Characterization of Mannose Binding Lectin (MBL) Levels in Type-2 Diabetes Mellitus Patients Amongst Pakistani Population

Abstract

Introduction: Mannose Binding Lectin (MBL) is a pattern recognizing molecule in the Lectin complement pathway and acts by activating the complement cascade via binding with ligands. There is evidence of increased autoreactivity of Mannose Binding Lectin in various diseases especially diabetes. MBL deficiency can reduce pathogen clearance and impair atherogenic lipoprotein removal whereas higher levels are associated with exaggerated immune response due to complement activation in the presence of hyperglycemia.

Aims & Objectives: This study aims to find out the association of MBL (Mannose Binding Lectin) with different clinical parameters in healthy controls and type 2 DM patients to predict disease outcome in type 2 diabetics. Mean level of MBL in type 2 diabetics and healthy population will be compared to characterize MBL levels amongst diabetics helping the clinicians to stratify patients according to disease severity.

Place and duration of study: It was a cross sectional analytical study conducted at Chughtai Institute of Pathology from July 2019 to January 2020 on samples collected nationwide at Chughtai Lab collection centres.

Material & Methods: We selected 300 adult male and females in this study after taking informed consent based on strict inclusion and exclusion criteria. Of these 200 were known cases of type 2 diabetes mellitus and 100 healthy controls. .Fasting blood samples were drawn from both groups were analyzed for hs-CRP, HbA1c, creatinine, Total Cholesterol, Alanine amino transfer as (ALT), HDL-Cholesterol, LDL-Cholesterol, Glucose, Triglyceride, and Mannose Binding lectin. eGFR (Estimated Glomerular Filtration rate) was calculated for each patient and control. Data was analyzed via Graph Pad Prism 5 and SPSS version 23.0, p value ? 0.05 was taken as significant.

Results: Mean age of the participants was 47.9 years in diabetic group and 39.3 years in healthy controls. The healthy population had a mean MBL level of 110.1 (SD±3.94) pg/ml and mean MBL level of diabetic group was 197.9 (SD±12.84) pg/ml (p<0.05). No differences in MBL levels were detected based on gender distribution. There was a significant difference among HbA1c, LDL-C, HDL-C, Fasting Glucose, TG, creatinine and eGFR amongst the diabetic and the healthy group (p<0.05). There was a negative correlation between MBL levels and plasma glucose and a positive correlation between the former and HDL-C in the healthy controls. In diabetic patients having MBL above 178pg/ml, a positive correlation of HbA1C with MBL was found. CRP in the healthy population resembled levels in patients with elevated MBL and the ratio Trig/HDL was higher in this subgroup having a positive correlation with MBL.

Conclusion: MBL plays a role in pathophysiology of diabetes mellitus and elevated MBL having positive correlation with HbA1c might show association of glycemic control with the biomarker levels. A direct relationship of MBL with development of cardiovascular complications in type 2 diabetics was suggested by a positive association of MBL with TG to HDL-C ratio.