AUTHOR=Song Mowei , Zhang Guofu , Shi Hang , Zhu Erjun , Deng Li , Shen Hongtao 

TITLE=Serum YKL-40 in coronary heart disease: linkage with inflammatory cytokines, artery stenosis, and optimal cut-off value for estimating major adverse cardiovascular events

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1242339

DOI=10.3389/fcvm.2023.1242339

ISSN=2297-055X

ABSTRACT=<sec><title>Objective</title><p>YKL-40, previously known as chitinase-3-like protein 1 (CHI3L1), is an inflammation-related glycoprotein that promotes atherosclerosis, but its application and optimal cut-off value as a prognostic biomarker in coronary heart disease (CHD) require more clinical evidence. Thus, this prospective study aimed to evaluate the linkage of serum YKL-40 with disease features, inflammatory cytokines, and major adverse cardiovascular events (MACEs) in CHD patients.</p></sec><sec><title>Methods</title><p>A total of 410 CHD patients were enrolled for serum YKL-40 determination via enzyme-linked immunosorbent assay. Meanwhile, serum YKL-40 levels in 100 healthy controls (HCs) were also quantified.</p></sec><sec><title>Results</title><p>YKL-40 level was higher in CHD patients compared with that in HCs (<italic>P </italic>&lt; 0.001). YKL-40 was positively linked with hyperlipidemia (<italic>P </italic>= 0.014), diabetes mellitus (<italic>P </italic>= 0.001), fasting blood glucose (<italic>P </italic>= 0.045), C-reactive protein (<italic>P </italic>&lt; 0.001), the Gensini score (<italic>P </italic>&lt; 0.001), and stenosis degree (graded by the Gensini score) (<italic>P </italic>&lt; 0.001) in CHD patients. In addition, an elevated YKL-40 level was associated with increased levels of tumor necrosis factor alpha (<italic>P </italic>= 0.001), interleukin (IL)-1β (<italic>P </italic>= 0.001), IL-6 (<italic>P </italic>&lt; 0.001), and IL-17A (<italic>P </italic>= 0.002) in CHD patients. The 1-/2-/3-year cumulative MACE rates of CHD patients were 5.5%, 14.4%, and 25.0%, respectively. Regarding the prognostic capability, YKL-40 ≥100 ng/ml (the median cut-off value) (<italic>P </italic>= 0.003) and YKL-40 ≥150 ng/ml (the third interquartile cut-off value) (<italic>P </italic>= 0.021) reflected an elevated accumulating MACE rate, whereas accumulating MACE was not different between CHD patients with YKL-40 ≥80 and &lt;80 ng/ml (the first interquartile cut-off value) (<italic>P </italic>= 0.083).</p></sec><sec><title>Conclusion</title><p>Serum YKL-40 is positively linked with inflammatory cytokines and the Gensini score, whose high expression cut-off by 100 and 150 ng/ml estimates a higher MACE risk in CHD patients.</p></sec>