Hansen Troels Krarup, Gall Mari-Anne, Tarnow Lise, Thiel Steffen, Stehouwer Coen D, Schalkwijk Casper G, Parving Hans-Henrik, Flyvbjerg Allan
Immunoendocrine Research Unit, Medical Department M and Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark.
Arch Intern Med. 2006 Oct 9;166(18):2007-13. doi: 10.1001/archinte.166.18.2007.
Inflammation and complement activation initiated by mannose-binding lectin (MBL) may be implicated in the pathogenesis of diabetic vascular complications. We evaluated the relationship between serum MBL and mortality and development of albuminuria in type 2 diabetes.
Levels of MBL and C-reactive protein (CRP) were measured at baseline in 326 patients with type 2 diabetes who attended the Steno Diabetes Center, Gentofte, Denmark, for control. Urinary albumin excretion was determined annually, and the vital status of all patients was traced after more than 15 years of follow-up.
During follow-up, 169 patients died. The risk of dying was significantly higher among patients with MBL levels greater than or equal to 1000 microg/L than among patients with levels less than 1000 microg/L (hazard ratio, 1.5; 95% confidence interval, 1.1-2.1; P = .005). After adjustment for known confounders, MBL remained a significant risk factor for death from any cause. It added to the predictive power of CRP, and mortality was significantly higher among patients with both high MBL (> or =1000 microg/L) and high CRP (above the median, 3.6 mg/L) levels than among patients with both low MBL and low CRP levels (hazard ratio, 2.7; 95% confidence interval, 1.7-4.3; P<.001). Normoalbuminuric patients with both high MBL and high CRP levels at baseline had a significantly increased risk of developing microalbuminuria or macroalbuminuria compared with patients with both low MBL and low CRP levels (hazard ratio, 2.6; 95% confidence interval, 1.5-4.4; P<.001).
In patients with type 2 diabetes, measurements of MBL alone or in combination with CRP can provide prognostic information on mortality and the development of albuminuria.
由甘露糖结合凝集素（MBL）引发的炎症和补体激活可能与糖尿病血管并发症的发病机制有关。我们评估了2型糖尿病患者血清MBL与死亡率及蛋白尿发生之间的关系。
对丹麦根措夫特斯泰诺糖尿病中心的326例2型糖尿病患者进行基线时MBL和C反应蛋白（CRP）水平测定以进行对照。每年测定尿白蛋白排泄量，并在随访超过15年后追踪所有患者的生命状态。
随访期间，169例患者死亡。MBL水平大于或等于1000μg/L的患者死亡风险显著高于水平低于1000μg/L的患者（风险比，1.5；95%置信区间，1.1 - 2.1；P = 0.005）。在对已知混杂因素进行校正后，MBL仍然是任何原因导致死亡的显著风险因素。它增加了CRP的预测能力，MBL高（≥1000μg/L）且CRP高（高于中位数3.6mg/L）的患者死亡率显著高于MBL和CRP均低的患者（风险比，2.7；95%置信区间，1.7 - 4.3；P<0.001）。基线时MBL和CRP均高的正常白蛋白尿患者发生微量白蛋白尿或大量白蛋白尿的风险与MBL和CRP均低的患者相比显著增加（风险比，2.6；95%置信区间，1.5 - 4.4；P<0.001）。
在2型糖尿病患者中，单独测量MBL或与CRP联合测量可提供关于死亡率和蛋白尿发生的预后信息。
