The Role of Uric Acid to HDL Cholesterol Ratio in Predicting Myocardial Ischemia in Myocardial Perfusion Scintigraphy in Diabetic Patients

Year 2023, , 131 - 139, 31.08.2023

Hamdi Afşin

https://doi.org/10.47493/abantmedj.1341855

Abstract

The Role of Uric Acid to HDL Cholesterol Ratio in Predicting Myocardial Ischemia in Myocardial Perfusion Scintigraphy in Diabetic Patients
Abstract
Objective: Diabetes Mellitus (DM) is a significant risk factor for cardiovascular diseases, particularly myocardial ischemia. Both diabetes mellitus type 2 and cardiovascular conditions are characterized by a high burden of inflammation. The uric Acid to High-Density Lipoprotein cholesterol ratio (UHR) has been suggested as a novel marker of metabolic and inflammatory diseases. Hence, this study investigated the predictive role of the Uric Acid to High-Density Lipoprotein cholesterol ratio (UHR) in myocardial ischemia detected by Myocardial Perfusion Scintigraphy (MPS) in diabetic patients.
Materials and Methods: This study included patients who underwent MPS between January 2022 and March 2023 at the Nuclear Medicine Department of Abant Izzet Baysal University Hospital. Based on the MPS results, the participants were divided into normal perfusion and myocardial ischemia. Variables such as age, sex, leukocyte count, hemoglobin, hematocrit, platelet count, serum uric acid, urea, creatinine, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, transaminase, blood fasting glucose, C-reactive protein, and serum albumin were recorded and compared between the groups.
Results: Among the 73 diabetic patients, 37 had myocardial ischemia, and 36 had normal MPS. Serum uric acid levels were higher in the ischemic group (6.3 ± 1.5 mg/dL) than in the normal group (5.1 ± 1.8 mg/dL) (p<0.05). The UHR in the ischemic group was significantly higher (0.15 ± 0.05) than that in the normal MPS group (0.11 ± 0.04). Serum UHR was significantly positively correlated with myocardial ischemia (r=0.36, p=0.002) )(p<0.05). With a cut-off value of ≥ 0.11, UHR exhibited 76% sensitivity and 58% specificity in detecting myocardial ischemia (p<0.05).
Conclusions: High UHR is an independent predictor and diagnostic tool for myocardial ischemia in patients with diabetes and coronary artery disease. Routine use of UHR as an independent predictive marker is recommended for diabetic patients with myocardial ischemia who undergo MPS.

Keywords

Uric Acid to High-Density Lipoprotein cholesterol ratio, Myocardial Ischemia, Myocardial Perfusion Scintigraphy, Diabetes Mellitus, Biomarkers

Supporting Institution

Yok

Project Number

Yok

Thanks

Acknowledgment We would like to thank all the Bolu Training and Research Hospital researchers.

Diyabetli Hastalarda Miyokard Perfüzyon Sintigrafisinde Miyokard İskemisini Öngörmede Ürik Asit-HDL Kolesterol Oranının Rolü

Abstract

Diyabetli Hastalarda Miyokard Perfüzyon Sintigrafisinde Miyokard İskemisini Öngörmede Ürik Asit-HDL Kolesterol Oranının Rolü
Öz
Amaç: Diabetes Mellitus (DM) başta miyokardiyal iskemi olmak üzere kardiyovasküler hastalıklar için önemli bir risk faktörüdür. Hem diabetes mellitus tip 2 hem de kardiyovasküler durumlar, yüksek bir inflamatuar yük ile karakterizedir. Ürik Asit -Yüksek Yoğunluklu Lipoprotein kolesterol oranı (UHR), metabolik ve enflamatuar hastalıkların yeni bir belirteci olarak önerilmiştir. Bu nedenle, bu çalışma diyabetik hastalarda Miyokard Perfüzyon Sintigrafisi (MPS) ile saptanan miyokard iskemisinde Ürik Asidin Yüksek Yoğunluklu Lipoprotein kolesterol oranının (UHR) öngörmedeki rolünü araştırmıştır. Gereç ve Yöntemler: Bu çalışmaya Ocak 2022 ile Mart 2023 tarihleri arasında Abant İzzet Baysal Üniversitesi Hastanesi Nükleer Tıp Anabilim Dalı'nda MPS uygulanan hastalar dahil edildi. MPS sonuçlarına göre katılımcılar normal perfüzyon ve miyokard iskemisi olarak iki gruba ayrıldı. Gruplar arasında yaş, cinsiyet, lökosit sayısı, hemoglobin, hematokrit, trombosit sayısı, serum ürik asit, üre, kreatinin, total kolesterol, LDL-kolesterol, HDL-kolesterol, trigliserit, transaminaz, kan açlık glikozu, C-reaktif protein ve serum albümini gibi değişkenler kaydedildi ve karşılaştırıldı.
Bulgular: Diyabetli 73 hastanın 37'sinde miyokardiyal iskemi, 36'sında normal MPS mevcuttu. Serum ürik asit düzeyleri iskemik grupta (6.3 ± 1.5 mg/dL) normal gruba (5.1 ± 1.8 mg/dL) göre daha yüksekti (p<0.05). İskemik gruptaki UHR, normal MPS grubundakinden (0.11 ± 0.04) anlamlı derecede yüksekti (0.15 ± 0.05). Serum UHR, miyokard iskemisi ile anlamlı olarak pozitif korelasyon gösterdi (r=0.36, p=0.002) )(p<0.05). Cut off değeri ≥ 0.11 olan UHR, miyokard iskemisini saptamada % 76 duyarlılık ve % 58 özgüllük sergiledi (p<0.05).
Sonuç: Yüksek UHR, diyabetli ve koroner arter hastalığı olan hastalarda miyokard iskemisi için bağımsız bir prediktör ve tanı aracıdır.
Keywords: Uric Acid to High-Density Lipoprotein cholesterol ratio, Myocardial Ischemia, Myocardial Perfusion Scintigraphy, Diabetes Mellitus, Biomarkers

Keywords

Uric Acid to High-Density Lipoprotein cholesterol ratio, Myocardial Ischemia, Myocardial Perfusion Scintigraphy, Diabetes Mellitus, Biomarkers

Project Number

Yok

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