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      Variations of CHI3L1, Levels of the Encoded Glycoprotein YKL-40 and Prediction of Fatal and Non-fatal Ischemic Stroke

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          Abstract

          Background

          Polymorphisms of CHI3L1 are associated with inter-individual YKL-40 levels and YKL-40 is associated with an increased mortality and is elevated in patients with cardiovascular disease. We investigated the association between single nucleotide polymorphisms (SNPs) of CHI3L1, serum YKL-40 levels and all-cause and cardiovascular mortality and first-time incidence of myocardial infarction, ischemic heart disease (IHD) and stroke.

          Methodology/Principal Findings

          12 SNPs of CHI3L1 were genotyped and serum YKL-40 was measured in 2656 Danes representative of the general population. Median follow-up period was 15 (0–16) years. Admission data and deaths were ascertained from registers from the Danish National Board of Health. Fourth quartile YKL-40 levels were associated with an increased mortality risk of ischemic stroke (HR 2.44 (1.01–5.88), p = 0.041) and so were homozygotes of the minor allele of rs872129 (HR 9.35 (1.25–69.87, p = 0.022)). Both continuous YKL-40 levels and 4 th quartile YKL-40 values (>85 ng/ml) were associated with all-cause mortality (HRs 1.22 (95% CI, 1.10–1.35), p<0.0001, and 1.40 (1.15–1.71), p<0.0001), an increased risk of first-time stroke (HR 1.16 (1.01–1.33), p = 0.04, and 1.63 (1.23–2.16), p = 0.001) and a decreased risk of incidence of IHD (HR 0.77 (0.65–0.91), p = 0.002, and 0.61 (0.44–0.85), p = 0.003).

          Conclusions/Signficance

          High YKL-40 levels (>85 ng/ml) and rs872129 were associated with an increased mortality risk of ischemic stroke, but high YKL-40 levels were also inverse related with the risk of incidence of IHD. This could be a chance finding but could also elucidate that YKL-40 plays different roles in development of thromboembolisms versus the formation of local thrombosis.

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          Most cited references27

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          Efficiency and power in genetic association studies.

          We investigated selection and analysis of tag SNPs for genome-wide association studies by specifically examining the relationship between investment in genotyping and statistical power. Do pairwise or multimarker methods maximize efficiency and power? To what extent is power compromised when tags are selected from an incomplete resource such as HapMap? We addressed these questions using genotype data from the HapMap ENCODE project, association studies simulated under a realistic disease model, and empirical correction for multiple hypothesis testing. We demonstrate a haplotype-based tagging method that uniformly outperforms single-marker tests and methods for prioritization that markedly increase tagging efficiency. Examining all observed haplotypes for association, rather than just those that are proxies for known SNPs, increases power to detect rare causal alleles, at the cost of reduced power to detect common causal alleles. Power is robust to the completeness of the reference panel from which tags are selected. These findings have implications for prioritizing tag SNPs and interpreting association studies.
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            Studies on serum YKL-40 as a biomarker in diseases with inflammation, tissue remodelling, fibroses and cancer.

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              Self-administration of a questionnaire on chest pain and intermittent claudication.

              A total of 18 403 men aged between 40 and 64 years took part in a screening examination which included a self-administered version of the London School of Hygiene questionnaire on chest pain and intermittent claudication. The yield of positives for "angina" and "history of possible infarction" was about twice as high as with interviewers, but the positive groups obtained by the two techniques differed little in their association with electrocardiographic findings or in their ability to predict five-year coronary mortality risk. This risk ranged from 0-9% in men negative to questionnaire and electrocardiograms (ECG), to 4-3% for those with positive ECG but no symptoms, 4-5% for those with angina and negative ECG, up to 16% for those with angina and positive ECG. The self-administered version of this questionnaire provides a simple and convenient means of identifying individuals with a high risk of major coronary heart disease.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2012
                24 August 2012
                : 7
                : 8
                : e43498
                Affiliations
                [1 ]Deptartment of Internal Medicine, Center of Endocrinology and Metabolism, Copenhagen University Hospital Herlev, Copenhagen, Denmark
                [2 ]Department of Cardiology and Endocrinology, Copenhagen University Hospital Hilleroed, Copenhagen, Denmark
                [3 ]Research Centre for Prevention and Health, Copenhagen University Hospital Glostrup, Copenhagen, Denmark
                [4 ]Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
                Leibniz-Institute for Arteriosclerosis Research at the University Muenster, Germany
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: CNR SBT AL HV. Performed the experiments: CNR AL. Analyzed the data: CNR SBT. Contributed reagents/materials/analysis tools: AL HV. Wrote the paper: CNR.

                Article
                PONE-D-12-12020
                10.1371/journal.pone.0043498
                3427346
                22937056
                e9ba597c-2b77-486c-9249-400ac83eab28
                Copyright @ 2012

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 25 April 2012
                : 24 July 2012
                Page count
                Pages: 9
                Funding
                The study was supported by a grant from The Danish Council for Independent Research, Medical Sciences, of the Danish Agency for Science, Technology and Innovation, Ministry of Science, Technology and Innovation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology
                Computational Biology
                Population Genetics
                Genetic Polymorphism
                Medicine
                Cardiovascular
                Atherosclerosis
                Coronary Artery Disease
                Myocardial Infarction
                Stroke
                Clinical Immunology
                Genetics of the Immune System
                Clinical Research Design
                Cohort Studies
                Epidemiology
                Diagnostic Medicine
                Pathology
                General Pathology
                Biomarkers
                Epidemiology
                Biomarker Epidemiology
                Cardiovascular Disease Epidemiology

                Uncategorized
                Uncategorized

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