Serum YKL-40 in young patients with β-thalassemia major: Relation to hepatitis C virus infection, liver stiffness by transient elastography and cardiovascular complications.

Autor: El-Asrar MA; Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt., Elbarbary NS; Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt., Ismail EA; Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt., Elshenity AM; Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Jazyk: angličtina
Zdroj: Blood cells, molecules & diseases [Blood Cells Mol Dis] 2016 Jan; Vol. 56 (1), pp. 1-8. Date of Electronic Publication: 2015 Sep 28.
DOI: 10.1016/j.bcmd.2015.09.006
Abstrakt: Background: YKL-40 is an inflammatory glycoprotein involved in endothelial dysfunction and elevated in sera of patients with liver diseases.
Aim: To determine serum YKL-40 among 50 children and adolescents with β-thalassemia major (β-TM) compared to 35 healthy controls and assess its relation to liver stiffness by transient elastography (TE), markers of hemolysis, iron overload and various hemolysis-associated complications.
Methods: β-TM patients asymptomatic for heart disease were studied stressing on chelation therapy, serum ferritin, liver iron concentration (LIC), cardiac T2* and YKL-40. Echocardiography and TE were performed.
Results: Liver cirrhosis (METAVIR F4; TE values>12.5kPa) was encountered in 32%. HCV-positive patients had significantly higher WBC count, alanine transaminase (ALT) and serum ferritin than HCV-negative patients. YKL-40 levels were significantly higher in β-TM patients compared with control (p<0.001). YKL-40 was significantly higher among patients with heart disease (p=0.014) or hepatitis C virus (p=0.004) than those without. YKL-40 was correlated with liver stiffness and the degree of hepatic fibrosis being highest among patients with F4 stage (p<0.001). The YKL-40 cutoff to identify β-TM patients with liver cirrhosis or heart disease was determined. Patients treated with combined chelation therapy had significantly lower levels of YKL-40 than the monotherapy group (p<0.001). YKL-40 was positively correlated with transfusion index, ALT, lactate dehydrogenase, serum ferritin and LIC but negatively correlated with cardiac T2*.
Conclusion: YKL-40 is a promising marker of cardiovascular disease and liver siderosis in β-TM patients. The combination of YKL-40 and TE provides a reliable method to assess hepatic fibrosis in young β-TM patients.
(Copyright © 2015 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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