Background: A positive association between elevated circulating YKL-40 levels and increasing levels of albuminuria have been
described in patients with type 1 diabetes indicating a role of YKL-40 in the progressing vascular damage resulting in
microvascular disease. Aim of study: Was to evaluate serum YKL-40 level and its association with albuminuria in Egyptian type
1 diabetic patients. Subjects and Methods: Study was carried out on 50 patients from those attending diabetes clinics of Banha
University Hospital they were divided into two groups: Group (a): Includes 20 healthy individuals their ages ranged from 20-35
years (12 males and 8 females), they were clinically free with normal laboratory findings. Group (b): Includes 30 diabetic
patients (18 males and 12 females), their ages ranged from 30-48 years with type 1 DM and microalbuminuria. The following
laboratory investigations were performed to all patients: Fasting plasma glucose, HbA1c, serum lipid profile, serum creatinine,
estimated glomerular filtration rate, urinary albumin / creatinine ratio (ACR), serum YKL-4. Results: Our results show:
Statistically significant increase in the mean of fasting blood sugar (FPG), hemoglobin A1c (HbA1c) , microalbumin in urine,
ACR levels in diabetic group compared to control group. Significant increase in the mean of low density lipoprotein cholesterol
(LDL-C), triglycerides, serum creatinine, urinary creatinine and YKL-40 levels in diabetic group compared to control group. The
mean of high density lipoprotein cholesterol l (HDL-C) and estimated glomeular filtration rate (eGFR) levels show a highly
statistically significant decrease in diabetic group compared to control group. A significant positive correlation between ACR and
each of age and duration of diabetes. Significant positive correlation between ACR and each of FPG , HbA1c, triglycerides,
serum creatinine and microalbumin in urine and negative correlation with eGFR. Significant positive correlation between YKL-
40 and each of age and duration of diabetes. Significant positive correlation between YKL-40 and each of FPG, HbA1C, HDL,
triglycerides, serum creatinine, microalbumin in urine, urinary creatinine and ACR, and negative correlation with eGFR. No
significant difference of sex distribution among the studied groups. Insignificant difference in the mean of (diastolic and systolic
blood pressure, total cholesterol level in diabetic group compared to control group). No significant correlation was found between
ACR and systolic or diastolic blood pressure. No significant correlation between ACR and each of total cholesterol, LDL-C,
HDL-C and urinary creatinine. No significant correlation betweenYKL-40 and systolic or diastolic blood pressure. No significant
correlation between YKL-40 and each of total cholesterol and LDL-C. Conclusion: It was concluded that Egyptian type1 diabetic
patients serum YKL-40 levels are significantly elevated and have a linear association with albuminuria. These data suggest that
YKL-40 levels could be a tool to assess the risk of diabetic microangiopathy in early stage of type1 diabetes. |