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Monosit Sayısı/HDL Oranı ile Koroner Arter Hastalığının Ciddiyeti ve Yaygınlığı Arasındaki İlişki

Yıl 2017, Cilt: 20 Sayı: 1, 30 - 35, 03.04.2017

Öz

Giriş: Kan dolaşımında bulunan monosit sayısı yeni aterosklerotik plak oluşumunda
öngörücüdür. Bununla birlikte yüksek dansiteli lipoprotein kolesterol (HDL)
düzeyleri ile ateroskleroz arasında güçlü bir negatif ilişki vardır. Bu
çalışmada, monosit sayısı/HDL oranıyla koroner arter hastalığı ciddiyeti
arasındaki ilişkiyi değerlendirmeyi amaçladık.



Hastalar ve
Yöntem:
Koroner anjiyografi yapılan toplam 760 hasta çalışmaya
dahil edildi. Koroner ateroskleroz ciddiyeti Gensini skorlama sistemi
kullanılarak değerlendirildi ve hastalar Gensini skorlarına göre yüksek (>
20) ve düşük (< 20) olarak iki gruba ayrıldı. Bazal karakteristik özellikler
ve laboratuvar parametreleri kaydedilerek yüksek ve düşük Gensini skoru olan
hastalar arasında karşılaştırıldı.



Bulgular: Hipertansiyon, diabetes mellitus, hiperlipidemi, ileri yaş ve sigara
içiciliği yüksek Gensini skoru olan hastalarda daha fazlaydı. Açlık kan şekeri,
kreatinin düzeyleri ve monosit/HDL oranı düşük Gensini skoru olan hastalarda
yüksek Gensini skoru olanlara kıyasla daha düşüktü. Lojistik regresyon
analizinde ileri yaş, açlık kan şekeri, hiperlipidemi, aile öyküsü ve erkek
cinsiyetin yüksek Gensini skoru için bağımsız parametreler olduğu gözlendi.
Monosit/HDL oranının, Gensini skoruyla korele olduğu (p< 0.001) ancak bu
korelasyonun çok zayıf olduğu tespit edildi (Spearman’s Rho: 0.159).



Sonuç: Monosit/HDL oranı ile Gensini skoruyla elde
edilen ateroskleroz yaygınlığı arasında zayıf da olsa bir ilişki izlenmiştir.
Ancak Monosit/HDL oranı ve aterosklerotik kalp hastalığı arasındaki ilişkiyi
belirlemek için daha fazla klinik çalışmaya ihtiyaç vardır.

Kaynakça

  • 1. Ross R. Atherosclerosis-an inflammatory disease. N Engl J Med 1999;340:115-26.
  • 2. Imhof BA, Aurrand-Lions M. Adhesion mechanisms regulating the migration of monocytes. Nat Rev Immunol 2004;4:432-44.
  • 3. Greaves DR, Gordon S. The macrophage scavenger receptor at 30 years of age: current knowledge and future challenges. J Lipid Res 2009;50(Suppl): 282-6.
  • 4. Johnsen SH, Fosse E, Joakimsen O, Mathiesen EB, Stensland- Bugge E, Njolstad I, et al. Monocyte count is a predictor of novel plaque formation: a 7-year follow-up study of 2610 persons without carotid plaque at baseline the Tromso Study. Stroke 2005;36:715-9.
  • 5. Chapman CM, Beilby JP, McQuillan BM, Thompson PL, Hung J. Monocyte count, but not C-reactive protein or interleukin-6, is an independent risk marker for subclinical carotid atherosclerosis. Stroke 2004;35:1619-24.
  • 6. Cockerill GW, Rye KA, Gamble JR, Vadas MA, Barter PJ. High-density lipoproteins inhibit cytokineinduced expression of endothelial cell adhesion molecules. Arterioscler Thromb Vasc Biol 1995;15:1987-94.
  • 7. Castelli WP, Garrison RJ, Wilson PW, Abbott RD, Kalousdian S, Kannel WB. Incidence of coronary heart disease and lipoprotein cholesterol levels. The Framingham Study. JAMA 1986;256:2835-8.
  • 8. Mehmet K, Yalcin S, Hilmi U, Yasemin GK, Mahmut G , Hakki C. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol 2014;46:1619-25.
  • 9. Canpolat U, Çetin EH, Cetin S, Aydin S, Akboga MK, Yayla C, et al. Association of monocyte-to-HDL cholesterol ratio with slow coronary flow is linked to systemic inflammation. Clin Appl Thromb Hemost 2016;22:476-82.
  • 10. Gensini GG. Coronary arteriography: role in myocardial revascularization. Postgrad Med 1978;63:121-8.
  • 11. Gensini G. A more meaningful scoring system for determining the severity of coronary artery disease. Am J Cardiol 1983;51:606.
  • 12. Oishi Y, Wakatsuki T, Nishikado A, Oki T, Ito S. Circulating adhesion molecules and severity of coronary atherosclerosis. Coron Artery Dis 2000;11:77-81.
  • 13. Nozawa N, Hibi K, Endo M, Sugano T, Ebina T, Kosuge M, et al. Association between circulating monocytes and coronary plaque progression in patients with acute myocardial infarction. Circ J 2010;74:1384-91.
  • 14. Olivares R, Ducimetière P, Claude JR. Monocyte count: A risk factor for coronary heart disease?.Am J Epidemiol 1993;137:49-53.
  • 15. Murphy AJ, Woollard KJ, Hoang A, Mukhamedova N, Stirzaker RA, McCormick SPA, et al. High-density lipoprotein reduces the human monocyte inflammatory response. Arterioscler Thromb Vasc Biol 2008;28:2071-7.
  • 16. Diederich W, Orso E, Drobnik W, Schmitz G. Apolipoprotein AI and HDL(3) inhibit spreading of primary human monocytes through a mechanism that involves cholesterol depletion and regulation of CDC42. Atherosclerosis 2001;159:313-24.
  • 17. Baker PW, Rye KA, Gamble JR, Vadas MA, Barter PJ. Ability of reconstituted high density lipoproteins to inhibit cytokine-induced expression of vascular cell adhesion molecule-1 in human umbilical vein endothelial cells. J Lipid Res 1999;40:345-53.
  • 18. Kundi H, Kiziltunc E, Cetin M, Cicekcioglu H, Cetin ZG, Cicek G, et al. Association of monocyte/HDL-C ratio with SYNTAX scores in patients with stable coronary artery disease. Herz 2016;41:523-9.
  • 19. Chelombitko MA, Shishkina VS, Ilyinskaya OP, Kaminnyi AI, Pavlunina TO, Samovilova NN, et al. A cytofluorometric study of membrane rafts in human monocyte subsets in atherosclerosis. Acta Naturae 2014;6:80-8.
  • 20. Superko HR, Pendyala L, Williams PT, Momary KM, King SB 3rd, Garrett BC. High-density lipoprotein subclasses and their relationship to cardiovascular disease. J Clin Lipidol 2012;6:496-523.

Relationship Between Monocyte/High-Density Lipoprotein Cholesterol Ratio and Angiographic Severity and Extent of Coronary Artery Disease

Yıl 2017, Cilt: 20 Sayı: 1, 30 - 35, 03.04.2017

Öz

Introduction:
Circulating
monocyte count is predictive of new atherosclerotic plaque development. In
addition, there is a strong inverse relationship between high-density
lipoprotein (HDL) cholesterol and atherosclerosis. We aimed to investigate the
relationship between the monocyte/HDL cholesterol ratio and severity of
coronary artery disease.



Patients
and Methods:
A total of 760 patients who underwent coronary
angiography were included in the study. The severity of coronary
atherosclerosis was calculated by the Gensini score, and the patients were
grouped as having low (< 20) and high (> 20) Gensini scores. Baseline
characteristics and laboratory parameters were recorded and compared between
patients with low and high Gensini scores.



Results: Hypertension,
diabetes mellitus, hyperlipidaemia, advanced age and smoking were more common
in patients with a high Gensini score. Fasting blood glucose levels, creatinine
levels and monocyte/HDL cholesterol ratio were significantly lower in patients
with a low Gensini score than in those with a high Gensini score. Logistic
regression analysis revealed that older age, fasting blood glucose levels,
hyperlipidaemia, family history of coronary artery disease and male gender were
independent predictors of a high Gensini score. We observed a correlation
between the monocyte/HDL cholesterol ratio and Gensini score (p< 0.001).
However, this correlation was weak (Spearman’s rho = 0.159).



Conclusion: We observed a positive but weak correlation
between the monocyte/HDL cholesterol; ratio and increased coronary
atherosclerotic burden, as calculated by Gensini scoring. Further studies are
required to demonstrate the relationship between the monocyte/HDL cholesterol
ratio and atherosclerotic cardiovascular disease.

Kaynakça

  • 1. Ross R. Atherosclerosis-an inflammatory disease. N Engl J Med 1999;340:115-26.
  • 2. Imhof BA, Aurrand-Lions M. Adhesion mechanisms regulating the migration of monocytes. Nat Rev Immunol 2004;4:432-44.
  • 3. Greaves DR, Gordon S. The macrophage scavenger receptor at 30 years of age: current knowledge and future challenges. J Lipid Res 2009;50(Suppl): 282-6.
  • 4. Johnsen SH, Fosse E, Joakimsen O, Mathiesen EB, Stensland- Bugge E, Njolstad I, et al. Monocyte count is a predictor of novel plaque formation: a 7-year follow-up study of 2610 persons without carotid plaque at baseline the Tromso Study. Stroke 2005;36:715-9.
  • 5. Chapman CM, Beilby JP, McQuillan BM, Thompson PL, Hung J. Monocyte count, but not C-reactive protein or interleukin-6, is an independent risk marker for subclinical carotid atherosclerosis. Stroke 2004;35:1619-24.
  • 6. Cockerill GW, Rye KA, Gamble JR, Vadas MA, Barter PJ. High-density lipoproteins inhibit cytokineinduced expression of endothelial cell adhesion molecules. Arterioscler Thromb Vasc Biol 1995;15:1987-94.
  • 7. Castelli WP, Garrison RJ, Wilson PW, Abbott RD, Kalousdian S, Kannel WB. Incidence of coronary heart disease and lipoprotein cholesterol levels. The Framingham Study. JAMA 1986;256:2835-8.
  • 8. Mehmet K, Yalcin S, Hilmi U, Yasemin GK, Mahmut G , Hakki C. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol 2014;46:1619-25.
  • 9. Canpolat U, Çetin EH, Cetin S, Aydin S, Akboga MK, Yayla C, et al. Association of monocyte-to-HDL cholesterol ratio with slow coronary flow is linked to systemic inflammation. Clin Appl Thromb Hemost 2016;22:476-82.
  • 10. Gensini GG. Coronary arteriography: role in myocardial revascularization. Postgrad Med 1978;63:121-8.
  • 11. Gensini G. A more meaningful scoring system for determining the severity of coronary artery disease. Am J Cardiol 1983;51:606.
  • 12. Oishi Y, Wakatsuki T, Nishikado A, Oki T, Ito S. Circulating adhesion molecules and severity of coronary atherosclerosis. Coron Artery Dis 2000;11:77-81.
  • 13. Nozawa N, Hibi K, Endo M, Sugano T, Ebina T, Kosuge M, et al. Association between circulating monocytes and coronary plaque progression in patients with acute myocardial infarction. Circ J 2010;74:1384-91.
  • 14. Olivares R, Ducimetière P, Claude JR. Monocyte count: A risk factor for coronary heart disease?.Am J Epidemiol 1993;137:49-53.
  • 15. Murphy AJ, Woollard KJ, Hoang A, Mukhamedova N, Stirzaker RA, McCormick SPA, et al. High-density lipoprotein reduces the human monocyte inflammatory response. Arterioscler Thromb Vasc Biol 2008;28:2071-7.
  • 16. Diederich W, Orso E, Drobnik W, Schmitz G. Apolipoprotein AI and HDL(3) inhibit spreading of primary human monocytes through a mechanism that involves cholesterol depletion and regulation of CDC42. Atherosclerosis 2001;159:313-24.
  • 17. Baker PW, Rye KA, Gamble JR, Vadas MA, Barter PJ. Ability of reconstituted high density lipoproteins to inhibit cytokine-induced expression of vascular cell adhesion molecule-1 in human umbilical vein endothelial cells. J Lipid Res 1999;40:345-53.
  • 18. Kundi H, Kiziltunc E, Cetin M, Cicekcioglu H, Cetin ZG, Cicek G, et al. Association of monocyte/HDL-C ratio with SYNTAX scores in patients with stable coronary artery disease. Herz 2016;41:523-9.
  • 19. Chelombitko MA, Shishkina VS, Ilyinskaya OP, Kaminnyi AI, Pavlunina TO, Samovilova NN, et al. A cytofluorometric study of membrane rafts in human monocyte subsets in atherosclerosis. Acta Naturae 2014;6:80-8.
  • 20. Superko HR, Pendyala L, Williams PT, Momary KM, King SB 3rd, Garrett BC. High-density lipoprotein subclasses and their relationship to cardiovascular disease. J Clin Lipidol 2012;6:496-523.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Orijinal Araştırmalar
Yazarlar

Emrullah Kızıltunç Bu kişi benim

Yakup Alsancak Bu kişi benim

Burak Sezenöz Bu kişi benim

Selçuk Özkan Bu kişi benim

Serkan Sivri

Aybüke Demir Alsancak Bu kişi benim

Gülten Taçoy Bu kişi benim

Yayımlanma Tarihi 3 Nisan 2017
Yayımlandığı Sayı Yıl 2017 Cilt: 20 Sayı: 1

Kaynak Göster

Vancouver Kızıltunç E, Alsancak Y, Sezenöz B, Özkan S, Sivri S, Demir Alsancak A, Taçoy G. Relationship Between Monocyte/High-Density Lipoprotein Cholesterol Ratio and Angiographic Severity and Extent of Coronary Artery Disease. Koşuyolu Heart Journal. 2017;20(1):30-5.