Mannose-Binding Lectin Levels and Carotid Intima-Media Thickness in Type 2 Diabetic Patients

Journal of Diabetes Research, Nov 2015

Introduction. Mannose-binding lectin (MBL) activates complement system and has been suggested to play a role in vascular complications in diabetics. Carotid intima-media thickness (cIMT) detects subclinical atherosclerosis. We evaluated the association of MBL and IMT in type 2 diabetic (T2DM) patients. Methods. Serum MBL levels and cIMT were measured in a total of 103 diabetics and in 98 age-matched healthy controls. Results. There was no significant difference in MBL level in T2DM versus controls. As expected, IMT was significantly higher in T2DM patients than in controls (). In T2DM, the lowest cIMT was seen in patients with normal MBL level (500–1000) while cIMT continuously increased with both high MBL and absolute MBL deficiency states. This was especially significant in high MBL versus normal MBL T2DM patients (). According to multiple regression analysis the main predictors of IMT in T2DM are age (), ApoA level (), and the MBL (). Conclusions. Our results suggest a dual role of MBL as a risk factor for cIMT in T2DM. MBL may also be used as a marker of macrovascular disease, as both low and high levels indicate the susceptibility for atherosclerosis in T2DM.

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Mannose-Binding Lectin Levels and Carotid Intima-Media Thickness in Type 2 Diabetic Patients

Mannose-Binding Lectin Levels and Carotid Intima-Media Thickness in Type 2 Diabetic Patients Miklós Káplár,1 Shah Sweni,2 Julianna Kulcsár,1 Barbara Cogoi,1 Regina Esze,1 Sándor Somodi,1 Mária Papp,3 László Oláh,4 Mária Tünde Magyar,4 Katalin Szabó,4 Katalin Réka Czuriga-Kovács,4 Jolán Hársfalvi,5,6 and György Paragh1 1Division of Metabolic Diseases, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei Körút 98, Debrecen 4032, Hungary 2Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London E1 1BB, UK 3Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei Körút 98, Debrecen 4032, Hungary 4Department of Neurology, Faculty of Medicine, University of Debrecen, Móricz Zsigmond Körtér 22, Debrecen 4032, Hungary 5Clinical Research Center, Faculty of Medicine, University of Debrecen, Tuzoltó Utca 37-47, Budapest 1094, Hungary 6Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary Received 18 November 2014; Revised 17 March 2015; Accepted 23 March 2015 Academic Editor: Bagher Larijani Copyright © 2016 Miklós Káplár et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Introduction. Mannose-binding lectin (MBL) activates complement system and has been suggested to play a role in vascular complications in diabetics. Carotid intima-media thickness (cIMT) detects subclinical atherosclerosis. We evaluated the association of MBL and IMT in type 2 diabetic (T2DM) patients. Methods. Serum MBL levels and cIMT were measured in a total of 103 diabetics and in 98 age-matched healthy controls. Results. There was no significant difference in MBL level in T2DM versus controls. As expected, IMT was significantly higher in T2DM patients than in controls (). In T2DM, the lowest cIMT was seen in patients with normal MBL level (500–1000) while cIMT continuously increased with both high MBL and absolute MBL deficiency states. This was especially significant in high MBL versus normal MBL T2DM patients (). According to multiple regression analysis the main predictors of IMT in T2DM are age (), ApoA level (), and the MBL (). Conclusions. Our results suggest a dual role of MBL as a risk factor for cIMT in T2DM. MBL may also be used as a marker of macrovascular disease, as both low and high levels indicate the susceptibility for atherosclerosis in T2DM. 1. Introduction Diabetes mellitus is the most prevalent and independent risk factor for atherosclerosis/cardiovascular diseases (CVD) [1] including coronary artery disease (CAD). CVD is the leading cause of mortality in type 2 diabetics (T2DM) [1]. Several inflammatory markers (fibrinogen, CRP, IL-18, and TNF-alpha) have been associated with markers of asymptomatic atherosclerosis in type 2 diabetics [2]. Mannose-binding lectin (MBL) has been suggested to play a role in the pathogenesis of CVD in diabetics [3, 4]. MBL, an important member of innate immunity, activating the lectin pathway of complement, is a weak-acute phase reactant [5] and its level increases only two- to threefold temporarily in response to different stress factors [6]. Previous studies analyzing the role of MBL in CVD have demonstrated a proatherogenic as well as an antiatherogenic role. Low MBL pheno- or genotype has been associated with higher risk of atherosclerosis [7, 8], arterial thrombosis [9], coronary artery disease [10, 11], bypass graft occlusion [12], and carotid artery plaques [13]. However, high MBL levels or normal genotypes have also been associated with coronary artery disease [14] and restenosis after carotid endarterectomy [15]. Furthermore, in type 2 diabetic population, low MBL genotype is associated with increased risk of cardiovascular events [16] and poorer outcomes of myocardial infarction [17]. Whereas high MBL is associated with increased mortality [18], disease progression, and nephropathy [19], protective role of high MBL in diabetics has also been suggested [20]. B mode ultrasonography mediated measurement of carotid artery intima-media thickness (cIMT) permits the study of subclinical carotid atherosclerosis, and patients at high risk for CVD can be identified [21]. Studies assessing correlation of MBL pheno- or genotypes with carotid intima-media thickness [22, 23] are conflicting. Independent of traditional risk factors, a quadratic U-shaped relation between serum MBL and cIMT was demonstrated in patients with rheumatoid arthritis. It supported a notion; both high and low MBL may play a role in CVD [24]. The objective of this study was to investigate hypothetical dual role of serum MBL level in intima-media thickness development among type 2 diabetic patients. 2. Methods2.1. Study Design After obtaining an institutional ethical clearance and an informed (...truncated)


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Miklós Káplár, Shah Sweni, Julianna Kulcsár, Barbara Cogoi, Regina Esze, Sándor Somodi, Mária Papp, László Oláh, Mária Tünde Magyar, Katalin Szabó, Katalin Réka Czuriga-Kovács, Jolán Hársfalvi, György Paragh. Mannose-Binding Lectin Levels and Carotid Intima-Media Thickness in Type 2 Diabetic Patients, Journal of Diabetes Research, 2015, 2016, DOI: 10.1155/2016/8132925