The Relationship Between Serum YKL-40 Levels on Admission and Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke

Guomei Shi; Wenxiu Chen; Pengyu Gong; Meng Wang; Junshan Zhou; Xiaorong Wang; Minwang Guo; Jingye Lu; Yan Li; Hongxuan Feng; Xuetao Fu; Rujuan Zhou; Shouru Xue

doi:10.2147/JIR.S329612

The Relationship Between Serum YKL-40 Levels on Admission and Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke

J Inflamm Res. 2021 Sep 2:14:4361-4369. doi: 10.2147/JIR.S329612. eCollection 2021.

Authors

Guomei Shi^#^{1

2}, Wenxiu Chen^#³, Pengyu Gong⁴, Meng Wang⁴, Junshan Zhou⁴, Xiaorong Wang¹, Minwang Guo¹, Jingye Lu¹, Yan Li¹, Hongxuan Feng^{2

5}, Xuetao Fu^{2

6}, Rujuan Zhou¹, Shouru Xue²

Affiliations

¹ Department of Neurology, The Taixing People's Hospital, Taixing, Jiangsu, People's Republic of China.
² Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China.
³ Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
⁴ Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
⁵ Department of Neurology, The Affiliated Suzhou Hospital of Nanjing Medical University (Suzhou Municipal Hospital), Suzhou, Jiangsu, People's Republic of China.
⁶ Department of Neurology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, People's Republic of China.

^# Contributed equally.

Abstract

Background: Stroke-associated pneumonia (SAP) is a standout complication after acute ischemic stroke (AIS), with a prevalence of 7-38%. The aim of this prospective study was to investigate the relationship between serum YKL-40 levels at admission and SAP.

Methods: Between August 2020 and February 2021, consecutive AIS patients from two centers were enrolled prospectively. Serum YKL-40 concentrations were measured via enzyme-linked immunosorbent assay. We performed logistic regression analyses to explore the relationship between YKL-40 and SAP. Receiver operating characteristic curve was also used to assess the predictive ability of YKL-40 in predicting SAP.

Results: Ultimately, a total of 511 AIS patients were recruited. Multivariate logistic regression analysis showed that YKL-40 was independently related to SAP, whether as a continuous variable or as quartiles (P=0.001). The area under curve of YKL-40 to predict SAP was 0.765. The optimal cutoff value of YKL-40 as a predictor of SAP was determined to be 206.4 ng/mL, where the sensitivity was 63.1% and the specificity was 82.0%.

Conclusion: Our study demonstrated that YKL-40 might be considered as a useful biomarker to predict SAP in AIS patients.

Keywords: YKL-40; acute ischemic stroke; stroke-associated pneumonia.

Grants and funding

This work was supported by the Key Program of Kangda College of Nanjing Medical University Science and Technique Development Foundation Project (KD2020KYJJZD019) and the Young Scientific and Technological Talents Promotion Project of Jiangsu Association for Science and Technology (TJ2021019).