The serum YKL-40 level is a potential biomarker for OSAHS: a systematic review and meta-analysis

  • Yan Zhang
  • Xiaoli SuEmail author
  • Pinhua Pan
  • Chengping Hu
Sleep Breathing Physiology and Disorders • Original Article



Several studies have reported that serum YKL-40 level was elevated in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). However, most of these studies had relatively small sample sizes and the results were inconsistent. Therefore, a meta-analysis was conducted to determine the potential role of serum YKL-40 level in OSAHS.


A systematic literature search was performed in several databases to identify eligible studies involving the relationship between serum YKL-40 level and OSAHS. The standardized mean difference (SMD) with its 95% confidence interval (CI) was calculated to determine the effect sizes.


Five eligible articles were extracted in this meta-analysis. The pooled results demonstrated that the serum YKL-40 level was significantly higher in OSAHS patients compared with their non-OSAHS controls (SMD 1.03, 95% CI 0.46, 1.59, I2 = 87%, P = 0.0004). The subgroup analysis showed that Asian (SMD 1.81, 95% CI 1.41, 2.21, I2 = 0%, P < 0.00001) and Caucasian (SMD 0.67, 95% CI 0.39, 0.96, I2 = 0%, P < 0.00001) patients with OSAHS had higher serum YKL-40 levels than their non-OSAHS controls. YKL-40 level in serum was increased in OSAHS patients with BMI < 28 (SMD 1.81, 95% CI 1.41, 2.21, I2 = 0%, P < 0.00001), as well as in patients with BMI ≥ 28 (SMD 0.57, 95% CI 0.33, 0.81, I2 = 0%, P < 0.00001). In addition, OSAHS patients with cardiac complications had a higher serum YKL-40 level compared with those patients without cardiac complications (SMD 0.80, 95% CI 0.32, 1.28, I2 = 67%, P = 0.001).


This study indicates that OSAHS patients have higher serum YKL-40 level, which may serve as a potential biomarker for OSAHS diagnosis and monitoring.


YKL-40 OSAHS Biomarker Meta-analysis 



We really thank Karan Sachdeva, a medical student in Maulana Azad Medical College in India, for helping to polish the language.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Yan Zhang
    • 1
  • Xiaoli Su
    • 1
    Email author
  • Pinhua Pan
    • 1
  • Chengping Hu
    • 1
  1. 1.Department of Respiratory Medicine, Xiangya Hospital (Key Cite of National Clinical Research Center for Respiratory Disease)Central South UniversityChangshaChina

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