SavedAdd your journal

Journals / Batı Karadeniz Tıp Dergisi / 2026 / Cilt: 10 Sayı: 1

The correlation between serum YKL-40, proteinuria and inflammation in patients with systemic lupus erythematosus

Sistemik lupus eritematozuslu hastalarda serum YKL-40, proteinüri ve inflamasyon düzeyi arasındaki ilişki

İlyas Öztürk(Department of Internal Medicine, Division of Nephrology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Türkiye)0000-0001-9431-8068
Fatma Betül Güzel(Department of Internal Medicine, Division of Nephrology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Türkiye)0000-0003-1569-9654
Serhat Kura(Department of Internal Medicine, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Türkiye)0000-0001-9973-7982
Enes Süleyman Gün(Department of Internal Medicine, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Türkiye)0009-0009-7313-4142
Burak Okyar(Department of Internal Medicine, Division of Rheumatology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Türkiye)0000-0002-9028-9930
Sinan Kazan(Department of Internal Medicine, Division of Nephrology, Afyonkarahisar Health Science University, Faculty of Medicine, Afyonkarahisar, Türkiye)0000-0001-7290-4680
Muhammed Seyithanoğlu(Department of Biochemistry, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaraş, Türkiye)0000-0002-8027-7549
Gözde Yıldırım Çetin(Department of Internal Medicine, Division of Rheumatology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Türkiye)0000-0001-9680-7535
Orçun Altunören(Department of Internal Medicine, Division of Nephrology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Türkiye)0000-0002-8913-4341
Özkan Güngör(Department of Internal Medicine, Division of Nephrology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Türkiye)0000-0003-1861-5452
Pages
25–30
Publication Date
2026-01-11
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: Serum YKL-40 was found to be associated with inflammatory markers such as CRP and ESR in SLE patients, but not with the amount of proteinuria.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aim: YKL-40 is a protein associated with acute and chronic inflammation and cancer.
📊
Key Findings & Data:Serum YKL-40 has been reported to be associated with proteinuria in diabetic and renal transplant patients.
💡
Conclusion & Impact:Conclusion: Serum YKL-40 was found to be associated with inflammatory markers such as CRP and ESR in SLE patients, but not with the amount of proteinuria.
🔬Design:Modeling & Simulation
📍Scope:2022 Verileri
⚙️Variables:Inflamasyon · proteinüri · sistemik lupus eritematozus

Abstract

Aim: YKL-40 is a protein associated with acute and chronic inflammation and cancer. Neutrophils, macrophages, and cancer cells normally produce it. It plays a role in cell proliferation, differentiation, angiogenesis, inflammation, and extracellular matrix remodeling. It is also a marker of endothelial dysfunction and atherosclerosis. Serum YKL-40 has been reported to be associated with proteinuria in diabetic and renal transplant patients. In this study, we aimed to investigate, for the first time in the literature, the relationship between the amount of proteinuria and inflammatory markers and YKL-40 in patients with systemic lupus erythematosus (SLE). Material and Methods: Fifty-one patients with SLE who presented to the adult nephrology outpatient clinic between June 2022 and January 2023 were included in the study. Blood and urine test results were obtained from the patients' routine examinations. ELISA was used to determine YKL-40. Results: The mean age of the patients was 38±14 years and 94% were female. The median creatinine was 0.72 (0.36-2.62) mg/dl, the mean estimated glomerular filtration rate was 99±31 ml/min, the mean C-reactive protein (CRP) was 8±7 mg/L, the median erythrocyte sedimentation rate (ESR) was 14.5 (4-72) mm/hour, the median amount of proteinuria was 190 (69-4959) mg/g and the mean YKL-40 was 12.9±9.2 pg/ ml. In correlation analysis, YKL-40 was positively correlated with glucose, CRP, and ESR [respectively (p=0.01, r=0.26), (p=0.02, r=0.06), (p=0.01, r=0.11)], and negatively correlated with calcium, albumin, intact parathyroid hormone, and complement-3 [respectively (p<0.001, r=-0.41), (p=0.01, r=-0.37), (p=0.01, r=-0.41), (p<0.001, r=-0.52)]. No correlation was found between YKL-40 and the amount of proteinuria (p=0.68, r=0.18). Conclusion: Serum YKL-40 was found to be associated with inflammatory markers such as CRP and ESR in SLE patients, but not with the amount of proteinuria.

Özet

Amaç: YKL-40; akut ve kronik inflamasyon yanında kanser ile de ilişkili bir proteindir. Hücre proliferasyonu, diferansiasyonu, anjiogenez, inflamasyon ve ekstrasellüler matriks remodellinginde görevli bu proteinler normalde nötrofiller, makrofajlar ve kanser hücreleri tarafından üretilir. Ayrıca endotel disfonksiyonunun ve aterosklerozun da bir göstergesidir. Diyabetik ve böbrek nakilli hastalarda serum YKL-40 düzeyinin proteinüri ile ilişkili olduğu bildirilmiştir. Biz de bu çalışmada, literatürde ilk defa, Sistemik Lupus Eritematozus (SLE) hastalarında YKL-40 düzeyi ile proteinüri miktarı ve inflamasyon belirteçleri arasındaki ilişkiyi incelemeyi amaçladık. Gereç ve Yöntemler: Çalışmaya Haziran 2022–Ocak 2023 tarihleri arasında Nefroloji Polikliniğe başvuran 51 SLE hastası dahil edildi. Kan ve idrar tetkik sonuçları hastaların rutin tetkiklerinden elde edildi. YKL- 40 düzeyi ELISA yöntemiyle ölçüldü. Bulgular: Hastaların yaş ortalaması 38±14 yıl olup %94’ü kadındı. Ortanca kreatin 0.72 (0.36-2.62) mg/dl, ortalama tahmini glomerüler filtrasyon hızı 99±31 ml/dk, ortalama C-reaktif protein (CRP) 8±7 mg/L, ortanca eritrosit sedimentasyon hızı (ESH) 14.5 (4-72) mm/sa, ortanca proteinüri miktarı 190 (69-4959) mg/g ve ortalama YKL-40 düzeyi 12.9±9.2 pg/ml’ydi. Korelasyon analizinde, YKL-40; glukoz, CRP, ESH ile pozitif korele [sırasıyla (p=0.01, r=0.26), (p=0.02, r=0.06), (p=0.01, r=0.11)], kalsiyum, albümin, intakt parathormon ve kompleman-3 düzeyi ile negatif korele [sırasıyla (p<0.001, r=-0.41), (p=0.01, r=-0.37), (p=0.01, r=-0.41), (p<0.001, r=-0.52)] bulundu. YKL-40 düzeyi ile proteinüri miktarı arasında ilişki tespit edilmedi (p=0.68, r=0.18). Sonuç: SLE hastalarında YKL-40 düzeyi ile CRP ve ESH gibi inflamasyon markerları arasında ilişki bulunmakla birlikte, proteinüri miktarıyla bir ilişki bulunamamıştır.

🔖

Cite This Article

Öztürk, İ., Güzel, F. B., Kura, S., Gün, E. S., Okyar, B., Kazan, S., Seyithanoğlu, M., Çetin, G. Y., Altunören, O., Güngör, Ö. (2026). The correlation between serum YKL-40, proteinuria and inflammation in patients with systemic lupus erythematosus. Batı Karadeniz Tıp Dergisi, Cilt: 10 Sayı: 1, 25–30. https://doi.org/10.29058/mjwbs.1793565

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (23)

  1. Rathcke CN, Vestergaard H. YKL-40, a new inflammatory marker with relation to insulin resistance and with a role in endothelial dysfunction and atherosclerosis. Inflamm. res. 55, 221–227 (2006). https://doi.org/10.1007/s00011-006-0076-y.
  2. Okyay GU, Er RE, Tekbudak MY, Paşaoğlu Ö, Inal S, Öneç K, et al. Novel Inflammatory Marker in Dialysis Patients: YKL‐40. Therapeutic Apheresis and Dialysis, 2013; 17(2), 193-201. https://doi.org/10.1111/j.1744-9987.2012.01141.x.
  3. Rathcke CN, Persson F, Tarnow L, Rossing P, Vestergaard H. YKL-40, a marker of inflammation and endothelial dysfunction, is elevated in patients with type 1 diabetes and increases with levels of albuminuria. Diabetes Care, 2009; 32: 323–28. https:// doi.org/10.2337/dc08-1144.
  4. Persson F, Rathcke CN, Gall MA, Parving H-H, Vestergaard H, Rossing P. High YKL-40 levels predict mortality in patients with type 2 diabetes. Diabetes Res Clin Pract, 2012; 96:84–89. https://doi.org/10.1016/j.diabres.2011.12.008.
  5. Tatar E, Gungor O, Celtik A, Sisman AR, Yaprak M, Asci G, et al. Correlation between serum YKL-40 (Chitinase-3-like protein 1) level and proteinuria in renal transplant recipients. Ann Transplant, 2013: 18: 95-100. https://doi.org/10.12659/AOT.883844.
  6. Kocyigit I, Gungor O, Dogan E, Karadavut S, Karakukcu C, Eroglu E, et al, Oymak O. (2014). The serum YKL-40 level is associated with vascular injury and predicts proteinuria in nephrotic syndrome patients. J Atheroscler Thromb, 2015; 22: 257-264. https://doi.org/10.5551/jat.26385.
  7. Keskin GSY, Helvacı Ö, Yayla Ç, Paşaoğlu ÖT, Keskin Ç, Arınsoy ST, et al. Relationship between plasma YKL-40 levels and endothelial dysfunction in chronic kidney disease. Turkish journal of medical sciences, 2019; 49(1), 139-146. https://doi. org/10.3906/sag-1804-169.
  8. Tizaoui K, Yang JW, Lee KH, Kim JH, Kim M, Yoon S, et al. The role of YKL-40 in the pathogenesis of autoimmune diseases: a comprehensive review. Int J Biol Sci, 2022; 18(9), 3731-3746. https://doi.org/10.7150/ijbs.67587.
  9. Siegel CH, Sammaritano LR. Systemic Lupus Erythematosus: A Review. JAMA. 2024;331(17):1480–1491. https://doi. org/10.1001/jama.2024.2315.
  10. Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortin PR, et al. Derivation andvalidation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012; 64: 2677–2686. https://doi.org/10.1002/art.34473.
  11. Kucur M, Isman FK, Karadag B, Vural VA, Tavsanoglu S. Serum YKL-40 levels in patients with coronary artery disease. Coron Artery Dis 2007;18(5):391–6. https://doi.org/10.1097/ MCA.0b013e328241d991.
  12. Rathcke CN, Vestergaard H. YKL-40—an emerging biomarker in cardiovascular disease and diabetes. Cardiovasc Diabetol 2009;8:61. https://doi.org/10.1186/1475-2840-8-61.
  13. El-Ghorab OAAN, Elshafey MHR, Negm MSA, Elkhateeb MAHT. Evaluation of YKL-40 as a Biomarker of Inflammation and Atherosclerosis in Chronic Kidney Disease Patients. Journal of Advances in Medicine and Medical Research. 2022;34(21),10-26.
  14. Currie G, Delles C.Proteinuria and its relation to cardiovascular disease. Int J Nephrol Renovas Dis. 2014; 7: 13-24. https://doi. org/10.2147/IJNRD.S40522.
  15. Joles JA, Stroes ESG, Rabelink TJ. Endothelial function in proteinuric renal disease. Kid Int 1999; 56: 71.pp57-61. https://doi. org/10.1046/j.1523-1755.1999.07115.x.
  16. Schalkwijk CG, Stehouwer CDA. Vascular complications in diabetes mellitus: the role of endothelial dysfunction. Clin Sci (Lond). 2005; 109(2):143-159. https://doi.org/10.1042/ CS20050025.
  17. Brix JM, Hollerl F, Koppensteiner R, Schernthaner G, Schernthaner GH. YKL-40 in type 2 diabetic patients with different levels of albuminuria. Eur J Clin Invest 2011;41(6):589–96. https:// doi.org/10.1111/j.1365-2362.2010.02446.x.
  18. Rondbjerg AK, Omerovic E, Vestergaard H. YKL-40 levels are independently associated with albuminuria in type 2 diabetes. Cardiovasc Diabetol 2011;10:54. https://doi.org/10.1186/1475- 2840-10-54.
  19. Lee JH, Kim SS, Kim IJ, Song SH, Kim YK, In Kim J, et al. Clinical implication of plasma and urine YKL-40, as a proinflammatory biomarker, on early stage of nephropathy in type 2 diabetic patients. J Diabetes Complications 2012; 26: 308-312. https:// doi.org/10.1016/j.jdiacomp.2012.04.012.
  20. Lorenz G, Schmalenberg M, Kemmner S, Haller B, Steubl D, Pham D, et al. Mortality prediction in stable hemodialysis patients is refined by YKL-40, a 40-kDa glycoprotein associated with inflammation. Kidney International, 2018; 93(1), 221-230. https://doi.org/10.1016/j.kint.2017.07.010.
  21. Ali AA, Yousef RN, Elsheikh MS, Salamah AR, Wu LL, Alnaggar AR, et al. YKL-40 in serum: a promising biomarker of juvenile SLE and strongly correlated with disease duration. Irish Journal of Medical Science (1971 -), 2024; 193(3), 1403-1409. https://doi.org/10.1007/s11845-023-03545-w.
  22. Gamal El-Agamy A, Abdel Noor R, M Mabrouk M, Ahmed El- Tatawy R, Salah Hegab D. Assessment of Serum Level of Chitinase-3-Like Protein-1 (Ykl-40) in Systemic Lupus Erythematosus Patients and Its Relation to Disease Activity. Journal of Advances in Medicine and Medical Research, 2023; 35(1), 28-37. https://doi.org/10.9734/jammr/2023/v35i14931.
  23. Chen C, Liang Y, Zhang Z, Zhang Z, Yang Z. Relationships between increased circulating YKL-40, IL-6 and TNF-α levels and phenotypes and disease activity of primary Sjögren’s syndrome. International Immunopharmacology, 2020; 88, 106878. https://doi.org/10.1016/j.intimp.2020.106878.