K. G. Jebsen - Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, University of Tromsø - The Arctic University of Norway, Tromsø, Norway.
Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
J Thromb Haemost. 2019 Oct;17(10):1661-1669. doi: 10.1111/jth.14539. Epub 2019 Jul 1.
Animal and observational studies have suggested a pathophysiological role for complement in venous thromboembolism (VTE), but the initiating mechanisms are unknown. Mannose-binding lectin (MBL) bound to altered host cells leads to activation of the lectin complement pathway, and both high and low MBL levels have been implicated in the pathophysiology of cardiovascular disease.
To investigate the association between plasma MBL levels and future risk of incident VTE.
We conducted a nested case-control study in 417 VTE patients and 849 age-matched and sex-matched controls derived from the general population (Tromsø Study). Plasma MBL levels were measured using enzyme-linked immunosorbent assay. Logistic regression models were used to estimate odds ratio (OR) for VTE across quartiles of plasma MBL levels.
Subjects with plasma MBL levels in the lowest quartile (<435 ng/mL) had a reduced OR for overall VTE (OR 0.79, 95% confidence interval [CI]: 0.56-1.10) and for DVT (OR 0.70, 95% CI: 0.47-1.04) compared to those with MBL in the highest quartile (≥2423 ng/mL) after multivariable adjustments. For VTE, DVT, and pulmonary embolism (PE) the ORs decreased substantially with decreasing time between blood sampling and VTE event.
Our findings suggest that low plasma MBL levels are associated with reduced risk of VTE, and DVT in particular.
动物和观察性研究表明，补体在静脉血栓栓塞症（VTE）中具有病理生理学作用，但启动机制尚不清楚。与改变的宿主细胞结合的甘露糖结合凝集素（MBL）导致凝集素补体途径的激活，并且高和低 MBL 水平都与心血管疾病的病理生理学有关。
研究血浆 MBL 水平与未来发生 VTE 的风险之间的关联。
我们在来自普通人群（特罗姆瑟研究）的 417 例 VTE 患者和 849 例年龄和性别匹配的对照者中进行了一项嵌套病例对照研究。使用酶联免疫吸附测定法测量血浆 MBL 水平。使用逻辑回归模型估计血浆 MBL 水平四分位数与 VTE 之间的比值比（OR）。
与 MBL 水平最高四分位数（≥2423ng/ml）相比，血浆 MBL 水平最低四分位数（<435ng/ml）的受试者总体 VTE（OR 0.79，95%置信区间[CI]：0.56-1.10）和 DVT（OR 0.70，95%CI：0.47-1.04）的 OR 降低。经过多变量调整后，对于 VTE、DVT 和肺栓塞（PE），随着采血与 VTE 事件之间的时间间隔缩短，OR 显著降低。
我们的研究结果表明，低血浆 MBL 水平与 VTE 风险降低相关，尤其是 DVT。
