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Elevated plasma YKL-40 levels and ischemic stroke in the general population.
MedLine Citation:
PMID:  21031582     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We hypothesized that elevated plasma YKL-40 levels are associated with increased risk of ischemic cardiovascular disease in the general population. In contrast to C-reactive protein (CRP) produced in the liver in response to inflammation, YKL-40 is produced by lipid-laden macrophages inside the vessel wall.
METHODS: We measured plasma YKL-40 in 8,899 21- to 93-year-old participants of the Copenhagen City Heart Study 1991-1994 examination, and followed them for up to 18 years. Endpoints were ischemic stroke, ischemic cerebrovascular disease, myocardial infarction, and ischemic heart disease. Hazard ratios were calculated for plasma YKL-40 levels in 10-year age percentile categories of 34 to 66%, 67 to 90%, and 91 to 100% versus 0 to 33%.
RESULTS: Multifactorially and CRP-adjusted hazard ratios for ischemic stroke were 1.2 (95% confidence interval, 0.9-1.6) for 33 to 66%, 1.8 (1.3-2.4) for 67 to 90%, and 2.3 (1.5-3.3) for 91 to 100% versus the 0 to 33% percentile category (p-trend < 0.001). Corresponding hazard ratios for ischemic cerebrovascular disease were 1.2 (0.9-1.5), 1.6 (1.2-2.0), and 2.2 (1.6-3.2) (p-trend < 0.001). Hazard ratios for myocardial infarction were not significant, whereas corresponding hazard ratios for ischemic heart disease were 1.0 (0.8-1.2), 1.2 (1.0-1.5), and 1.3 (1.0-1.6) (p-trend = 0.01). Stratifying for CRP or other risk factors gave similar results. A doubling in plasma YKL-40 was associated with multifactorially and CRP-adjusted increased risk of 20% (95% confidence interval, 11%-30%) for ischemic stroke, 16% (8%-24%) for ischemic cerebrovascular disease, 3% (-5%-11%) for myocardial infarction, and 7% (1%-12%) for ischemic heart disease.
INTERPRETATION: In the general population, elevated plasma YKL-40 levels are associated with increased risk of ischemic stroke and ischemic cerebrovascular disease, independent of plasma CRP levels.
Alisa D Kjaergaard; Stig E Bojesen; Julia S Johansen; Børge G Nordestgaard
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of neurology     Volume:  68     ISSN:  1531-8249     ISO Abbreviation:  Ann. Neurol.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-29     Completed Date:  2010-11-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7707449     Medline TA:  Ann Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  672-80     Citation Subset:  IM    
Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark.
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MeSH Terms
Aged, 80 and over
Brain Ischemia / blood*,  complications,  epidemiology
Follow-Up Studies
Glycoproteins / blood*
Lectins / blood*
Middle Aged
Myocardial Infarction / blood,  complications,  epidemiology
Myocardial Ischemia / blood,  complications,  epidemiology
Prospective Studies
Risk Factors
Stroke / blood*,  complications,  epidemiology
Reg. No./Substance:
0/CHI3L1 protein, human; 0/Glycoproteins; 0/Lectins

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