Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
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Urinary YKL-40 as a Candidate Biomarker for Febrile Urinary Tract Infection in Young Children

  • Kim, Hyun Hee (Department of Pediatrics, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Chung, Mi Hae (Department of Pediatrics, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Bin, Joong Hyun (Department of Pediatrics, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Cho, Kyoung Soon (Department of Pediatrics, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Lee, Juyoung (Department of Pediatrics, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Suh, Jin-Soon (Department of Pediatrics, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • Received : 2017.04.04
  • Accepted : 2017.09.19
  • Published : 2018.01.01
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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 sexmatched 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.

Keywords

Acknowledgement

Supported by : Institute of Clinical Medicine Research of Bucheon St. Mary’s Hospital

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