nach oben

Erschienen in:

01.07.2010 | Article

Association between mannose-binding lectin, high-sensitivity C-reactive protein and the progression of diabetic nephropathy in type 1 diabetes

verfasst von: T. K. Hansen, C. Forsblom, M. Saraheimo, L. Thorn, J. Wadén, P. Høyem, J. Østergaard, A. Flyvbjerg, P.-H. Groop, on behalf of the FinnDiane Study Group

Erschienen in: Diabetologia | Ausgabe 7/2010

Einloggen, um Zugang zu erhalten

Abstract

Aims/hypothesis

Diabetic nephropathy has been associated with low-grade inflammation and activation of the complement system in cross-sectional studies. Data from prospective studies are sparse. We investigated the associations of the complement activator mannose-binding lectin (MBL) and the inflammatory marker high-sensitivity C-reactive protein (hsCRP) with the development of nephropathy in a large prospective study of patients with type 1 diabetes from the Finnish Diabetic Nephropathy (FinnDiane) Study.

Methods

Baseline MBL and hsCRP were measured in 1,564 type 1 diabetes patients from the FinnDiane study, of whom 1,010 had a normal albumin excretion rate, 236 had microalbuminuria and 318 had macroalbuminuria. The main outcome was progression in renal disease during follow-up.

Results

Both baseline MBL (p = 0.038) and hsCRP (p < 0.001) increased with increasing level of albuminuria. During 5.8 ± 2.2 years of follow-up, progression to a higher albuminuria level or end-stage renal disease (ESRD) occurred in 201 patients. MBL levels were higher in progressors compared with non-progressors at all steps of progression, and in a covariate adjusted multivariate Cox-regression analysis MBL levels above the median were significantly associated with progression from macroalbuminuria to ESRD (hazard ratio 1.88, 95% CI 1.06–3.32, p = 0.030). In a univariate analysis, hsCRP levels above the median were significantly associated with progression from normal albumin excretion rate to microalbuminuria, but the association was only borderline significant after adjustment for covariates (hazard ratio 1.56, 95% CI 0.97–2.51, p = 0.068).

Conclusions/interpretation

This study demonstrates that concentrations of both MBL and hsCRP are associated with the progression of renal disease in type 1 diabetes.

Nur mit Berechtigung zugänglich

Hovind P, Tarnow L, Rossing P et al (2004) Predictors for the development of microalbuminuria and macroalbuminuria in patients with type 1 diabetes: inception cohort study. BMJ 328:1105CrossRefPubMed

Walport MJ (2001) Complement. First of two parts. N Engl J Med 344:1058–1066CrossRefPubMed

Walport MJ (2001) Complement. Second of two parts. N Engl J Med 344:1140–1144CrossRefPubMed

Qin X, Goldfine A, Krumrei N et al (2004) Glycation inactivation of the complement regulatory protein CD59: a possible role in the pathogenesis of the vascular complications of human diabetes. Diabetes 53:2653–2661CrossRefPubMed

Uesugi N, Sakata N, Nangaku M et al (2004) Possible mechanism for medial smooth muscle cell injury in diabetic nephropathy: glycoxidation-mediated local complement activation. Am J Kidney Dis 44:224–238CrossRefPubMed

Ostergaard J, Thiel S, Gadjeva M, Hansen TK, Rasch R, Flyvbjerg A (2007) Mannose-binding lectin deficiency attenuates renal changes in a streptozotocin-induced model of type 1 diabetes in mice. Diabetologia 50:1541–1549CrossRefPubMed

Best LG, Ferrell RE, DeCroo S et al (2009) Genetic and other factors determining mannose-binding lectin levels in American Indians: the Strong Heart Study. BMC Med Genet 10:5CrossRefPubMed

Kaunisto M, Sjolind L, Sallinen R et al (2009) Elevated MBL concentrations are not an indication of association between the MBL2 gene and type 1 diabetes or diabetic nephropathy. Diabetes 58:1710–1714CrossRefPubMed

Aittoniemi J, Turpeinen H, Tiittanen M et al (2008) Relation among mannose-binding lectin 2 genotype, beta-cell autoantibodies, and risk for type 1 diabetes in Finnish children. Hum Immunol 69:108–111CrossRefPubMed

10.

Hansen TK, Thiel S, Knudsen ST et al (2003) Elevated levels of mannan-binding lectin in patients with type 1 diabetes. J Clin Endocrinol Metab 88:4857–4861CrossRefPubMed

11.

Bouwman LH, Eerligh P, Terpstra OT et al (2005) Elevated levels of mannose-binding lectin at clinical manifestation of type 1 diabetes in juveniles. Diabetes 54:3002–3006CrossRefPubMed

12.

Hansen TK, Tarnow L, Thiel S et al (2004) Association between mannose-binding lectin and vascular complications in type 1 diabetes. Diabetes 53:1570–1576CrossRefPubMed

13.

Saraheimo M, Forsblom C, Hansen TK et al (2005) Increased levels of mannan-binding lectin in type 1 diabetic patients with incipient and overt nephropathy. Diabetologia 48:198–202CrossRefPubMed

14.

Hovind P, Hansen TK, Tarnow L et al (2005) Mannose-binding lectin as a predictor of microalbuminuria in type 1 diabetes: an inception cohort study. Diabetes 54:1523–1527CrossRefPubMed

15.

Schalkwijk CG, Poland DC, van Dijk W et al (1999) Plasma concentration of C-reactive protein is increased in type I diabetic patients without clinical macroangiopathy and correlates with markers of endothelial dysfunction: evidence for chronic inflammation. Diabetologia 42:351–357CrossRefPubMed

16.

Jenkins AJ, Rothen M, Klein RL et al (2008) Cross-sectional associations of C-reactive protein with vascular risk factors and vascular complications in the DCCT/EDIC cohort. J Diabetes Complicat 22:153–163CrossRefPubMed

17.

Saraheimo M, Teppo AM, Forsblom C, Fagerudd J, Groop PH (2003) Diabetic nephropathy is associated with low-grade inflammation in type 1 diabetic patients. Diabetologia 46:1402–1407CrossRefPubMed

18.

Schaumberg DA, Glynn RJ, Jenkins AJ et al (2005) Effect of intensive glycemic control on levels of markers of inflammation in type 1 diabetes mellitus in the diabetes control and complications trial. Circulation 111:2446–2453CrossRefPubMed

19.

Stehouwer CD, Gall MA, Twisk JW, Knudsen E, Emeis JJ, Parving HH (2002) Increased urinary albumin excretion, endothelial dysfunction, and chronic low-grade inflammation in type 2 diabetes: progressive, interrelated, and independently associated with risk of death. Diabetes 51:1157–1165CrossRefPubMed

20.

Retnakaran R, Cull CA, Thorne KI, Adler AI, Holman RR (2006) Risk factors for renal dysfunction in type 2 diabetes: U.K. Prospective Diabetes Study 74. Diabetes 55:1832–1839CrossRefPubMed

21.

Lin J, Glynn RJ, Rifai N et al (2008) Inflammation and progressive nephropathy in type 1 diabetes in the diabetes control and complications trial. Diabetes Care 31:2338–2343CrossRefPubMed

22.

Hansen TK, Gall MA, Tarnow L et al (2006) Mannose-binding lectin and mortality in type 2 diabetes. Arch Intern Med 166:2007–2013CrossRefPubMed

23.

Verma S, Szmitko PE, Ridker PM (2005) C-reactive protein comes of age. Nat Clin Pract Cardiovasc Med 2:29–36CrossRefPubMed

24.

Ridker PM, Danielson E, Fonseca FA et al (2008) Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med 359:2195–2207CrossRefPubMed

25.

Hage FG, Szalai AJ (2007) C-reactive protein gene polymorphisms, C-reactive protein blood levels, and cardiovascular disease risk. J Am Coll Cardiol 50:1115–1122CrossRefPubMed

26.

Zacho J, Tybjaerg-Hansen A, Jensen JS, Grande P, Sillesen H, Nordestgaard BG (2008) Genetically elevated C-reactive protein and ischemic vascular disease. N Engl J Med 359:1897–1908CrossRefPubMed

27.

Hansen TK, Thiel S, Dall R et al (2001) GH strongly affects serum concentrations of mannan-binding lectin: evidence for a new IGF-I independent immunomodulatory effect of GH. J Clin Endocrinol Metab 86:5383–5388CrossRefPubMed

28.

Hansen TK, Thiel S, Wouters PJ, Christiansen JS, van den Berghe G (2003) Intensive insulin therapy exerts antiinflammatory effects in critically ill patients and counteracts the adverse effect of low mannose-binding lectin levels. J Clin Endocrinol Metab 88:1082–1088CrossRefPubMed

Titel: Association between mannose-binding lectin, high-sensitivity C-reactive protein and the progression of diabetic nephropathy in type 1 diabetes
verfasst von: T. K. Hansen
C. Forsblom
M. Saraheimo
L. Thorn
J. Wadén
P. Høyem
J. Østergaard
A. Flyvbjerg
P.-H. Groop
on behalf of the FinnDiane Study Group
Publikationsdatum: 01.07.2010
Verlag: Springer-Verlag
Erschienen in: Diabetologia / Ausgabe 7/2010
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-010-1742-8

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

24.04.2024 | DGIM 2024 | Kongressbericht | Nachrichten

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Association between mannose-binding lectin, high-sensitivity C-reactive protein and the progression of diabetic nephropathy in type 1 diabetes

Abstract

Aims/hypothesis

Methods

Results

Conclusions/interpretation

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Metformin rückt in den Hintergrund

Myokarditis nach Infekt – richtig schwierig wird es bei Profisportlern

Thrombophiliescreening – Wenn, dann richtig und nur bei therapeutischer Konsequenz

Bei Senioren mit Prostatakarzinom auf Anämie achten!

Update Innere Medizin

Springer Medizin

Abstract

Aims/hypothesis

Methods

Results

Conclusions/interpretation

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 7/2010

Hyperglycaemia and ketosis induced by gamma hydroxybutyrate (GHB)

Persistence of TNFα in diabetic wounds

External validation and optimisation of a model for predicting foot ulcers in patients with diabetes

Differences between amyloid toxicity in alpha and beta cells in human and mouse islets and the role of caspase-3

Serum uric acid does not predict cardiovascular or all-cause mortality in type 2 diabetes: the Fremantle Diabetes Study

Insulin resistance, lipotoxicity, type 2 diabetes and atherosclerosis: the missing links. The Claude Bernard Lecture 2009

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Metformin rückt in den Hintergrund

Myokarditis nach Infekt – richtig schwierig wird es bei Profisportlern

Thrombophiliescreening – Wenn, dann richtig und nur bei therapeutischer Konsequenz

Bei Senioren mit Prostatakarzinom auf Anämie achten!

Update Innere Medizin