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

Öz

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.

Anahtar Kelimeler

• Inflamasyon
• proteinüri
• sistemik lupus eritematozus
• Ykl-40

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

Öz

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.

Anahtar Kelimeler

• Inflammation
• proteinuria
• systemic lupus erythematosus
• Ykl-40

Kaynakça

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