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Acta Psychiatr Scand. 2019 Jan;139(1):37-45. doi: 10.1111/acps.12971. Epub 2018 Oct 17.

An association between YKL-40 and type 2 diabetes in psychotic disorders.

Author information

1
NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Oslo, Norway.
2
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
3
Department of Neuro Habilitation, Oslo University Hospital Ullevål, Oslo, Norway.
4
Kristiansund District Psychiatric Centre, More and Romsdal Health Trust, Kristiansund, Norway.
5
Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital and University of Oslo, Oslo, Norway.
6
Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.
7
Department of Genetics, Environment and Mental Health, Norwegian Institute of Public Health, Oslo, Norway.
8
Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.
9
Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, Norway.
10
K.G. Jebsen Inflammatory Research Center, University of Oslo, Oslo, Norway.
11
NORMENT, KG Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway.
12
Department of Medical Genetics, Oslo University Hospital, Oslo, Norway.

Abstract

OBJECTIVE:

This study examines if YKL-40 is increased in individuals with psychotic disorders and if elevated YKL-40 levels at baseline is associated with subsequent development of type 2 diabetes.

METHOD:

A total of 1383 patients with a diagnosis of schizophrenia or affective psychosis and 799 healthy controls were recruited in the period 2002-2015. Plasma YKL-40 and metabolic risk factors were measured and medication was recorded. Using national registry data, association between baseline risk factors and later development of type 2 diabetes was assessed using Cox proportional hazards models.

RESULTS:

Plasma YKL-40 was higher in patients vs. healthy controls also after adjusting for metabolic risk factors, with no difference between the schizophrenia and affective psychosis groups. Patients were diagnosed with type 2 diabetes at a significantly younger age. Multivariate Cox regression analyses showed that elevated YKL-40 (hazard ratio (HR) = 5.6, P = 0.001), elevated glucose (HR = 3.6, P = 0.001), and schizophrenia diagnosis (HR = 3.0, P = 0.014) at baseline were associated with subsequent development of type 2 diabetes.

CONCLUSIONS:

Patients with psychotic disorders have at baseline increased levels of YKL-40 beyond the effect of comorbid type 2 diabetes and metabolic risk factors. Elevated YKL-40 level at baseline is associated with later development of type 2 diabetes.

KEYWORDS:

YKL-40; bipolar disorder; schizophrenia; type 2 diabetes

PMID:
30328100
DOI:
10.1111/acps.12971

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