Serum YKL-40 levels in gestational diabetes mellitus

Abstract

Objective: Serum YKL-40 levels are elevated in patients with type 1 and 2 diabetes. However, the correlation between YKL-40 and gestational diabetes mellitus (GDM) remains unknown. The present study compared serum YKL-40 levels in pregnant women with GDM and those with normal glucose tolerance and evaluated the relationship between YKL-40 and insulin-resistant syndrome.

Methods: Thirty-five patients with GDM and 43 age-matched healthy pregnant women at 24–28 weeks of gestation were studied. In addition to anthropometric assessments, serum glucose, insulin, YKL-40, total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein and glycated hemoglobin were measured in all subjects. All subjects underwent a 2-h 75-g oral glucose tolerance test (OGTT). Body mass index (BMI) and the homeostasis model assessment of insulin resistance (HOMA-IR) were calculated.

Results: Fasting and 2 h serum YKL-40 levels were significantly higher in pregnant women with GDM compared with controls (77.3 ± 29.3 versus 50.9 ± 16.7 ng/mL, p < 0.001, fasting concentrations; 63.5 ± 20.1 versus 40.6 ± 10.7 ng/mL, p = 0.009, 2 h concentrations). OGTT had no effect on YKL-40 levels in either group (p > 0.05). There were significant correlations between YKL-40 and glycated hemoglobin (β = 0.37, p = 0.006), fasting insulin (β = 0.49, p = 0.001) and HOMA-IR (β = 0.18, p = 0.015) in the GDM group.

Conclusions: Serum YKL-40 levels are elevated in patients with GDM but are unaffected by OGTT. YKL-40 levels are related to glycated hemoglobin, fasting insulin and HOMA-IR. These results suggest that YKL-40 may be a major contributor to GDM.

Chinese abstract

目的：1型和2型糖尿病患者血清YKL-40的水平升高。然而，YKL-40和妊娠期糖尿病（GDM）之间的相关性尚不清楚。此研究比较了GDM孕妇和糖耐量正常的孕妇血清YKL-40水平，评估YKL-40和胰岛素抵抗综合征之间的关系。

方法：35例妊娠期糖尿病患者和43例年龄匹配的健康孕妇纳入此研究(均为孕24-28周)。除了人体测量，还测定了所有研究对象的血糖、胰岛素、YKL-40、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白和糖化血红蛋白。所有受试者均接受2小时75克口服葡萄糖耐量试验（OGTT）。计算体重指数（BMI）和稳态模型胰岛素抵抗指数（HOMA-IR）。

结果：GDM孕妇空腹及餐后2小时血清YKL-40水平均明显高于对照组（空腹浓度77.3±29.3 vs 50.9±16.7ng/mL，P＜0.001，餐后2小时浓度63.5±20.1 vs 40.6±10.7 ng/mL，P=0.009）。两组OGTT对YKL-40水平均无影响（P＞0.05）。GDM组YKL-40和糖化血红蛋白（β= 0.37，P = 0.006）、空腹胰岛素（β= 0.49,P = 0.001）以及HOMA-IR（β= 0.18，P = 0.015）之间均存在显著的相关性。

结论：GDM患者血清YKL-40水平升高，但不受OGTT的影响。YKL-40水平与糖化血红蛋白、空腹胰岛素及HOMA-IR相关。这些结果表明，YKL-40可能是导致GDM的一个主要因素。

• Gestational diabetes mellitus
• oral glucose tolerance test
• YKL-40

Declaration of interest

The authors report no conflicts of interest.