The predictive value of serum Mannan-Binding Lectin (MBL) levels for diabetic control and renal complications in type 2 diabetic patients
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Objectives: To evaluate the predictability of estimation of serum mannan-binding lectin (MBL) for the presence of infectious complications in type-2 diabetes mellitus (12DM) and its relation to the extent of diabetes control. Patients & Methods: Patients with type 2 diabetes mellitus (12DM) complaining of diabetic complications other than infection "i.e., non infectious complications" (group B, n=30), type-2 diabetes mellitus (12DM) patients complaining of infectious complications ( group C, n=30) and 30 healthy volunteers as control group (group A, n =30) were participating in the study. All patients and controls underwent evaluation of insulin sensitivity (Homeostasis Model Assessment of Insulin Resistance, HOMA-IR) and gave blood samples for estimation of fasting blood glucose (FBG), hemoglobin Al c (HbAlc) and serum insulin, urea, creatinine, C-reactive protein (CRP) and MBL. Results: All patients had significantly increased FBG, serum insulin and HOMA-IR index compared to control group with significantly higher levels in infectious complicated patients (group C). Levels of HbAlc, serum urea and creatinine were significantly higher in patients than controls, with non-significantly higher levels in infectious complicated patients (group C). Serum CRP and MBL levels were significantly elevated in patients compared to controls, with significantly higher levels in infectious complicated patients (group C), but 16 patients of the infectious complications group C patients had discrepant serum MBL and CRP levels. There was a positive significant correlation between serum MBL and FBG, HOMA-IR index, serum urea, creatinine and CRP levels. ROC curve analysis in infectious cases revealed high FBG, HOMA-IR index and serum levels of HbAlc, CRP and MBL, while regression analysis defined elevated serum MBL levels as a significant independent predictor for the presence of infection. Conclusion: Elevated serum MBL in 12DM patients indicated poor diabetic control and bad progression of the disease with possibility of presence or development of diabetic nephropathy especially in combination with elevated serum CRP.