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Elevated Serum Mannose-Binding Lectin Levels Are Associated with Poor Outcome After Acute Ischemic Stroke in Patients with Type 2 Diabetes

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Abstract

The activation of the complement system may be involved in the pathology of stroke and type 2 diabetes (T2DM). We therefore evaluated the long-term prognostic value of early measurement of serum mannose-binding lectin (MBL) levels, an activator of the complement system, in Chinese T2DM with acute ischemic stroke (AIS). Serum MBL levels were determined in T2DM patients with AIS (N = 188). The adjudicated end points were 1-year functional outcomes and mortality. The prognostic value of MBL was compared with the National Institutes of Health Stroke Scale score and with other known outcome predictors. Patients with an unfavorable outcomes and nonsurvivors had significantly increased MBL levels on admission (P < 0.0001 and P < 0.0001). Multivariate logistic regression analysis adjusted for common risk factors showed that MBL was an independent predictor of functional outcome (odds ratio (OR) = 8.99, 95 % CI 2.21–30.12) and mortality (OR = 13.22, 95 % CI 2.05–41.21). The area under the receiver operating characteristic curve of MBL was 0.75 (95 % CI 0.68–0.83) for functional outcome and 0.85 (95 % CI 0.80–0.90) for mortality. In type 2 diabetic patients with stroke, high levels of MBL predict future functional outcomes and mortality. This indicated that the elevated MBL levels may play a significant role in the pathology of the subsequent damage and that the pathways leading to complement activation warrant further exploration as potential therapeutic targets to improve the prognosis for these patients.

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Acknowledgments

We are grateful to the Department of Neurology and Emergency; the nurses, physicians, and patients who participated in our study; and the staff of the central laboratory of the hospital. Authors also acknowledge the contribution of the editors and reviewers who have helped us to improve the manuscript.

Conflict of Interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Neurology, Laiwu People’s Hospital, No.001, Xuehudajie, Laiwu, 271100, People’s Republic of China

    Fang-Yu Song, Meng-Hai Wu, Li-hua Zhu & Qin-De Qi

  2. Department of Cardiology, Laiwu People’s Hospital, Laiwu, 271100, People’s Republic of China

    Zhi-Qiang Zhang

  3. Department of Rehabilitation, Linyi People’s Hospital, No.27, Jiefang Road, Linyi City, 276003, Shandong Province, People’s Republic of China

    Chang-li Lou

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  1. Fang-Yu Song
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  2. Meng-Hai Wu
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Correspondence to Qin-De Qi or Chang-li Lou.

Additional information

Fang-Yu Song and Meng-Hai Wucontributed equally to this study.

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Song, FY., Wu, MH., Zhu, Lh. et al. Elevated Serum Mannose-Binding Lectin Levels Are Associated with Poor Outcome After Acute Ischemic Stroke in Patients with Type 2 Diabetes. Mol Neurobiol 52, 1330–1340 (2015). https://doi.org/10.1007/s12035-014-8941-0

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