Influence of serum levels of YKL-40，NGAL and SOCS1 in patients with multidrug-resistant tuberculosis after treatment on the conversion of sputum bacteria to negative state

doi:10.3969/j.issn.1673-8640.2026.07.002

Abstract

Abstract:

Objective To investigate the influence of serum chitinase protein 40（YKL-40），neutrophil gelatinase-associated lipocalin（NGAL）and suppressor of cytokine signaling 1（SOCS1）levels on sputum bacterial negativity after treatment in patients with multidrug-resistant tuberculosis（MDR-TB）. Methods A total of 149 MDR-TB patients from the Third Hospital of Cangzhou from March 2022 to February 2024 were enrolled. The clinical data were collected，and serum YKL-40，NGAL and SOCS1 levels were determined before and 1 month after treatment. According to the sputum culture results after 6 months of treatment，the patients were classified into sputum bacterial negativity group and non-sputum bacterial negativity group. The differences in serum levels of YKL-40，NGAL and SOCS1 in MDR-TB patients were compared before and after treatment. The differences in clinical data between sputum bacterial negativity group and non-sputum bacterial negativity group were compared. Multivariate Logistic regression analysis was used to evaluate the influencing factors of sputum bacterial negativity after MDR-TB treatment. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of serum YKL-40，NGAL and SOCS1 in judging sputum bacterial negativity after MDR-TB treatment. Results After treatment，the serum levels of YKL-40 and NGAL in MDR-TB patients were lower than those before treatment （P<0.001），while the level of SOCS1 was higher than that before treatment （P<0.001）. Serum YKL-40 and NGAL levels in sputum bacterial negativity group and non-sputum bacterial negativity group before treatment showed no statistical significance（P>0.05）. After treatment，serum YKL-40 and NGAL levels in sputum bacterial negativity group were lower than those in non-sputum bacterial negativity group（P<0.001），and serum SOCS1 levels were higher than those in non-sputum bacterial negativity group（P<0.001）. The number of drug resistance drugs and diabetes history and the proportion of retreated cases in sputum bacterial negativity group were lower than those in non-sputum bacterial negativity group（P<0.05），while other clinical data showed no statistical significance between the 2 groups（P>0.05）. Elevated serum YKL-40，NGAL and decreased SOCS1 were risk factors for non-sputum bacterial negativity after MDR-TB treatment（P<0.05）. The areas under curves（AUC）of single and combined determinations of serum YKL-40，NGAL and SOCS1 for judging sputum bacterial negativity after MDR-TB treatment were 0.834，0.866，0.845 and 0.954，respectively. Conclusions Serum YKL-40 and NGAL decrease，and SOCS1 increases in MDR-TB patients after treatment，which are related to sputum bacterial negativity. The combined determination of the 3 indicators has certain value in the assessment of sputum bacterial negativity after MDR-TB treatment.

Key words: Chitinase protein 40, Neutrophil gelatinase-associated lipocalin, Suppressor of cytokine signaling 1, Multidrug-resistant tuberculosis, Sputum bacterial negativity

CLC Number:

R446.1

GUO Meifeng, NI Leilei, ZHANG Xinyuan, WANG Guiqin, LI Jihan. Influence of serum levels of YKL-40，NGAL and SOCS1 in patients with multidrug-resistant tuberculosis after treatment on the conversion of sputum bacteria to negative state[J]. Laboratory Medicine, 2026, 41(7): 625-630.

Figures/Tables 6

References 24

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项目	例数	YKL-40/（pg·mL^-1）	NGAL/（ng·mL^-1）	SOCS1/（μg·L^-1）
治疗前	149	85.48±9.05	41.08±5.02	135.47±18.61
治疗后	149	72.62±8.13	32.82±4.95	181.77±22.43
t值		33.259	14.302	49.323
P值		<0.001	<0.001	<0.001

项目	例数	YKL-40/（pg·mL^-1）	NGAL/（ng·mL^-1）	SOCS1/（μg·L^-1）
治疗前	149	85.48±9.05	41.08±5.02	135.47±18.61
治疗后	149	72.62±8.13	32.82±4.95	181.77±22.43
t值		33.259	14.302	49.323
P值		<0.001	<0.001	<0.001

组别	例数	治疗前			治疗后
组别	例数	YKL-40/（pg·mL^-1）	NGAL/（ng·mL^-1）	SOCS1/（μg·L^-1）	YKL-40/（pg·mL^-1）	NGAL/（ng·mL^-1）	SOCS1/（μg·L^-1）
非痰菌阴转组	63	87.12±10.05	41.95±5.13	136.95±21.43	77.35±6.48	37.02±5.14	165.89±17.59
痰菌阴转组	86	84.27±9.41	40.45±4.72	134.38±19.88	69.16±6.31	29.74±4.68	193.41±24.52
t值		1.774	1.847	0.754	7.738	8.997	7.589
P值		0.078	0.067	0.452	<0.001	<0.001	<0.001

组别	例数	治疗前			治疗后
组别	例数	YKL-40/（pg·mL^-1）	NGAL/（ng·mL^-1）	SOCS1/（μg·L^-1）	YKL-40/（pg·mL^-1）	NGAL/（ng·mL^-1）	SOCS1/（μg·L^-1）
非痰菌阴转组	63	87.12±10.05	41.95±5.13	136.95±21.43	77.35±6.48	37.02±5.14	165.89±17.59
痰菌阴转组	86	84.27±9.41	40.45±4.72	134.38±19.88	69.16±6.31	29.74±4.68	193.41±24.52
t值		1.774	1.847	0.754	7.738	8.997	7.589
P值		0.078	0.067	0.452	<0.001	<0.001	<0.001

组别	例数	年龄/岁	性别		BMI/（kg·m^-2）	病程/年	耐药药物数量		高血压史/[例（%）]
组别	例数	年龄/岁	男/[例（%）]	女/[例（%）]	BMI/（kg·m^-2）	病程/年	<3种/[例（%）]	≥3种/[例（%）]	高血压史/[例（%）]
痰菌阴转组	86	57.52±4.60	44（51.16）	42（48.84）	23.64±1.49	5.61±1.15	53（61.63）	33（38.97）	21（24.42）
非痰菌阴转组	63	57.94±4.98	37（58.73）	26（41.27）	23.85±1.52	5.77±1.13	26（41.27）	37（58.73）	16（25.40）
统计值		0.532	0.839		0.843	0.845	6.050		0.019
P值		0.596	0.360		0.401	0.399	0.014		0.891
组别	糖尿病史/[例（%）]		肺外结核/[例（%）]		吸烟史/[例（%）]	饮酒史/[例（%）]	肺结核空洞/[例（%）]	治疗类型
组别	糖尿病史/[例（%）]		肺外结核/[例（%）]		吸烟史/[例（%）]	饮酒史/[例（%）]	肺结核空洞/[例（%）]	初治/[例（%）]	复治/[例（%）]
痰菌阴转组	12（13.95）		25（29.07）		24（27.91）	26（30.23）	16（18.60）	66（76.74）	20（23.26）
非痰菌阴转组	18（28.57）		23（36.51）		22（34.92）	20（31.75）	19（30.16）	35（55.56）	28（44.44）
统计值	4.832		0.921		0.838	0.039	2.701	7.476
P值	0.028		0.337		0.360	0.843	0.100	0.006