<b>Objective</b>: Mannose-binding
lectin (MBL) is linked to risk of cardiovascular disease in diabetes, but the
nature of the association is unclear. We investigated the association between
MBL and risk of cardiovascular events (CVE) and all-cause mortality in type 2
diabetes.
<p><b>Research Design and Methods</b>: In a cohort
study of 7588 patients with type 2 diabetes, we measured serum MBL in 7305 and
performed MBL expression genotyping in 3043. We grouped serum MBL and MBL
expression genotypes into three categories: low, intermediate, and high.
Outcomes were CVE (myocardial infarction, stroke, coronary revascularization,
unstable angina, and cardiovascular death) and all-cause mortality. The
association with outcomes was examined by spline and Cox regression analyses. </p>
<p><b>Results</b>: Serum MBL and CVE showed a
U-shaped association. Compared to the intermediate serum MBL category, the
adjusted hazard ratio (HR) for CVE was 1.82 (95% CI, 1.34 to 2.46) for the low-MBL
category and 1.48 (95% CI, 1.14 to 1.92) for the high-MBL category. We found a
similar U-shaped association for all-cause mortality, but with lower risk
estimates. Compared to the intermediate MBL expression genotype, the adjusted
HR for CVE was 1.40 (95% CI, 0.87 to 2.25) for the low-expression genotype and
1.44 (95% CI, 1.01 to 2.06) for the high-expression genotype. MBL expression
genotype was not associated with all-cause mortality. </p>
<p><b>Conclusions:</b> Both serum MBL
and MBL expression genotype showed a U-shaped association with CVE risk in
individuals with type 2 diabetes. Our findings suggest that serum MBL is a risk
factor for cardiovascular
disease in this population.</p>