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Published on: January 28, 2020
Circulating mannose-binding lectin concentration in patients with stable coronary artery disease is associated with
Teng-Hung Yu1, Cheng-Ching Wu2, I-Ting Tsai3
1Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan.
Insights
Elevated mannose-binding lectin (MBL) levels are linked to worse kidney function and heart failure in stable coronary artery disease (CAD) patients. This suggests MBL may play a role in the development of chronic kidney disease and heart failure.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Immunology
Background:
- Mannose-binding lectin (MBL) is implicated in cardiovascular disease, diabetic nephropathy, and kidney injury.
- The specific relationship between plasma MBL levels and heart failure or renal function in coronary artery disease (CAD) patients remains unclear.
Purpose of the Study:
- To investigate the association between plasma MBL concentration and both renal function and heart failure in patients with stable CAD.
Main Methods:
- 348 stable CAD patients were enrolled.
- Plasma MBL concentrations were measured using ELISA.
- Renal function was categorized by estimated glomerular filtration rate (eGFR) into KDIGO stages.
- Heart failure was defined as left ventricular ejection fraction (LVEF) ≤ 40%.
Main Results:
- Plasma MBL showed positive associations with diabetes, smoking, blood urea nitrogen, creatinine, and brain natriuretic peptide.
- MBL levels were negatively associated with eGFR and LVEF.
- Higher MBL tertiles correlated with increased prevalence of advanced kidney disease (KDIGO G3a-G4) and heart failure.
- Multivariate analysis confirmed independent associations between MBL and both advanced kidney disease and heart failure.
Conclusions:
- Circulating MBL concentration is associated with impaired renal function and heart failure in stable CAD patients.
- Increased plasma MBL may contribute to the pathogenesis of chronic kidney disease and heart failure in this population.
Background:
Mannose-binding lectin (MBL) has been associated with cardiovascular disease and its complications, the progression of diabetic nephropathy, and complement-mediated renal interstitial injury. However, the relationship between plasma MBL concentration with both heart failure and renal function is unclear. In this study, we examined associations of plasma MBL with both renal function and heart failure in patients with stable coronary artery disease (CAD).
Methods:
We enrolled 348 consecutive stable CAD patients and used ELISA to evaluate plasma concentrations of MBL. Renal function was classified into KDIGO G1, G2 and G3a-G4 groups according to the eGFR of ≥ 90, 60-89 and 15-59, ml/min/1.73 m2, respectively. Patients with a left ventricular ejection fraction (LVEF) ≤ 40 % were classified to have heart failure.
Results:
A significant positive association was found between MBL with diabetes mellitus, current smoker, blood urea nitrogen, creatinine, and brain natriuretic peptide, and a significant negative association was found between MBL with eGFR and LVEF. KDIGO stage G3a-G4 and heart failure increased along with tertiles of MBL (p for trend < 0.05). Multivariate analysis showed that compared to the patients with a low MBL concentration, the odds ratios of having KDIGO stage G3a-G4 were 1.89 (1.01-3.55) times and 2.37 (1.25-4.59) times higher for those with medium and high MBL concentrations. Furthermore, compared to the patients with a low MBL concentration, the OR of having heart failure were 1.97 (1.01-3.93) times higher for those with high MBL concentrations. Moreover, multivariate analysis showed an independent association between plasma MBL concentration with both KDIGO stage G3a-G4 and heart failure (LVEF < 40 %). In addition, the effect of MBL on both LVEF and eGFR was confirmed by structural equation model analysis.
Conclusion:
There are associations between circulating MBL concentration with both heart failure and renal function in stable CAD patients, suggesting that increased plasma MBL may contribute to the pathogenesis of both chronic kidney disease and heart failure.
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