title: Mannose-binding lectin and mortality in type 2 diabetes.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Immunoendocrine Research Unit, Medical Department M and Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark. tkh@dadlnet.dk
authors.forename: Troels Krarup
authors.initials: TK
authors.lastname: Hansen
authors.forename: Mari-Anne
authors.initials: MA
authors.lastname: Gall
authors.forename: Lise
authors.initials: L
authors.lastname: Tarnow
authors.forename: Steffen
authors.initials: S
authors.lastname: Thiel
authors.forename: Coen D
authors.initials: CD
authors.lastname: Stehouwer
authors.forename: Casper G
authors.initials: CG
authors.lastname: Schalkwijk
authors.forename: Hans-Henrik
authors.initials: HH
authors.lastname: Parving
authors.forename: Allan
authors.initials: A
authors.lastname: Flyvbjerg
mesh_terms: D000419:Albuminuria / Q000453:epidemiology; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D003718:Denmark / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D037601:Mannose-Binding Lectin / Q000097:blood*; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D037601:Mannose-Binding Lectin; D002097:C-Reactive Protein