Plasma YKL-40 and Total and Disease-Specific Mortality in the General Population

• Published in: Clinical chemistry (Baltimore, Md.) Md.), 2010-10, Vol.56 (10), p.1580-1591
• Main Authors: JOHANSEN, Julia S, BOJESEN, Stig E, TYBJAERG-HANSEN, Anne, MYLIN, Anne K, PRICE, Paul A, NORDESTGAARD, Borge G
• Format: Article
• Language: English
• Subjects: Adipokines; Adult; Aged; Aged, 80 and over; Analytical, structural and metabolic biochemistry; Biological and medical sciences; Biomarkers - blood; Cancer; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - blood; Cardiovascular Diseases - mortality; Cause of Death; Chitinase-3-Like Protein 1; Female; Fundamental and applied biological sciences. Psychology; Glycoproteins - blood; Humans; Investigative techniques, diagnostic techniques (general aspects); Kaplan-Meier Estimate; Lectins - blood; Male; Medical sciences; Middle Aged; Molecular biophysics; Mortality; Neoplasms - blood; Neoplasms - mortality; Plasma; Survival; Young Adult
• ISSN: 0009-9147; 1530-8561
• DOI: 10.1373/clinchem.2010.146530

Increased plasma YKL-40 is associated with short-term survival in patients with cardiovascular disease and cancer. We tested the hypothesis that increased plasma YKL-40 is associated with total and disease-specific mortality in the general population. We measured plasma YKL-40 in 8899 study participants, aged 20-95 years, in the Copenhagen City Heart Study from the Danish general population who were followed for 16 years: 3059 died, 2158 had ischemic cardiovascular disease, 2271 had cancer, and 2820 had other diseases associated with increased YKL-40. Hazard ratios for early death and absolute 10-year mortality rates were calculated according to plasma YKL-40 percentile groupings computed within sex and age decade: 0%-33%, 34%-66%, 67%-90%, 91%-95%, and 96%-100%. Median survival age decreased from 83 years for participants with plasma YKL-40 in category 0%-33% to 69 years in category 96%-100% (trend, P < 0.0001). Risk of early death was increased (multifactorially adjusted hazard ratios) by 10% for YKL-40 category 34%-66%, by 30% for 67%-90%, by 70% for 91%-95%, and by 90% for 96%-100% vs YKL-40 category 0%-33% (trend, P < 0.0001). Corresponding increases in participants with ischemic cardiovascular disease were 10%, 20%, 80%, and 60% (P < 0.0001); in those with cancer were 10%, 20%, 50%, and 70% (P < 0.0001); and in those with other diseases were 10%, 20%, 40%, and 60% (P < 0.0001). Highest absolute 10-year mortality rates were 78% and 90% in women and men, respectively, who were >70 years old, smoked, and were in YKL-40 category 96%-100%. Increased plasma YKL-40 is associated with risk of early death from cardiovascular disease, cancer, and other diseases in the general population.