The association of level of plasma YKL-40 in obstructive sleep apnea hypopnea syndrome patients: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

BAI Min , YANG Xue , TONG Xiang , LIU Sitong , WANG Dongguang ,  FAN Hong

Department of Respiratory & Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

FAN Hong, Email: fanhongfan@qq.com

Keywords：

Obstructive sleep apnea hypopnea syndrome; Chitinase-like protein (YKL-40); Case control study; Meta-analysis

DOI：

10.7507/1672-2531.201710056

Video：

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ObjectiveTo systematically review the association between the level of plasma YKL-40 and obstructive sleep apnea hypopnea syndrome (OSAHS).MethodsWe searched PubMed, EMbase, MEDLINE, CNKI, WanFang Data, VIP database and supplemented by Google academic retrieval to collect case-control studies about the association between the level of plasma YKL-40 and OSAHS from inception to April 2017. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. And then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 5 case-control studies were included, involving 755 OSAHS patients and control population. The results of meta-analysis showed that the level of plasma YKL-40 in OSAHS patients was higher than that in control group (SMD=1.20, 95%CI 0.33 to 2.06, P=0.007). The subgroup analysis showed that the level of plasma YKL-40 in OSAHS patients from Asia was significantly higher than that in control group (SMD=1.79, 95%CI 0.83 to 2.75, P=0.000 2). The comparison between different severity of OSAHS showed that the wild-medium group had lower plasma level of YKL-40 than the severe group (SMD=–0.83, 95%CI –1.46 to –0.19, P=0.01).ConclusionYKL-40 may play an important role in the pathogenesis of OSAHS. Due to limited quantity and quality of the included studies, more high quality studies are needed to verify above conclusions.

Citation： BAI Min, YANG Xue, TONG Xiang, LIU Sitong, WANG Dongguang, FAN Hong. The association of level of plasma YKL-40 in obstructive sleep apnea hypopnea syndrome patients: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2018, 18(4): 354-358. doi: 10.7507/1672-2531.201710056 Copy

1.	Atkeson A, Yeh SY, Malhotra A, et al. Endothelial function in obstructive sleep apnea. Prog Cardiovasc Dis, 2009, 51(5): 351-362.
2.	Shackelton LM, Mann DM, Millis AJ. Identification of a 38-kDa heparin-binding glycoprotein (gp38k) in differentiating vascular smooth muscle cells as a member of a group of proteins associated with tissue remodeling. J Biol Chem, 1995, 270(22): 13076-13083.
3.	Lee CG, Da SC, Dela CC, et al. Role of chitin and chitinase/chitinase-like proteins in inflammation, tissue remodeling, and injury. Annu Rev Physiol, 2011, 73: 479-501.
4.	Rathcke CN, Vestergaard H. YKL-40-an emerging biomarker in cardiovascular disease and diabetes. Cardiovasc Diabetol, 2009, 8: 61.
5.	Jafari B, Mohsenin V. Chitinase-3-like protein-1 (YKL-40) as a marker of endothelial dysfunction in obstructive sleep apnea. Sleep Med, 2016, 25: 87-92.
6.	Li W, Yu Z, Jiang C. Association of serum YKL-40 with the presence and severity of obstructive sleep apnea syndrome. Lab Med, 2014, 45(3): 220-225.
7.	Wang X, Xing GH. Serum YKL-40 concentrations are elevated and correlated with disease severity in patients with obstructive sleep apnea syndrome. Scand J Clin Lab Invest, 2014, 74(1): 74-78.
8.	Bakirci EM, Unver E, Degirmenci H, et al. Serum YKL-40/chitinase 3-like protein 1 level is an independent predictor of atherosclerosis development in patients with obstructive sleep apnea syndrome. Turk Kardiyol Dern Ars, 2015, 43(4): 333-339.
9.	Duru S, Yuce G, Firat H, et al. YKL-40: may be used as a new inflammatory biomarker in obstructive sleep apnea syndrome? Tuberk Toraks, 2015, 63(3): 158-164.
10.	杭燕萍, 肖永龙, 张德平, 等. 阻塞性睡眠呼吸暂停低通气综合征患者血清 YKL-40 变化及其临床意义. 临床肺科杂志, 2011, 16(6): 857-859.
11.	Davignon J, Ganz P. Role of endothelial dysfunction in atherosclerosis. Circulation, 2004, 109(23 Suppl 1): I27-I32.
12.	Lee CG, Elias JA. Role of breast regression protein-39/YKL-40 in asthma and allergic responses. Allergy Asthma Immunol Res, 2010, 2(1): 20-27.
13.	Ober C, Tan Z, Sun Y, et al. Effect of variation in CHI3L1 on serum YKL-40 level, risk of asthma, and lung function. N Engl J Med, 2008, 358(16): 1682-1691.
14.	Gomez JL, Crisafi GM, Holm CT, et al. Genetic variation in chitinase 3-like 1 (CHI3L1) contributes to asthma severity and airway expression of YKL-40. J Allergy Clin Immunol, 2015, 136(1): 51-58.
15.	Kjaergaard AD, Bojesen SE, Johansen JS, et al. Elevated plasma YKL-40 levels and ischemic stroke in the general population. Ann Neurol, 2010, 68(5): 672-680.
16.	Ridker PM, Chasman DI, Rose L, et al. Plasma levels of the proinflammatory chitin-binding glycoprotein YKL-40, variation in the chitinase 3-like 1 gene (CHI3L1), and incident cardiovascular events. J Am Heart Assoc, 2014, 3(3): e897.
17.	Harutyunyan M, Gotze JP, Winkel P, et al. Serum YKL-40 predicts long-term mortality in patients with stable coronary disease: a prognostic study within the CLARICOR trial. Immunobiology, 2013, 218(7): 945-951.
18.	Harutyunyan M, Christiansen M, Johansen JS, et al. The inflammatory biomarker YKL-40 as a new prognostic marker for all-cause mortality in patients with heart failure. Immunobiology, 2012, 217(6): 652-656.
19.	Marin JM, Carrizo SJ, Vicente E, et al. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet, 2005, 365(9464): 1046-1053.
20.	Punjabi NM, Beamer BA, Jain A, et al. Elevated levels of neopterin in sleep-disordered breathing. Chest, 2007, 132(4): 1124-1130.

1. Atkeson A, Yeh SY, Malhotra A, et al. Endothelial function in obstructive sleep apnea. Prog Cardiovasc Dis, 2009, 51(5): 351-362.
2. Shackelton LM, Mann DM, Millis AJ. Identification of a 38-kDa heparin-binding glycoprotein (gp38k) in differentiating vascular smooth muscle cells as a member of a group of proteins associated with tissue remodeling. J Biol Chem, 1995, 270(22): 13076-13083.
3. Lee CG, Da SC, Dela CC, et al. Role of chitin and chitinase/chitinase-like proteins in inflammation, tissue remodeling, and injury. Annu Rev Physiol, 2011, 73: 479-501.
4. Rathcke CN, Vestergaard H. YKL-40-an emerging biomarker in cardiovascular disease and diabetes. Cardiovasc Diabetol, 2009, 8: 61.
5. Jafari B, Mohsenin V. Chitinase-3-like protein-1 (YKL-40) as a marker of endothelial dysfunction in obstructive sleep apnea. Sleep Med, 2016, 25: 87-92.
6. Li W, Yu Z, Jiang C. Association of serum YKL-40 with the presence and severity of obstructive sleep apnea syndrome. Lab Med, 2014, 45(3): 220-225.
7. Wang X, Xing GH. Serum YKL-40 concentrations are elevated and correlated with disease severity in patients with obstructive sleep apnea syndrome. Scand J Clin Lab Invest, 2014, 74(1): 74-78.
8. Bakirci EM, Unver E, Degirmenci H, et al. Serum YKL-40/chitinase 3-like protein 1 level is an independent predictor of atherosclerosis development in patients with obstructive sleep apnea syndrome. Turk Kardiyol Dern Ars, 2015, 43(4): 333-339.
9. Duru S, Yuce G, Firat H, et al. YKL-40: may be used as a new inflammatory biomarker in obstructive sleep apnea syndrome? Tuberk Toraks, 2015, 63(3): 158-164.
10. 杭燕萍, 肖永龙, 张德平, 等. 阻塞性睡眠呼吸暂停低通气综合征患者血清 YKL-40 变化及其临床意义. 临床肺科杂志, 2011, 16(6): 857-859.
11. Davignon J, Ganz P. Role of endothelial dysfunction in atherosclerosis. Circulation, 2004, 109(23 Suppl 1): I27-I32.
12. Lee CG, Elias JA. Role of breast regression protein-39/YKL-40 in asthma and allergic responses. Allergy Asthma Immunol Res, 2010, 2(1): 20-27.
13. Ober C, Tan Z, Sun Y, et al. Effect of variation in CHI3L1 on serum YKL-40 level, risk of asthma, and lung function. N Engl J Med, 2008, 358(16): 1682-1691.
14. Gomez JL, Crisafi GM, Holm CT, et al. Genetic variation in chitinase 3-like 1 (CHI3L1) contributes to asthma severity and airway expression of YKL-40. J Allergy Clin Immunol, 2015, 136(1): 51-58.
15. Kjaergaard AD, Bojesen SE, Johansen JS, et al. Elevated plasma YKL-40 levels and ischemic stroke in the general population. Ann Neurol, 2010, 68(5): 672-680.
16. Ridker PM, Chasman DI, Rose L, et al. Plasma levels of the proinflammatory chitin-binding glycoprotein YKL-40, variation in the chitinase 3-like 1 gene (CHI3L1), and incident cardiovascular events. J Am Heart Assoc, 2014, 3(3): e897.
17. Harutyunyan M, Gotze JP, Winkel P, et al. Serum YKL-40 predicts long-term mortality in patients with stable coronary disease: a prognostic study within the CLARICOR trial. Immunobiology, 2013, 218(7): 945-951.
18. Harutyunyan M, Christiansen M, Johansen JS, et al. The inflammatory biomarker YKL-40 as a new prognostic marker for all-cause mortality in patients with heart failure. Immunobiology, 2012, 217(6): 652-656.
19. Marin JM, Carrizo SJ, Vicente E, et al. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet, 2005, 365(9464): 1046-1053.
20. Punjabi NM, Beamer BA, Jain A, et al. Elevated levels of neopterin in sleep-disordered breathing. Chest, 2007, 132(4): 1124-1130.

Chinese Journal of Evidence-Based Medicine

The association of level of plasma YKL-40 in obstructive sleep apnea hypopnea syndrome patients: a meta-analysis

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