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. 2024 Jun;193(3):1403-1409.
doi: 10.1007/s11845-023-03545-w. Epub 2023 Oct 24.

YKL-40 in serum: a promising biomarker of juvenile SLE and strongly correlated with disease duration

Asmaa A Ali  1 , Rasha N Yousef  2 , Mai S Elsheikh  3 , Abeer R Salamah  4 , Liang L Wu  1 , Alshaimaa R Alnaggar  5 , Noha M Khalil  5 , Mervat E Behiry  5
Affiliations

YKL-40 in serum: a promising biomarker of juvenile SLE and strongly correlated with disease duration

Asmaa A Ali et al. Ir J Med Sci. 2024 Jun.

Abstract

Background: The biological function of YKL-40 is not well determined in different inflammatory and autoimmune diseases; however, some data highlighted its possible connection with disease activity.

Aim: We investigated the diagnostic utility of serum YKL-40 in patients with SLE and examined its correlation with disease activity. Additionally, we examined any differences in serum YKL-40 levels between juvenile and adult SLE patients.

Methods: We included 78 female patients with SLE and 42 controls. The level of YKL-40 in serum was measured by ELISA.

Results: The serum YKL-40 level in SLE patients was significantly higher compared to the control group (9 (3) ng/mL vs. 5.5 (0.1) ng/mL; p < 0.001). YKL-40 showed excellent diagnostic utility with an AUC of 1 (p < 0.001) and a cutoff point of 5.6, providing sensitivity and specificity of 100%. YKL-40 was higher in adolescents and those with a positive family history of SLE (p = 0.01 for both) and positively correlated with disease duration (r = 0.45, p < 0.001). YKL-40 level was significantly higher in patients with photosensitivity, fever, vasculitis, blood disorders, positive anti-dsDNA, and APL ab (p < 0.05 for all). Conversely, patients with skin manifestations had a significantly lower YKL-40 (p = 0.004). In juvenile SLE, the AUC was 0.65 and a p-value of 0.01, and at a cutoff value of (8.7) ng/mL, the sensitivity and specificity were 72% and 60%, respectively.

Conclusion: YKL-40 in serum could be a promising biomarker in patients with SLE, especially in adolescent-onset cases. It is independently influenced by disease duration, anemia, thrombocytopenia, positive anti-dsDNA, and APL ab features.

Keywords: Disease duration; Juvenile onset SLE; SLE; YKL-40.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Abundance of SLE features
Fig. 2
Fig. 2
YKL-40 in patients with SLE: a Test of significant: independent t-test, b Diagnostic utility of YKL-40 in patients with SLE, AUC: area under curve, sensitivity and specificity were 100% at cutoff point above 5.6 (ng/mL), p < 0.05 considered significant
Fig. 3
Fig. 3
YKL-40 correlation with age group, family history and disease duration: a and b test of significance: independent t-test, c test of significance: Pearson correlation coefficient, the sign before “r” denote the direction of relationship, p < 0.05 considered significant
Fig. 4
Fig. 4
Utility of YKL-40 in juvenile SLE
See this image and copyright information in PMC

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