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. 2014:5:1000174.
doi: 10.4172/2155-9929.1000174.

YKL-40 is a Protective Biomarker for Fatty Liver in World Trade Center Particulate Matter-Exposed Firefighters

Soo Jung Cho  1 , Ghislaine C Echevarria  2 , Young Im Lee  1 , Sophia Kwon  1 , Kwan Yong Park  1 , Jun Tsukiji  1 , William N Rom  3 , David J Prezant  4 , Anna Nolan  5 , Michael D Weiden  5
Affiliations

YKL-40 is a Protective Biomarker for Fatty Liver in World Trade Center Particulate Matter-Exposed Firefighters

Soo Jung Cho et al. J Mol Biomark Diagn. 2014.

Abstract

Background: Serum biomarkers of metabolic syndrome predict abnormal lung function in World Trade Center particulate matter (WTC-PM)-exposed Fire Department of New York (FDNY) rescue workers. In animal models, exposure to ambient PM induces non-alcoholic fatty liver disease (NAFLD), a well-known comorbidity of metabolic syndrome. YKL-40 is an inflammatory biomarker for both liver and lung disease. We tested if YKL-40 is a biomarker for NAFLD in this dust-exposed cohort.

Methods: Using a nested case-control design, we studied 131 FDNY personnel who had Computer Tomography performed within 5 years post 9/11. NAFLD was defined by a liver/spleen attenuation ratio of ≤1. Serum biomarkers, lipid panel and liver function were measured in serum that had been drawn within 6 months of September 11, 2001. YKL-40 and chitotriosidase were assayed by ELISA. We tested biomarker and NAFLD association using logistic regression adjusted for age, BMI, and post-911 lung function.

Results: NAFLD was present in 29/131 (22%) of the cohort. In a multivariable model increasing YKL-40 was protective while increasing triglyceride and alkaline phosphatase were risk factors for NAFLD.

Conclusions: Increased YKL-40 is a protective biomarker in non-alcoholic fatty liver disease. Further studies may reveal a link between PM-induced lung and liver diseases.

Keywords: Biomarker; Non-alcoholic fatty liver disease; YKL-40.

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Figures

Figure 1
Figure 1
Study design. WTC: World Trade Center; FDNY: Fire Department City of New York; NHANES: National Health and Nutrition Examination Survey; L/S ratio: Liver/Spleen attenuation ratio.
Figure 2
Figure 2
BMI (Panel A) and FEV1 post-911 (Panel B) are significantly different between cases (N=29) and control subjects (N=102). Results represented as box (median and interquartile range) and whiskers (10th–90th percentile). Significance determined by Wilcoxon Rank Sum test. NAFLD=Non-alcoholic fatty liver disease.
Figure 3
Figure 3
Final logistic model prediction A. Calculated probability of L/S ratio ≤ 1.0 as the concentration of YKL-40 increased over the observed biomarker range with all other covariates held constant. B. Calculated probability of L/S ratio ≤ 1.0 as triglyceride increases C. Calculated probability of L/S ratio ≤ 1.0 as ALP increases. L/S ratio: Liver/Spleen attenuation ratio; ALP: Alkaline phosphatase.
Figure 4
Figure 4
Receiver operating characteristic (ROC) of the final model to predict L/S ratio ≤ 1.0. Area under the curve (AUC) = 0.866. L/S ratio=Liver/Spleen attenuation ratio.
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