Mannose-Binding Lectin and Diabetic Nephropathy in Type 1 Diabetes.

OBJECTIVE

The aim of this study was to investigate serum levels of mannose-binding lectin (MBL) in type 1 diabetes with diabetic nephropathy (DN) and persistent normoalbuminuria (PN).

METHOD

Serum MBL levels were determined in 224 type 1 diabetes with overt nephropathy and 224 type 1 diabetes with PN matched for sex, age, and duration of diabetes The prediction value of MBL was compared with hemoglobin A1c (HbA1c), high-sensitivity C-reactive protein (Hs-CRP) and other known predictors. Multivariate analyses were performed using logistic regression models.

RESULTS

The serum MBL levels were significantly higher in diabetes with DN as compared to with PN (P < 0.0001). Based on the receiver operating characteristic (ROC) curve, the optimal cutoff value of serum MBL levels as an indicator for diagnosis of DN was projected to be 1,680 μg/l, which yielded a sensitivity of 75.4% and a specificity of 78.8%, with the area under the curve at 0.768 (95% confidence interval [CI], 0.724-0.815). Multivariate logistic regression analysis adjusted for common factors showed that serum MBL level ≥ 1,680 μg/l was an independent indictor of DN (odds ratio [OR] = 6.99; 95% CI: 2.83-17.15).

CONCLUSION

In type 1 diabetic patient, evaluated serum levels of MBL can be seen as an independent marker of DN even after correcting for possible confounding factors.