OBJECTIVE: Our study aimed at evaluating the association between plasma human cartilage glycoprotein-39 (YKL-40) and depressive symptoms at 3 months among acute ischemic stroke patients. METHODS: Plasma YKL-40 levels were measured in 619 patients with ischemic stroke who participated in the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). The patients' depressive symptoms at 3 months after stroke were assessed using the Hamilton Rating Scale for Depression (HRSD-24). RESULTS: During the 3-month follow-up period, 242 (39.1 %) participants were classified as experiencing depressive symptoms. Patients in the highest quartile of YKL-40 had a 1.98-fold (95 %CI: 1.19-3.30, P for trend = 0.02) risk of depressive symptoms compared with those in the lowest quartile. Per 1-SD increase of logarithm-transformed YKL-40 was associated with a 32 % (95 % CI: 10 %-58 %) increased risk for the depressive symptoms. The multiple-adjusted spline regression model confirmed dose-response relationships between YKL-40 levels and depressive symptoms (P for linearity = 0.02). Adding YKL-40 to a model containing conventional risk factors significantly improved the discriminatory power (area under the receiver operating characteristic curve improved by 0.02, P = 0.04) and reclassification power for depressive symptoms (net reclassification improvement = 18.77 %, P = 0.02
integrated discrimination improvement = 1.30 %, P = 0.005). CONCLUSIONS: Elevated YKL-40 levels might be a potential risk marker of depressive symptoms at 3 months among acute ischemic stroke patients. REGISTRATION: URL: https://www. CLINICALTRIALS: gov
Unique identifier: NCT01840072.