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Akut iskemik inme hastalarýnda serum YKL-40 düzeyleri ve bunun enfarktüs hacmi ile iliþkisi

Aynur Kýrbaþ¹, Serkan Kýrbaþ², Medine Cumhur Cüre³, Ahmet Tüfekçi^4
1Ahi Evran Üniversitesi Týp Fakültesi Týbbi Biyokimya Anabilim Dalý,Kýrþehir
²Ýnova Hastanesi Nöroloji Kliniði,Aksaray
³Medilab Laboratuvar ve Görüntüleme Merkezi, Týbbi Biyokimya Bölümü,Ýstanbul
⁴Recep Tayyip Erdoðan Üniversitesi Týp Fakültesi Nöroloji Anabilim Dalý,Rize

GÝRÝÞ ve AMAÇ: YKL-40, yeni bir inflamatuvar glikoproteindir ve anjiyogenez, doku fibrozu, inflamasyon ve oksidatif doku hasarýyla iliþkilidir. YKL-40'ýn iskemik inme geliþiminde rol oynadýðý bildirilmiþtir. Bu çalýþmanýn amacý, akut iskemik inmeli (aÝÝ) hastalarýn serumlarýnda YKL-40 düzeylerini ve bunun enfarktüs hacmi ile olan iliþkisini araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Çalýþmaya 50 aÝÝ hastasý ve 40 saðlýklý kontrol olmak üzere toplam 90 kiþi dahil edildi. Akut serebral enfarktüs, difüzyon aðýrlýklý görüntülerde (DAG) artmýþ sinyal yoðunluðuna sahip bir alan olarak tanýmlandý. Akut iskemik inmeyi etiyolojik alt tipe göre sýnýflandýrmak için Trials of Org 10172 in Acute Stroke Treatment kullanýldý. Serum YKL-40 düzeyi ELISA ile ölçüldü. DAG üzerindeki serebral infarktüs hacmi, ayrý bir araþtýrmacý tarafýndan Scion Image yazýlýmý kullanýlarak ölçüldü.
BULGULAR: Hasta grubu 28 erkek ve 22 kadýndan (ortalama yaþ 60.4 ± 7.9 yýl), kontrol grubu ise 21 erkek ve 19 kadýn (ortalama yaþ 59.2 ± 6.8 yýl) bireyden oluþmaktaydý. aÝÝ hastalarýnýn serum YKL-40 düzeyleri anlamlý derecede yüksekti. Serum YKL-40 düzeyleri aÝÝ hastalarýnda 227,28 ± 78,23 ng/ml ve kontrollerde 74,78 ± 13,94 ng/ml idi (p<0,001). aÝÝ hastalarýnda serum YKL-40 düzeyleri ile enfarkt hacmi arasýnda anlamlý pozitif korelasyon vardý (r = 0.931, p < 0.001).
TARTIÞMA ve SONUÇ: Çalýþmamýz, aÝÝ hastalarýnda serum YKL-40 düzeylerinin artmýþ olduðunu ve serum YKL-40 düzeyi ile serebral enfarktüs hacmi arasýnda pozitif bir iliþki olduðunu göstermiþtir. Daha ileri çalýþmalar, YKL-40'ýn akut-subakut serebral iskemi patofizyolojisi üzerindeki etkisini açýkça ortaya koymalý ve inme nüksü riskini ve inme sonrasý prognozu öngörmeyi amaçlamalýdýr.

Anahtar Kelimeler: YKL-40, iskemik inme, infarkt hacmi.

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Serum levels of YKL-40 in acute ischemic stroke patients, and its relationship to infarct volume

Aynur Kýrbaþ¹, Serkan Kýrbaþ², Medine Cumhur Cüre³, Ahmet Tüfekçi^4
1Deparment Of Medical Biochemistry, Faculty Of Medicine, Ahi Evran University, Kýrþehir,Türkiye
²Department of Neurology, Ýnova Hospital, Aksaray, Türkiye
³Deparment of Biochemistry, Medilab Lab&Imaging, Ýstanbul, Türkiye
⁴Deparment of Neurology, Faculty of Medicine, Recep Tayyip Erdoðan University, Rize, Türkiye

INTRODUCTION: YKL-40, a novel inflammatory factor and has been shown to be involved in angiogenesis, tissue fibrosis, inflammation, and oxidative tissue injury. YKL‐40 was reported to be implicated in the development of ischemic stroke. The aim of this study was to investigate of the levels of YKL-40 in serum from patients with acute ischemic stroke (aIS), and its relationship to infarct volume.
METHODS: A total of 90 subjects, including 50 patients with aIS and 40 healthy controls were enrolled in study. Acute cerebral infarction was defined as area of increase signal intensity on the diffusion weighted images (DWI). To classify acute ischemic stroke according to etiologic subtype, used the Trials of Org 10172 in Acute Stroke Treatment. Serum YKL-40 levels was measured by ELISA. Volume of the cerebral infarction on DWI was measured by a separate investigator by Scion image software.
RESULTS: The patient group consisted of 28 males and 22 females with a mean age of 60.4 ± 7.9 years, while the control group comprised 21 males and 19 females with a mean age of 59.2 ± 6.8 years. Serum YKL-40 levels of aIS patients were significantly higher than controls. Serum YKL-40 levels were 227.28 ± 78,23 ng/ml in aIS patients and 74.78 ± 13,94 ng/ml in controls (p<0.001).There were significantly positively correlated with between serum YKL-40 levels and infarct volume in patients with aIS (r = 0.931, p < 0.001).
DISCUSSION AND CONCLUSION: Our study showed that serum YKL-40 levels increased in aIS patients, and the presence of a positive the relationship between the serum YKL-40 level and cerebral infarct volume. Further studies should clearly establish the effect of YKL-40 on the pathophysiology of acute-subacute cerebral ischemia and aim to predict the risk of stroke recurrence and post-stroke prognosis.

Keywords: YKL-40, ischemic stroke, infarct volume.

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