Circulating mannose-binding lectin concentration in patients with stable coronary artery disease is associated with heart failure and renal function

Teng-Hung Yu; Cheng-Ching Wu; I-Ting Tsai; Chin-Feng Hsuan; Thung-Lip Lee; Chao-Ping Wang; Ching-Ting Wei; Fu-Mei Chung; Yau-Jiunn Lee; Wei-Chin Hung; Wei-Hua Tang

doi:10.1016/j.cca.2023.117528

Circulating mannose-binding lectin concentration in patients with stable coronary artery disease is associated with heart failure and renal function

Clin Chim Acta. 2023 Aug 1:548:117528. doi: 10.1016/j.cca.2023.117528. Epub 2023 Aug 26.

Authors

Teng-Hung Yu¹, Cheng-Ching Wu², I-Ting Tsai³, Chin-Feng Hsuan⁴, Thung-Lip Lee⁵, Chao-Ping Wang⁵, Ching-Ting Wei⁶, Fu-Mei Chung⁷, Yau-Jiunn Lee⁸, Wei-Chin Hung⁹, Wei-Hua Tang¹⁰

Affiliations

¹ Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan.
² Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan; Division of Cardiology, Department of Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan.
³ School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan; Department of Emergency, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan.
⁴ Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan; Division of Cardiology, Department of Internal Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan.
⁵ Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan; School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, 82445, Taiwan.
⁶ Division of General Surgery, Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan; The School of Chinese Medicine for Post Baccalaureate, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan.
⁷ Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan.
⁸ Lee's Endocrinologic Clinic, Pingtung 90000, Taiwan.
⁹ Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan. Electronic address: p7411906@ms19.hinet.net.
¹⁰ Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Yuli Branch, Hualien 98142, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan. Electronic address: africapaul@mail.vhyl.gov.tw.

PMID: 37640132
DOI: 10.1016/j.cca.2023.117528

Abstract

Background: Mannose-binding lectin (MBL) has been associated with cardiovascular disease and its complications, the progression of diabetic nephropathy, and complement-mediated renal interstitial injury. However, the relationship between plasma MBL concentration with both heart failure and renal function is unclear. In this study, we examined associations of plasma MBL with both renal function and heart failure in patients with stable coronary artery disease (CAD).

Methods: We enrolled 348 consecutive stable CAD patients and used ELISA to evaluate plasma concentrations of MBL. Renal function was classified into KDIGO G1, G2 and G3a-G4 groups according to the eGFR of ≥ 90, 60-89 and 15-59, ml/min/1.73 m², respectively. Patients with a left ventricular ejection fraction (LVEF) ≤ 40 % were classified to have heart failure.

Results: A significant positive association was found between MBL with diabetes mellitus, current smoker, blood urea nitrogen, creatinine, and brain natriuretic peptide, and a significant negative association was found between MBL with eGFR and LVEF. KDIGO stage G3a-G4 and heart failure increased along with tertiles of MBL (p for trend < 0.05). Multivariate analysis showed that compared to the patients with a low MBL concentration, the odds ratios of having KDIGO stage G3a-G4 were 1.89 (1.01-3.55) times and 2.37 (1.25-4.59) times higher for those with medium and high MBL concentrations. Furthermore, compared to the patients with a low MBL concentration, the OR of having heart failure were 1.97 (1.01-3.93) times higher for those with high MBL concentrations. Moreover, multivariate analysis showed an independent association between plasma MBL concentration with both KDIGO stage G3a-G4 and heart failure (LVEF < 40 %). In addition, the effect of MBL on both LVEF and eGFR was confirmed by structural equation model analysis.

Conclusion: There are associations between circulating MBL concentration with both heart failure and renal function in stable CAD patients, suggesting that increased plasma MBL may contribute to the pathogenesis of both chronic kidney disease and heart failure.

Keywords: Heart failure; Mannose-binding lectin; Renal function; Stable coronary artery disease.

MeSH terms

Cardiovascular Diseases*
Coronary Artery Disease* / complications
Heart Failure* / complications
Humans
Stroke Volume
Ventricular Function, Left