Plasma YKL-40 and all-cause mortality in patients with chronic obstructive pulmonary diseaseReport as inadecuate




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BMC Pulmonary Medicine

, 13:77

COPD and occupational lung disease

Abstract

BackgroundChronic obstructive pulmonary disease COPD is hallmarked by inflammatory processes and a progressive decline of lung function. YKL-40 is a potential biomarker of inflammation and mortality in patients suffering from inflammatory lung disease, but its prognostic value in patients with COPD remains unknown. We investigated whether high plasma YKL-40 was associated with increased mortality in patients with moderate to very severe COPD.

MethodsFour hundred and ninety-three patients with moderate to very severe COPD were followed prospectively for up to 10 years. Patients were divided into two groups according to plasma YKL-40: concentration higher than the 75 percentile for age-matched healthy subjects i.e. high levels and normal levels. Outcome was overall survival OS and was evaluated in uni- and multivariate proportional hazards Cox regression analyses and adjusted for factors affecting mortality.

ResultsMedian plasma YKL-40 was increased in patients with COPD 81 ng-ml, p < 0.001 compared to healthy subjects 40 ng-ml. Patients with high plasma YKL-40 had a hazard ratio HR of 1.42 95% CI: 1.15–1.75, p = 0.001 for all-cause mortality. Multivariate analysis showed that YKL-40 HR 1.38; 95% CI: 1.11–1.72, p = 0.004, age HR 1.05; 95% CI: 1.03–1.06, p < 0.0001, Severe COPD HR 1.35; 95 CI: 1.03-1.76, p = 0.03 very severe COPD HR 2.19; 95% CI: 1.60 - 2.99 < 0.0001, neutrophil granulocyte count HR 1.05; 95% CI: 1.01-1.08, p = 0.01, and a smoking history of > 40 years HR 1.38; 95% CI: 1.11-1.71, p = 0.003 were independent prognostic markers of OS.

ConclusionHigh plasmaYKL-40 is associated with increased mortality in patients with moderate to very severe COPD, suggesting a role for YKL-40 as a potential biomarker of mortality in this patient group.

Trial registrationClinicalTrials.gov: NCT00132860.

KeywordsCOPD Inflammation Mortality Prognosis YKL-40 Electronic supplementary materialThe online version of this article doi:10.1186-1471-2466-13-77 contains supplementary material, which is available to authorized users.

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Author: Dennis B Holmgaard - Lone H Mygind - Ingrid L Titlestad - Hanne Madsen - Svend Stenvang Pedersen - Julia S Johansen - C

Source: https://link.springer.com/



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