Strong predictive value of mannose-binding lectin levels for cardiovascular risk of hemodialysis patientsReport as inadecuate




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Journal of Translational Medicine

, 14:236

Disease biomarkers

Abstract

BackgroundHemodialysis patients have higher rates of cardiovascular morbidity and mortality compared to the general population. Mannose-binding lectin MBL plays an important role in the development of cardiovascular disease. In addition, hemodialysis alters MBL concentration and functional activity. The present study determines the predictive value of MBL levels for future cardiac events C-event, cardiovascular events CV-event and all-cause mortality in HD patients.

MethodsWe conducted a prospective study of 107 patients on maintenance hemodialysis. Plasma MBL, properdin, C3d and sC5b-9 was measured before and after one dialysis session. The association with future C-events, CV-events, and all-cause mortality was evaluated using Cox regression models.

ResultsDuring median follow-up of 27 months, 36 participants developed 21 C-events and 36 CV-events, whereas 37 patients died. The incidence of C-events and CV-events was significantly higher in patients with low MBL levels <319 ng-mL, lower quartile. In fully adjusted models, low MBL level was independently associated with increased CV-events hazard ratio 3.98; 95 % CI 1.88–8.24; P < 0.001 and C-events hazard ratio 3.96; 95 % CI 1.49–10.54; P = 0.006. No association was found between low MBL levels and all-cause mortality. Furthermore, MBL substantially improved risk prediction for CV-events beyond currently used clinical markers.

ConclusionsLow MBL levels are associated with a higher risk for future C-events and CV-events. Therefore, MBL levels may help to identify hemodialysis patients who are at risk to develop cardiovascular disease.

KeywordsComplement MBL Cardiovascular Risk Hemodialysis AbbreviationsADPKDautosomal dominant polycystic kidney disease

BMIbody mass index

BSAbovine serum albumin

C5b-9membrane attack complex

C-eventcardiac event

CABGcoronary artery bypass grafting

CIconfidence interval

CV-eventcardiovascular event

CVAcerebrovascular accident

EDTAethylenediaminetetraacetic acid

ELISAenzyme-linked immunosorbent assay

FSGSfocal segmental glomerulosclerosis

HbA1cglycated hemoglobin A1c

HDhemodialysis

HRPhorseradish peroxidase

hsCRPhigh sensitive C-reactive protein

IDIintegrated discrimination improvement

IQRinterquartile range

LPlectin pathway

MASP-1MBL-associated serine proteases 1

MASP-2bMBL-associated serine proteases 2

MBLmannose-binding lectin

PCIpercutaneous coronary intervention

Felix Poppelaars and Mariana Gaya da Costa contributed equally to this work

Electronic supplementary materialThe online version of this article doi:10.1186-s12967-016-0995-5 contains supplementary material, which is available to authorized users.

An erratum to this article can be found at http:-dx.doi.org-10.1186-s12967-016-1004-8.





Author: Felix Poppelaars - Mariana Gaya da Costa - Stefan P. Berger - Solmaz Assa - Anita H. Meter-Arkema - Mohamed R. Daha - Wil

Source: https://link.springer.com/







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