J Rheum Dis.  2019 Oct;26(4):257-263. 10.4078/jrd.2019.26.4.257.

YKL-40 Levels in Rheumatoid Arthritis and Their Correlation with Disease Activity: A Meta-analysis

• Lee YH
• Song GG

• KMID: 2459450
• DOI: http://doi.org/10.4078/jrd.2019.26.4.257

Abstract

OBJECTIVE
To examine the relationship of serum/plasma YKL-40 levels with rheumatoid arthritis (RA) and their correlation with RA activity and rheumatoid factor (RF) level.
METHODS
We performed a meta-analysis comparing the serum/plasma YKL-40 levels between patients with RA and controls and examined the correlation coefficients of the circulating YKL-40 level with the RF level and RA activity based on the 28-joint disease activity score (DAS28), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) level.
RESULTS
Nine studies (707 patients with RA and 1,041 controls) were included in the meta-analysis. The YKL-40 levels were significantly higher in the RA group than in the control group (standardized mean difference [SMD]=1.071, 95% confidence interval [CI]=0.726~1.417, p<0.001). Stratification by ethnicity showed significantly elevated YKL-40 levels in the RA groups from European, Asian, North American, and Arab populations. The YKL-40 level was significantly higher in the RA group than in the control group in both age- and sex-matched and only age-matched populations (SMD=0.937, 95% CI=0.554~1.320, p<0.001; SMD=2.951, 95% CI=1.389~4.512, p<0.001, respectively). Subgroup analysis by sample size showed significantly increased YKL-40 levels in the RA group in both small (n<100) and large (n>100) populations. Meta-analysis of correlation coefficients showed a significant positive correlation between the YKL-40 levels and DAS28, ESR, CRP level, and RF level (DAS28: correlation coefficient=0.381, 95% CI=0.044~0.640, p=0.028; RF level: correlation coefficient=0.341, 95% CI=0.176~0.487, p<0.001).
CONCLUSION
The circulating YKL-40 levels are high in patients with RA and positively correlate with RA activity and RF level.

Keyword

YKL-40; Rheumatoid arthritis; Activity

MeSH Terms

Arabs
Arthritis, Rheumatoid*
Asian Continental Ancestry Group
Blood Sedimentation
C-Reactive Protein
Humans
Rheumatoid Factor
Sample Size
C-Reactive Protein
Rheumatoid Factor

Figure

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  Figure 1. Meta-analysis of the relationship between the plasma/serum YKL-40 levels and rheumatoid arthritis (RA) in all study subjects. Std diff: standardized difference, CI: confidence interval.

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  Figure 2. Meta-analysis of the relationship between the plasma/serum YKL-40 levels and rheumatoid arthritis (RA) in each ethnic group. Std diff: standardized difference, CI: confidence interval.

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  Figure 3. Meta-analysis of the correlation coefficient between the YKL-40 levels and DAS28 (A) and ESR (B). DAS28: 28-joint disease activity score, ESR: erythrocyte sedimentation rate, CI: confidence interval.

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