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| Significance of YKL-40 Levels in Predicting the Risk of Acute Exacerbation in Chronic Obstructive Pulmonary Disease |
| HE Yun, LIU Lin, HAN Ruiping, et al |
| Wuhan Integrated Traditional Chinese and Western Medicine Hospital / Wuhan First Hospital, Hubei Wuhan 430022, China |
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Abstract Objective: To explore the significance of chitin enzyme protein 40(YKL-40) and CXC chemokine ligand 9(CXCL9) in predicting the acute exacerbation risk of chronic obstructive pulmonary disease (COPD). Methods: From October 2019 to October 2021, 150 COPD patients (38 females and 112 males) and 150 normal people were selected as the research objects. Serum YKL-40 and CXCL9 levels were measured by ELISA, and the hospitalization time was calculated. Follow up the number of acute exacerbations of COPD within one year after this hospitalization. Results: Compared with the control group, the serum YKL-40 level in COPD patients increased significantly (22.23±15.35 ng/ml vs 63.96±13.66 ng/ml, t=24.79, P<0.0001), while the level of CXCL9 did not change significantly (17.92±9.01 ng/ml vs 19.29±9.84 ng/mL,t=1.26, P=0.210). Serum YKL-40 increased with the increase of GOLD grade in COPD patients (grade 1-2: 51.82 ±12.82 ng/ml; Grade 3: 63.26±4.59 ng/ml; Grade 4: 76.86±7.59 ng/mL, F=96.92, P<0.0001). Compared with COPD patients with mMRC score ≤ 2, the serum YKL-40 level of COPD patients with mMRC score of 2~3 or ≥3 was increased (58.35±15.37 ng/ml vs 64.55±10.60 ng/ml, 68.79±12.66 ng/mL, P<0.05). In COPD patients, serum YKL-40 was negative correlated with FEV1(r=-0.668, P<0.001) and FEV1/FVC(r=-0.167, P=0.041), and serum YKL-40 was positively correlated with IL-6(r=0.257, P=0.002), TNF-α(r=0.522, P<0.001) and CRP(r=0.231, P=0.006). Compared with COPD patients whose hospitalization time was ≤8 d, the serum YKL-40 level of COPD patients whose hospitalization time was 8~13 d and ≥13 d was increased (57.31±15.82 ng/ml vs 64.96±9.98 ng/ml, 69.79±11.58 ng/mL, P<0.05). The level of serum YKL-40 in patients with acute exacerbation ≤2 times was significantly lower than that in patients with acute exacerbation > 2 times (58.77±15.66 ng/ml vs 69.58±9.08 ng/ml, t=5.17, P<0.001). Multiple linear regression showed that serum YKL-40 was negatively correlated with FEV1% (OR=0.700, 95%CI=-0.958, -0.272) and positively correlated with hospitalization time ≥ 13 d (OR=1.125, 95%CI=1.007, 1.472). Conclusion: The level of serum YKL-40 at admission is positively correlated with the severity and poor prognosis of COPD patients.
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2023, Vol. 29 
