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Plasma YKL-40 and all-cause mortality in patients with chronic obstructive pulmonary disease

BACKGROUND: Chronic 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 C...

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Autores principales: Holmgaard, Dennis B, Mygind, Lone H, Titlestad, Ingrid L, Madsen, Hanne, Pedersen, Svend Stenvang, Johansen, Julia S, Pedersen, Court
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3890498/
https://www.ncbi.nlm.nih.gov/pubmed/24373580
http://dx.doi.org/10.1186/1471-2466-13-77
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author Holmgaard, Dennis B
Mygind, Lone H
Titlestad, Ingrid L
Madsen, Hanne
Pedersen, Svend Stenvang
Johansen, Julia S
Pedersen, Court
author_facet Holmgaard, Dennis B
Mygind, Lone H
Titlestad, Ingrid L
Madsen, Hanne
Pedersen, Svend Stenvang
Johansen, Julia S
Pedersen, Court
author_sort Holmgaard, Dennis B
collection PubMed
description BACKGROUND: Chronic 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. METHODS: Four 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(th) 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. RESULTS: Median 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. CONCLUSION: High 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 REGISTRATION: ClinicalTrials.gov: NCT00132860.
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spelling pubmed-38904982014-01-15 Plasma YKL-40 and all-cause mortality in patients with chronic obstructive pulmonary disease Holmgaard, Dennis B Mygind, Lone H Titlestad, Ingrid L Madsen, Hanne Pedersen, Svend Stenvang Johansen, Julia S Pedersen, Court BMC Pulm Med Research Article BACKGROUND: Chronic 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. METHODS: Four 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(th) 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. RESULTS: Median 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. CONCLUSION: High 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 REGISTRATION: ClinicalTrials.gov: NCT00132860. BioMed Central 2013-12-30 /pmc/articles/PMC3890498/ /pubmed/24373580 http://dx.doi.org/10.1186/1471-2466-13-77 Text en Copyright © 2013 Holmgaard et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Holmgaard, Dennis B
Mygind, Lone H
Titlestad, Ingrid L
Madsen, Hanne
Pedersen, Svend Stenvang
Johansen, Julia S
Pedersen, Court
Plasma YKL-40 and all-cause mortality in patients with chronic obstructive pulmonary disease
title Plasma YKL-40 and all-cause mortality in patients with chronic obstructive pulmonary disease
title_full Plasma YKL-40 and all-cause mortality in patients with chronic obstructive pulmonary disease
title_fullStr Plasma YKL-40 and all-cause mortality in patients with chronic obstructive pulmonary disease
title_full_unstemmed Plasma YKL-40 and all-cause mortality in patients with chronic obstructive pulmonary disease
title_short Plasma YKL-40 and all-cause mortality in patients with chronic obstructive pulmonary disease
title_sort plasma ykl-40 and all-cause mortality in patients with chronic obstructive pulmonary disease
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3890498/
https://www.ncbi.nlm.nih.gov/pubmed/24373580
http://dx.doi.org/10.1186/1471-2466-13-77
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