The Journal of Experimental Medicine
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Published online 28 December 2004 doi:10.1084/jem.20041431
Rockefeller University Press, 0022-1007 $8.00
JEM, Volume 201, Number 1, 117-125
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ARTICLE

 Mannan binding lectin as an adjunct to risk assessment for myocardial infarction in individuals with enhanced risk

Saedis Saevarsdottir1, Oskar Orn Oskarsson1, Thor Aspelund2, Gudny Eiriksdottir2, Thora Vikingsdottir1, Vilmundur Gudnason2, and Helgi Valdimarsson1

1 Department of Immunology, Landspitali-University Hospital, 101 Reykjavik, Iceland
2 The Icelandic Heart Association, Heart Preventive Clinic and Research Institute, 201 Kopavogur, Iceland

CORRESPONDENCE Helgi Valdimarsson: helgiv{at}landspitali.is

Inflammation can predispose to myocardial infarction (MI), and mannan binding lectin (MBL) promotes phagocytic clearance of inflammatory agents, but the predictive value of MBL levels for MI is not known. MBL was analyzed in subgroups of the population-based Reykjavik study, a cohort of 19,381 participants recruited from 1967. MBL levels were very stable over time (self correlation: 0.86). In a cross-sectional group from the original cohort (n = 987), high MBL (>1,000 µg/L) was associated with a greatly lowered odds ratio for MI (0.64, P < 0.001). To verify this finding, a nested case control sample (n = 1,309) was randomly selected from the cohort. High MBL at recruitment was also associated with decreased MI risk in this follow-up group, but to a lesser extent and not significant for the whole group, smokers, or hypertensive individuals. However, high MBL was as in the cross-sectional group, associated with greatly decreased MI risk in diabetic (P = 0.02) or hypercholesterolemic individuals (P = 0.004). This also applied to raised erythrocyte sedimentation rate (P = 0.007). Diabetic patients with high MBL did not have a higher MI risk than nondiabetic individuals. Our findings indicate that high MBL may predict decreased likelihood of MI, particularly in diabetics, and are consistent with the possibility that MBL may promote clearance of atherogenic agents.

Abbreviations used: ESR, erythrocyte sedimentation rate; G1cNAc, N-acetylglucosamine; LDL, low density lipoprotein; MBL, mannan binding lectin; MI, myocardial infarction; ROC, receiver operating characteristic; SLE, systemic lupus erythematosus.


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