Serum YKL-40/chitinase 3-like protein 1 level is an independent predictor of atherosclerosis development in patients with obstructive sleep apnea syndrome Obstrüktif uyku apne sendromlu hastalarda serum YKL-40/kitinaz 3-benzeri protein 1 düzeyi ateroskleroz gelişiminin bağimsiz bir öngörücüsüdür

Objective: The inflammatory process plays an important role in the development of cardiovascular complications in patients with obstructive sleep apnea syndrome (OSAS). YKL-40/chitin- ase 3-like protein 1 is a novel biomarker of systemic inflamma - tion. This study aimed to investigate whether carotid intima-me- dia thickness (CIMT), a useful marker for early atherosclerosis, is associated with serum YKL-40/chitinase 3-like protein 1 lev- els in patients with normotensive and nondiabetic OSAS. Methods: The study included 40 OSAS patients and 40 age- sex- and body mass index-matched healthy controls. Serum YKL-40 levels were detected by enzyme-linked immunosor- bent assay . CIMT was measured by B-mode ultrasound. Results: The patients with OSAS had significantly increased CIMT and higher YKL-40 and high sensitivity C-reactive protein (hsCRP) levels than those of the controls. CIMT was strongly correlated with serum YKL-40 levels (r=0.694, p<0.001), hsCRP (r=0.622, p<0.001), age (r=0.525, p=0.001), and weakly correlated with apnea-hypopnea index (AHI) (r=0.365, p=0.021) and the percentage of recording time spent (PRTS) of oxygen saturation <90% (r=0.488, p=0.001). Moreover, it was detected that serum YKL-40 levels were strongly correlated with AHI (r=0.617, p<0.001), and weakly correlated with SaO 2 <90% of PRTS (r=0.394, p=0.012) and hsCRP (r=0.486, p=0.001). In multiple regression analyses, age and serum levels of YKL-40 and hsCRP were found to be independent predictors of CIMT. Conclusion: In patients with OSAS, CIMT was increased. This increase was associated with serum YKL-40 level. In- creased serum level of YKL-40 may be an early predictor of atherosclerosis development in patients with OSAS. Amac: Enflamatuvar surec obstruktif uyku apne sendromu (OUAS) bulunan hastalarda kardiyovaskuler komplikasyonla- rin gelismesinde onemli bir rol oynar. YKL-40/kitinaz 3-benzeri protein 1 sistemik enflamasyonun guncel bir belirtecidir. Bu ca - lismada, erken ateroskleroz icin faydali bir belirtec olan karotis intima medya kalinliginin (KIMK) diyabeti olmayan normotansif OUAS'li hastalarda serum YKL-40/Kitinaz 3-benzeri protein 1 duzeyleri ile iliskisi arastirildi. Yontemler: Calismaya OUAS'li 40 hasta ile yas, cinsiyet ve beden kutle indeksi acisindan eslestirilmis 40 saglikli kontrol alindi. Serum YKL-40 duzeyleri enzim bagli immunosorbent olcum yontemi ile belirlendi. KIMK, B-mod ultrason ile olculdu. Bulgular: OUAS'li hastalar, kontrole gore onemli olcude artmis KIMK ve daha yuksek YKL-40 ve yuksek duyarlikli C-reaktif protein (hsCRP) duzeylerine sahipti. KIMK; serum YKL-40 duzeyleri (r=0.694, p<0.001), hsCRP (r=0.622, p<0.001) ve yas (r=0.525, p=0.001) ile guclu bir sekilde, apne-hipopne in- deksi (AHI) (r=0.365, p=0.021) ve %90 altindaki ortalama ok- sijen saturasyon suresinin yuzdesi (r=0.488, p=0.001) ile zayif bir sekilde iliskili idi. Ayrica serum YKL-40 duzeylerinin AHI (r=0.617, p<0.001) ile guclu bir sekilde, %90 altindaki ortala- ma oksijen saturasyon suresinin yuzdesi (r=0.394, p=0.012) ve hsCRP (r=0.486, p=0.001) ile zayif bir sekilde iliskili oldugu tespit edildi. Coklu regresyon analizinde, yas, serum YKL-40 ve hsCRP duzeylerinin KIMK'nin bagimsiz ongorduruculeri oldugu bulundu. Sonuc: OUAS'li hastalarda KIMK artmistir. Bu artis serum YKL-40 duzeyi ile iliskilidir. OUAS'li hastalarda artmis serum YKL-40 duzeyi ateroskleroz gelisiminin erken ongorucusu olabilir. ABSTRACT OZET