Study On The Correlation Between YKL-40 And Diabetic Kidney Disease

Objective:To investigate the correlation between plasma YKL-40 level and diabetic kidney disease in patients with type 2 diabetes mellitus and whether YKL-40 can be used as a biomarker for early diagnosis of DKD.Methods:A total of 144 patients with type 2 diabetes were enrolled in the outpatient department and inpatient department of the Affiliated Hospital of North Sichuan Medical University.Plasma YKL-40 concentration was determined by enzyme-linked immunosorbent assay.According to the 2021 Chinese guidelines for diagnosis and treatment of diabetic kidney disease,the random urinary albumin to creatinine ratio of patients were divided into normoalbuminuria group,microalbuminuria group,and macroalbuminuria group for comparative analysis.Data are reported as χ±s for normally distributed values,median and quartile intervals for nonparametric values,Frequency or relative number(rate,constituent ratio)for categorical variables.Distribution of continuous variables was examined,and logarithm-transformed values of non-normal distribution variables were used for conducting analyses.Analysis of variance was used for comparison of measurement data,and Chi-square test was used for comparison of counting data.Spearman rank correlation analysis was used to determine the correlation between plasma YKL-40 with general data and Inspection data.ROC curve was used to analyze the diagnostic value of YKL-40 to albuminuria.Results:The data were statistically significant differences in creatinine,eGFR,YKL-40,UACR between the three groups(P<0.05).Linear correlation analysis showed that ACEI/ARB,duration of diabetes,albumin,total cholesterol,urea,eGFR,UACR were correlated with YKL-40.Multivariate linear regression analysis showed that UACR(Beta=0.801,P<0.001)and the duration of diabetes mellitus(Beta=0.145,P=0.014)had statistically significant effects on YKL-40.The area under ROC curve of YKL-40 diagnosing albuminuria was 0.653±0.046(P=0.002),the Youden index was 0.344,the sensitivity was 48.6%,and the specificity was 85.7%.Conclusion:Plasma YKL-40 levels in T2DM patients were positively correlated with albuminuria and negatively correlated with eGFR.YKL-40 may provide a possible reference for the early diagnosis of albuminuria in patients with type 2 diabetes mellitus,but whether it can be used as a new biomarker for early diagnosis of DKD need more research to confirm.