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KMID : 1100720180380010039
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Annals of Laboratory Medicine
2018 Volume.38 No. 1 p.39 ~ p.45
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Urinary YKL-40 as a Candidate Biomarker for Febrile Urinary Tract Infection in Young Children
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Kim Hyun-Hee
Chung Mi-Hae
Bin Joong-Hyun
Cho Kyoung-Soon
Lee Ju-Young
Suh Jin-Soon
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Abstract
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Background: Given that YKL-40 is a known marker of inflammation, we sought to determine its association with urinary tract infection (UTI) in febrile children.
Methods: In total, 44 children aged 0 to 24 months with febrile UTI and 35 age- and sex-matched controls with fever from other causes were enrolled in the study. ELISA was performed to determine the level of YKL-40 in urine collected from each child.
Results: The ratio of urinary YKL-40 to creatinine (Cr) was higher in the children with a UTI than in the controls (P〈0.001). The area under the ROC curve for detecting UTI was 0.88 for the urinary YKL-40/Cr ratio, 0.86 for pyuria, and 0.71 for positive nitrite on urinalysis. We applied a cut-off value of 125.23 pg/mg to urinary YKL-40/Cr for detecting UTI. Eight of nine children in the control group with pyuria had urinary YKL-40/Cr levels lower than 125.23 pg/mg, and the one child in the UTI group without pyuria or positive nitrite had a urinary YKL-40/Cr level greater than 125.23 pg/mg.
Conclusions: Determining the levels of urinary YKL-40/Cr may help identify true cases of UTI in febrile young children, especially when they have pyuria but not nitrite, or have neither pyuria nor nitrite in the urine.
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KEYWORD
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Biomarker, Children, Fever, Urinary tract infection, YKL-40
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