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Background and Aim of work: The aim of the present study is to evaluate serum YKL-40 levels in patients with type II diabetes with increasing levels of albuminuria, and to examine a possible correlation to high-sensitivity C-reactive protein (hsCRP) and insulin resistance in these patients. Methods: The study comprised 125 patients with type II diabetes attending Diabetes& Endocrinology Unit in Mansoura Specialized Medical Hospital. They were divided into 3 groups: 39 patients had normoalbuminuria (urinary albumin excretion rate < 30 mg/24 h), 46 patients had persistent microalbuminuria (urinary albumin excretion rate 30–300 mg/24 h), and 40 patients had persistent macroalbuminuria/diabetic nephropathy (urinary albumin excretion rate > 300 mg/24 h). The control group included 35 healthy individuals with matched age and sex. Serum YKL-40 was measured by sandwich enzyme immunoassay and serum hsCRP was measured by particle enhanced immunonephelometry. Insulin resistance was assessed using Homeostasis Model Assessment index for Insulin Resistance (HOMA-IR). Results: Mean serum YKL-40 level was 38.48ng/ml, 75.33ng/ml, 116.87ng/ml and 146.43ng/ml in control, normo, microand macroalbuminuria groups respectively. Serum YKL-40 levels were significantly elevated in the three diabetic groups versus control group (P < 0.001 for each group). Also, YKL 40 was correlated with hsCRP and HOMA-IR (r = 0.746, P < 0.001 & r = 0.792, P < 0.001, respectively) in the total group of participants. ROC curve analysis showed that YKL-40 is a good marker to discriminate between patients with and without albuminuria with sensitivity 93% and specificity of 88%. Conclusion: It could be concluded that YKL-40, is a marker of inflammation and endothelial dysfunction. It is elevated in patients with type II diabetes with marked elevation in patients with macroalbuminuria/ nephropathy. These results suggest a role for YKL-40 in the gradually progressing vascular complications in patients with diabetes, with YKL-40 being a possible early and good marker of renal affection. It seems to be useful for screening because it is detectable in early stages and subclinical diseases.

Evaluation of YKL-40 in Patients with Type II Diabetes Mellitus with Increasing Levels of Albuminuria