Genetically determined high serum levels of mannose-binding lectin and agalactosyl IgG are associated with ischemic heart disease in rheumatoid arthritis
Article first published online: 28 DEC 2006
Copyright © 2006 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 56, Issue 1, pages 21–29, January 2007
How to Cite
Troelsen, L. N., Garred, P., Madsen, H. O. and Jacobsen, S. (2007), Genetically determined high serum levels of mannose-binding lectin and agalactosyl IgG are associated with ischemic heart disease in rheumatoid arthritis. Arthritis & Rheumatism, 56: 21–29. doi: 10.1002/art.22302
- Issue published online: 2 JAN 2007
- Article first published online: 28 DEC 2006
- Manuscript Accepted: 22 SEP 2006
- Manuscript Received: 20 MAR 2006
- Danish Rheumatism Association
- Novo Nordisk Research Foundation
- Health Insurance Denmark Research Foundation
- Danish Medical Research Council
- Copenhagen Hospital Corporation Research Foundation
Patients with rheumatoid arthritis (RA) have excess morbidity and mortality due to ischemic heart disease. It has been suggested that high serum levels of mannose-binding lectin (MBL) and agalactosyl IgG (IgG-G0) are associated with increased inflammation in RA. MBL also enhances inflammation-mediated tissue injury during postischemic reperfusion. This study was undertaken to examine whether these factors are associated with increased risk of ischemic heart disease in RA.
MBL alleles were genotyped in 229 Danish patients with RA. In addition, serum levels of MBL and IgG-G0 were measured. Incidences of ischemic heart disease, myocardial infarction, and death due to ischemic heart disease after the diagnosis of RA were assessed in a prospective study.
During a median followup of 9.5 years, ischemic heart disease was diagnosed in 8 of 27 patients with genetically determined high serum levels of MBL, as compared with 24 of the remaining 192 patients (data not available on 10 patients). After correction for other known risk factors, the hazard ratio (HR) was 3.6 (95% confidence interval [95% CI] 1.4–9.2). The corrected HR for myocardial infarction was 9.0 (95% CI 2.2–36.4). High serum levels of MBL also conferred an increased risk of death due to ischemic heart disease (age- and sex-adjusted HR 10.5, 95% CI 2.7–41.3). However, further analyses showed that these associations were present only in patients with high serum levels of IgG-G0.
Genetically determined high serum levels of MBL and high serum levels of IgG-G0 are associated with increased risk of ischemic heart disease, myocardial infarction, and premature death in patients with RA.