Double role of mannose-binding lectin in relation to carotid intima-media thickness in patients with rheumatoid arthritis.
BACKGROUND
Patients with rheumatoid arthritis (RA) have increased risk of atherosclerosis and cardiovascular disease (CVD) that cannot be explained by excess of traditional risk factors. Several studies indicate that mannose-binding lectin (MBL) may modify the development of atherosclerosis; both high and low serum levels of MBL are reported to be associated with CVD. Intima-media thickness of the common carotid artery (ccIMT) is a validated non-invasive anatomic measure of subclinical CVD. We examined the relation between ccIMT and MBL in 114 RA patients.


METHODS
In a cross-sectional study MBL2 genotypes and serum concentrations of MBL were assessed; ccIMT was determined by means of ultrasonography; traditional and RA related cardiovascular risk modifiers were measured.


RESULTS
The median ccIMT was 0.67 mm. The investigated MBL2 genotypes were not significantly associated with ccIMT. Using a general linear model, ccIMT was not linearly associated with serum MBL but was highly associated with the quadratic term of serum MBL (MBL(2)) (P=0.001) reflecting a U-shaped relation. MBL(2) was also significantly associated with ccIMT in a multivariable analysis adjusting for traditional and RA related cardiovascular risk modifiers (P=0.025).


CONCLUSIONS
In RA patients, a quadratic U-shaped relation between serum MBL and ccIMT was observed independently of the effects of traditional and RA related risk factors for CVD. These results provide further support to the notion that both high and low levels of MBL may be associated with CVD.
Troelsen
Lone N
LN
Department of Rheumatology, Rigshospitalet, Copenhagen University Hospital, Denmark. lone.troelsen@mail.dk
Garred
Peter
P
Christiansen
Buris
B
Torp-Pedersen
Christian
C
Christensen
Ib J
IJ
Narvestad
Eva
E
Jacobsen
Søren
S
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000150:complications; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging* / Q000473:pathology; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005838:Genotype; D006801:Humans; D016014:Linear Models; D008297:Male; D037601:Mannose-Binding Lectin / Q000097:blood* / Q000235:genetics; D008875:Middle Aged; D012307:Risk Factors; D018709:Statistics, Nonparametric; D017539:Tunica Intima / Q000000981:diagnostic imaging* / Q000473:pathology; D017540:Tunica Media / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography
C445619:MBL2 protein, human; D037601:Mannose-Binding Lectin