Ann Lab Med.  2018 Jan;38(1):39-45. 10.3343/alm.2018.38.1.39.

Urinary YKL-40 as a Candidate Biomarker for Febrile Urinary Tract Infection in Young Children

• Kim HH
• Chung MH
• Bin JH
• Cho KS
• Lee J
• Suh JS

• KMID: 2397600
• DOI: http://doi.org/10.3343/alm.2018.38.1.39

Abstract

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.

Keyword

Biomarker; Children; Fever; Urinary tract infection; YKL-40

MeSH Terms

Child*
Creatinine
Enzyme-Linked Immunosorbent Assay
Fever
Humans
Inflammation
Pyuria
ROC Curve
Urinalysis
Urinary Tract Infections*
Urinary Tract*
Creatinine

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