIs) for the highest (91-100%) versus the lowest (0-33%) YKL-40 percentile category were 1.31 (1.04-1.66) for AF, 1.43 (0.98-2.07) for IS, 1.07 (0.65-1.76) VTE, 0.88 (0.52-1.48) for MI, 1.66 (1.19-2.31) for HF, 1.66 (1.12-2.48) for PAD, and 2.18 (1.85-2.56) for all-cause, 1.64 (1.07-2.50) for cardiovascular, and 2.73 (2.05-3.63) for cancer mortality. Each 1 SD log increase in YKL-40 and CRP levels similarly increased CVE risks, with CRP being superior for MI and cardiovascular mortality.CONCLUSIONS: YKL-40 is a prognostic biomarker for most CVEs, and even more so for all-cause mortality, primarily driven by cancer-related causes.
AB - AIMS: We investigated the association of the inflammatory biomarker YKL-40 with cardiovascular events (CVEs) and mortality in individuals with type 2 diabetes.METHODS: We followed 11,346 individuals recently diagnosed with type 2 diabetes for up to 14 years. Baseline YKL-40 levels (measured in 9,010 individuals) were grouped into percentiles (0-33 %, 34-66 %, 67-90 %, and 91-100 %) and analyzed continuously (per 1 SD log increment), with comparisons to CRP (measured in 9,644 individuals). Cox regression assessed associations with atrial fibrillation (AF), ischemic stroke (IS), venous thromboembolism (VTE), myocardial infarction (MI), heart failure (HF), peripheral artery disease (PAD), and all-cause, cardiovascular, and cancer mortality.RESULTS: Adjusted HRs (95% CIs) for the highest (91-100%) versus the lowest (0-33%) YKL-40 percentile category were 1.31 (1.04-1.66) for AF, 1.43 (0.98-2.07) for IS, 1.07 (0.65-1.76) VTE, 0.88 (0.52-1.48) for MI, 1.66 (1.19-2.31) for HF, 1.66 (1.12-2.48) for PAD, and 2.18 (1.85-2.56) for all-cause, 1.64 (1.07-2.50) for cardiovascular, and 2.73 (2.05-3.63) for cancer mortality. Each 1 SD log increase in YKL-40 and CRP levels similarly increased CVE risks, with CRP being superior for MI and cardiovascular mortality.CONCLUSIONS: YKL-40 is a prognostic biomarker for most CVEs, and even more so for all-cause mortality, primarily driven by cancer-related causes.
KW - Aged
KW - Biomarkers/blood
KW - C-Reactive Protein/analysis
KW - Cardiovascular Diseases/mortality
KW - Chitinase-3-Like Protein 1/blood
KW - Cohort Studies
KW - Denmark/epidemiology
KW - Diabetes Mellitus, Type 2/blood
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
U2 - 10.1016/j.diabres.2024.111970
DO - 10.1016/j.diabres.2024.111970
M3 - Article
C2 - 39719182
SN - 0168-8227
VL - 219
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
M1 - 111970
ER -