Dept of Internal Medicine, Center of Endocrinology and Metabolism, Copenhagen University Hospital Herlev, Denmark.
Cardiovasc Diabetol. 2009 Nov 23;8:61. doi: 10.1186/1475-2840-8-61.
Several inflammatory cytokines are involved in vascular inflammation resulting in endothelial dysfunction which is the earliest event in the atherosclerotic process leading to manifest cardiovascular disease. YKL-40 is an inflammatory glycoprotein involved in endothelial dysfunction by promoting chemotaxis, cell attachment and migration, reorganization and tissue remodelling as a response to endothelial damage. YKL-40 protein expression is seen in macrophages and smooth muscle cells in atherosclerotic plaques with the highest expression seen in macrophages in the early lesion of atherosclerosis. Several studies demonstrate, that elevated serum YKL-levels are independently associated with the presence and extent of coronary artery disease and even higher YKL-40 levels are documented in patients with myocardial infarction. Moreover, elevated serum YKL-40 levels have also been found to be associated with all-cause as well as cardiovascular mortality. Finally, YKL-40 levels are elevated both in patients with type 1 and type 2 diabetes, known to be at high risk for the development of cardiovascular diseases, when compared to non-diabetic persons. A positive association between elevated circulating YKL-40 levels and increasing levels of albuminuria have been described in patients with type 1 diabetes indicating a role of YKL-40 in the progressing vascular damage resulting in microvascular disease. This review describes the present knowledge about YKL-40 and discusses its relation to endothelial dysfunction, atherosclerosis, cardiovascular disease and diabetes and look ahead on future perspectives of YKL-40 research.
几种炎症细胞因子参与血管炎症，导致内皮功能障碍，这是动脉粥样硬化过程中导致明显心血管疾病的最早事件。YKL-40 是一种参与内皮功能障碍的炎症糖蛋白，通过促进趋化、细胞附着和迁移、重组和组织重塑来响应内皮损伤。YKL-40 蛋白表达可见于动脉粥样硬化斑块中的巨噬细胞和平滑肌细胞，在动脉粥样硬化早期病变中的巨噬细胞中表达最高。几项研究表明，血清 YKL-水平升高与冠状动脉疾病的存在和严重程度独立相关，甚至在心肌梗死患者中也记录到更高的 YKL-40 水平。此外，升高的血清 YKL-40 水平也与全因和心血管死亡率相关。最后，与非糖尿病患者相比，1 型和 2 型糖尿病患者的血清 YKL-40 水平升高，已知这些患者患心血管疾病的风险很高。在 1 型糖尿病患者中，描述了循环 YKL-40 水平升高与白蛋白尿水平升高之间的正相关，表明 YKL-40 在导致微血管疾病的血管损伤进展中发挥作用。这篇综述描述了目前关于 YKL-40 的知识，并讨论了它与内皮功能障碍、动脉粥样硬化、心血管疾病和糖尿病的关系，并展望了 YKL-40 研究的未来前景。
