Research Article
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Year 2022, , 835 - 839, 30.12.2022
https://doi.org/10.33808/clinexphealthsci.1094774

Abstract

References

  • Saito, S. Preeclampsia Basic, Genomic, and Clinical; Springer Nature Singapore Pte Ltd.: Singapore, 2018.
  • Eiland E, Nzerue C, Faulkner M. Preeclampsia. J Pregnancy 2012. ID 586578.
  • Mustafa R, Ahmed S, Gupta A, Venuto RC. A comprehensive review of hypertension in pregnancy. J Pregnancy 2012;2012: 105918.
  • De Groot CJ, Taylor RN. New insights into the etiology of preeclampsia. Ann Med 1993;25(3):243–249.
  • Ghio A, Bertolotto A, Resi V, Volpe L, Cianni GD. Triglyceride metabolism in pregnancy. Adv Clin Chem. 2011;55:133–153. doi: 10.1016/b978-0-12-387042-1.00007-1.
  • Pijnenborg R, Bland JM, Robertson WB, Brosens I. Uteroplacental arterial changes related to interstitial trophoblast migration in early human pregnancy. Placenta 1983;4:397-413.
  • Saito S, Shiozaki A, Nakashima A, Sakai M, Sasaki Y. The role of the immune system in preeclampsia. Mol Aspects Med. 2007;28(2):192-209. doi: 10.1016/j.mam.2007.02.006.
  • Ancuta P, Wang J, Gabuzda D. CD16+ monocytes produce IL-6, CCL2, and matrix metalloproteinase-9 upon interaction with CX3CL1-expressing endothelial cells. J Leukoc Biol 2006 Nov;80(5):1156-64.
  • Epelman S, Lavine KJ, Randolph GJ. Origin and Functions of Tissue Macrophages. Immunity 2014;41(1): 21–35.
  • Nonn O, Güttler J, Forstner D, Maninger S, Zadora J, Balogh A, Frolova A, Glasner A, Herse F, Gauster M. Placental CX3CL1 is deregulated by angiotensin II and contributes to a proinflammatory trophoblast-monocyte interaction. Int J Mol Sci. 2019; 20(3):641. doi: 10.3390/ijms20030641.
  • Siwetz M, Sundl M, Kolb D, Hiden U, Herse F, Huppertz B, Gauster M. Placental fractalkine mediates adhesion of THP-1 monocytes to villous trophoblast. Histochem Cell Biol. 2015;143(6):565–574. doi: 10.1007/s00418.014.1304-0.
  • Canpolat U, Çetin EH, Cetin S, Aydin S, Akboga MK, Yayla C, Turak O, Aras D, Aydogdu S. Association of monocyte-to-HDL cholesterol ratio with slow coronary flow is linked to systemic inflammation. Clin Appl Thromb Hemost. 2016;22(5):476-482. doi: 10.1177/107.602.9615594002.
  • Ertek S. High-density Lipoprotein (HDL) Dysfunction and the Future of HDL. Curr Vasc Pharmacol 2018; 16(5): 490–498.
  • Ganjali S, Gotto AM, Ruscica M, Atkin SL, Butler AE, Banach M, Sahebkar A. Monocyte-to-HDL-cholesterol ratio as a prognostic marker in cardiovascular diseases. J Cell Physiol. 2018;233(12): 9237–9246. doi: 10.1002/jcp.27028.
  • Sibai B, Dekker G, Kupferminc M. Preeclampsia Lancet 2005;365:785–99.
  • Faas MM, Vos PD. Maternal monocytes in pregnancy and preeclampsia in humans and in rats. J Reprod Immunol. 2017;119:91-97. doi: 10.1016/j.jri.2016.06.009.
  • Wang J, Zhu QW, Cheng XY, Liu JY, Zhang LL, Tao YM, Cui YB, Wei Y. Assessment efficacy of neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio in preeclampsia. J Reprod Immunol. 2019;132: 29–34. doi: 10.1016/j.jri.2019.02.001.
  • Brien ME, Boufaied I, Soglio DD, Rey E, Leduc L, Girard S. Distinct inflammatory profile in preeclampsia and postpartum preeclampsia reveal unique mechanisms. Biology of Reproduction. 2019;100(1):187–194. doi: 10.1093/biolre/ioy164.
  • Belo L, Santos-Silva A, Caslake M, Cooney J, Leite-Pereira L, Quintanilha A, Rebelo I. Neutrophil activation and C-reactive protein concentration in preeclampsia. Hypertens Pregnancy. 2003;22(2):129-41. doi: 10.1081/PRG 120021059.
  • Mahendru AA, Everett TR, Wilkinson IB, Lees CC, McEniery CM. A longitudinal study of maternal cardiovascular function from preconception to the postpartum period. J Hypertens. 2014;32(4):849–856. doi: 10.1097/HJH.000.000.0000000090.
  • Staff AC, Benton SJ, von Dadelszen P, Roberts JM, Taylor RN, Powers RW, Charnock-Jones DS, Redman CW. Redefining preeclampsia using placenta-derived biomarkers. Hypertension. 2013;61(5):932– 942. doi: 10.1161/HYPERTENSIONAHA.111.00250.
  • Nicholls SJ, Nelson AJ. HDL and cardiovascular disease. Pathology. 2019; 51(2):142–147. doi: 10.1016/j.pathol.2018.10.017.
  • Leon-Reyes G, Maida-Claros RF, Urrutia-Medina AX, JorgeGalarza E, Guzmán-Grenfell AM, Fuentes-García S, MedinaNavarro R, Moreno-Eutimio MA, Muñoz-Sánchez JL, Hicks JJ, Torres-Ramos YD. Oxidative profiles of LDL and HDL isolated from women with preeclampsia. Lipids in Health and Disease. 2017;16(1):90. doi: 10.1186/s12944.017.0480-z.
  • Cao W, Wang X, Chen T, Xu W, Feng F, Zhao S, Wang Z, Hu Y, Xie B. Maternal lipids, BMI and IL-17/IL-35 imbalance in concurrent gestational diabetes mellitus and preeclampsia. Experimental and Therapeutic Medicine. 2018;16(1):427–435. doi: 10.3892/etm.2018.6144.
  • Konrad E, Güralp O, Shaalan W, Elzarkaa AA, Moftah R, Alemam D, Malik E, Soliman AA. Correlation of elevated levels of lipoprotein(a), high-density lipoprotein and low-density lipoprotein with severity of preeclampsia: A prospective longitudinal study. Obstet Gynaecol. 2020;40(1):53-58. doi: 10.1080/01443.615.2019.1603214.
  • Khaire AA, Thakar SR, Wagh GN, Joshi SR. Placental lipid metabolism in preeclampsia. Hypertens 2021 Jan;39(1):127-134.
  • Kanbay M, Solak Y, Unal HU, Kurt YG, Gok M, Cetinkaya H, Karaman M, Oguz Y, Eyileten T, Vural A, Covic A, Goldsmith D, Turak O, Yilmaz MI. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol. 2014;46(8):1619-25. doi: 10.1007/ s11255.014.0730-1.
  • Ucar FM. A potential marker of bare metal stent restenosis: monocyte count-to-HDL cholesterol ratio. BMC Cardiovasc Disord 2016;16:186.
  • Sun M, Liang C, Lin H, Meng Y, Tang Q, Shi X, Zhang E, Tang Q. Monocyte to HDL cholesterol ratio as a marker of the presence and severity of obstructive sleep apnea in hypertensive patients. Sci Rep. 2021;11(1):15821. doi: 10.1038/ s41598.021.95095-3.
  • You S, Zhong C, Zheng D, Xu J, Zhang Xia, Liu H, Zhang Y, Shi J, Huang Z, Cao Y, Liu CF. Monocyte to HDL cholesterol ratio is associated with discharge and 3-month outcome in patients with acute intracerebral hemorrhage. J Neurol Sci. 2017;372:157–161. doi: 10.1016/j.jns.2016.11.022.
  • Usta A, Avci E, Bulbul CB, Kadi H, Adali E. The monocyte counts to HDL cholesterol ratio in obese and lean patients with polycystic ovary syndrome. Reprod Biol Endocrinol. 2018;16(1):34. doi: 10.1186/s12958.018.0351-0.
  • Onat T, Demir Caltekin M, Turksoy VA, Baser E, Kirmizi DA, Kara M, Yalvac ES. The relationship between heavy metal exposure, trace element level, and monocyte to HDL cholesterol ratio with gestational diabetes mellitus. Biol Trace Elem Res. 2021;199(4):1306-1315. doi: 10.1007/s12011.020.02499-9.
  • Selcuk M, Yildirim E, Saylik F. Comparison of monocyte with high density lipoprotein cholesterol ratio in dipper and nondipper hypertensive patients. Biomark Med 2019 Oct;13(15):1289-1296.
  • Gembillo G, Siligato R, Cernaro V, Satta E, Conti G, Salvo A, Romeo A, Calabrese V, Sposito G, Ferlazzo G, Santoro D. Monocyte to HDL ratio: A novel marker of resistant hypertension in CKD patients. Int Urol Nephrol. 2022;54(2):395-403.
  • Celik E, Turkcuoglu I, Ata B, Karaer A, Kırıcı P, Eraslan S, Taşkapan Ç, Berker B. Metabolic and carbohydrate characteristics of different phenotypes of polycystic ovary syndrome. J Turkish German Gynecol Assoc. 2016;17(4):201-208.
  • Herkiloglu D, Gokce S. Correlation of monocyte/HDL ratio (MHR) with inflammatory parameters in obese patients diagnosed with polycystic ovary syndrome. Ginekol Pol. 2021;92(8):537-543.
  • Dincgez Cakmak B, Dundar B, Ketenci Gencer F, Boyama BA, Yildiz DE. TWEAK and monocyte to HDL ratio as a predictor of metabolic syndrome in patients with polycystic ovary syndrome. Gynecol Endocrinol. 2019;35(1):66-71.
  • Melekoğlu R, Yaşar Ş, Çelik ZN, Özdemir H. Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross-sectional, case-control study. Turk J Obstet Gynecol. 2022;19(1):7-20.

Monocyte to HDL Ratio in Preeclamptic Patients: Can It Be a Predictive Marker?

Year 2022, , 835 - 839, 30.12.2022
https://doi.org/10.33808/clinexphealthsci.1094774

Abstract

Objective: Preeclampsia (PE) is a severe and high – risk pregnancy complication for both the mother and fetus. Generalized inflammation is a prominent feature of PE. Based on the proinflammatory property of monocytes and the contrary anti-inflammatory mechanism of High-density lipoprotein (HDL), monocyte count to HDL ratio (MHR) could be used as a new marker of systemic inflammation. Our aim is to evaluate the relationship between PE and MHR in terms of diagnosis of PE.
Methods: A retrospective case-control study was recruited preeclamptic and healthy pregnant women in the third trimester of gestation (n=69 and n= 71, respectively).
Results: Maternal age (years), gravity, and body mass index (BMI) were similar in the two groups. The gestational week at delivery was significantly earlier in the PE group than in the control group (p < 0.001). Fetal weight in PE was significantly lower than in the control group (p = 0.001). Monocyte counts were comparable between the two groups (0.76 ± 0.28 vs. 0.76 ± 0.71; p = 0.25). The mean HDL level of PE patients was lower than the control group, but it was not statistically significant (63.87 ± 15.3 vs. 68.23 ± 13.5; p = 0.77). The monocyte/HDL ratio was higher in the PE group, but this increment did not reach statistical significance (12.5 ± 5.9 vs. 10.9 ± 4.3, p = 0.08).
Conclusion: MHR might be a new marker of inflammation and oxidative stress. The present study did not reach a result indicating a diagnostic marker of PE. Further studies with more cases are needed to evaluate the relationship between MHR and PE.

References

  • Saito, S. Preeclampsia Basic, Genomic, and Clinical; Springer Nature Singapore Pte Ltd.: Singapore, 2018.
  • Eiland E, Nzerue C, Faulkner M. Preeclampsia. J Pregnancy 2012. ID 586578.
  • Mustafa R, Ahmed S, Gupta A, Venuto RC. A comprehensive review of hypertension in pregnancy. J Pregnancy 2012;2012: 105918.
  • De Groot CJ, Taylor RN. New insights into the etiology of preeclampsia. Ann Med 1993;25(3):243–249.
  • Ghio A, Bertolotto A, Resi V, Volpe L, Cianni GD. Triglyceride metabolism in pregnancy. Adv Clin Chem. 2011;55:133–153. doi: 10.1016/b978-0-12-387042-1.00007-1.
  • Pijnenborg R, Bland JM, Robertson WB, Brosens I. Uteroplacental arterial changes related to interstitial trophoblast migration in early human pregnancy. Placenta 1983;4:397-413.
  • Saito S, Shiozaki A, Nakashima A, Sakai M, Sasaki Y. The role of the immune system in preeclampsia. Mol Aspects Med. 2007;28(2):192-209. doi: 10.1016/j.mam.2007.02.006.
  • Ancuta P, Wang J, Gabuzda D. CD16+ monocytes produce IL-6, CCL2, and matrix metalloproteinase-9 upon interaction with CX3CL1-expressing endothelial cells. J Leukoc Biol 2006 Nov;80(5):1156-64.
  • Epelman S, Lavine KJ, Randolph GJ. Origin and Functions of Tissue Macrophages. Immunity 2014;41(1): 21–35.
  • Nonn O, Güttler J, Forstner D, Maninger S, Zadora J, Balogh A, Frolova A, Glasner A, Herse F, Gauster M. Placental CX3CL1 is deregulated by angiotensin II and contributes to a proinflammatory trophoblast-monocyte interaction. Int J Mol Sci. 2019; 20(3):641. doi: 10.3390/ijms20030641.
  • Siwetz M, Sundl M, Kolb D, Hiden U, Herse F, Huppertz B, Gauster M. Placental fractalkine mediates adhesion of THP-1 monocytes to villous trophoblast. Histochem Cell Biol. 2015;143(6):565–574. doi: 10.1007/s00418.014.1304-0.
  • Canpolat U, Çetin EH, Cetin S, Aydin S, Akboga MK, Yayla C, Turak O, Aras D, Aydogdu S. Association of monocyte-to-HDL cholesterol ratio with slow coronary flow is linked to systemic inflammation. Clin Appl Thromb Hemost. 2016;22(5):476-482. doi: 10.1177/107.602.9615594002.
  • Ertek S. High-density Lipoprotein (HDL) Dysfunction and the Future of HDL. Curr Vasc Pharmacol 2018; 16(5): 490–498.
  • Ganjali S, Gotto AM, Ruscica M, Atkin SL, Butler AE, Banach M, Sahebkar A. Monocyte-to-HDL-cholesterol ratio as a prognostic marker in cardiovascular diseases. J Cell Physiol. 2018;233(12): 9237–9246. doi: 10.1002/jcp.27028.
  • Sibai B, Dekker G, Kupferminc M. Preeclampsia Lancet 2005;365:785–99.
  • Faas MM, Vos PD. Maternal monocytes in pregnancy and preeclampsia in humans and in rats. J Reprod Immunol. 2017;119:91-97. doi: 10.1016/j.jri.2016.06.009.
  • Wang J, Zhu QW, Cheng XY, Liu JY, Zhang LL, Tao YM, Cui YB, Wei Y. Assessment efficacy of neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio in preeclampsia. J Reprod Immunol. 2019;132: 29–34. doi: 10.1016/j.jri.2019.02.001.
  • Brien ME, Boufaied I, Soglio DD, Rey E, Leduc L, Girard S. Distinct inflammatory profile in preeclampsia and postpartum preeclampsia reveal unique mechanisms. Biology of Reproduction. 2019;100(1):187–194. doi: 10.1093/biolre/ioy164.
  • Belo L, Santos-Silva A, Caslake M, Cooney J, Leite-Pereira L, Quintanilha A, Rebelo I. Neutrophil activation and C-reactive protein concentration in preeclampsia. Hypertens Pregnancy. 2003;22(2):129-41. doi: 10.1081/PRG 120021059.
  • Mahendru AA, Everett TR, Wilkinson IB, Lees CC, McEniery CM. A longitudinal study of maternal cardiovascular function from preconception to the postpartum period. J Hypertens. 2014;32(4):849–856. doi: 10.1097/HJH.000.000.0000000090.
  • Staff AC, Benton SJ, von Dadelszen P, Roberts JM, Taylor RN, Powers RW, Charnock-Jones DS, Redman CW. Redefining preeclampsia using placenta-derived biomarkers. Hypertension. 2013;61(5):932– 942. doi: 10.1161/HYPERTENSIONAHA.111.00250.
  • Nicholls SJ, Nelson AJ. HDL and cardiovascular disease. Pathology. 2019; 51(2):142–147. doi: 10.1016/j.pathol.2018.10.017.
  • Leon-Reyes G, Maida-Claros RF, Urrutia-Medina AX, JorgeGalarza E, Guzmán-Grenfell AM, Fuentes-García S, MedinaNavarro R, Moreno-Eutimio MA, Muñoz-Sánchez JL, Hicks JJ, Torres-Ramos YD. Oxidative profiles of LDL and HDL isolated from women with preeclampsia. Lipids in Health and Disease. 2017;16(1):90. doi: 10.1186/s12944.017.0480-z.
  • Cao W, Wang X, Chen T, Xu W, Feng F, Zhao S, Wang Z, Hu Y, Xie B. Maternal lipids, BMI and IL-17/IL-35 imbalance in concurrent gestational diabetes mellitus and preeclampsia. Experimental and Therapeutic Medicine. 2018;16(1):427–435. doi: 10.3892/etm.2018.6144.
  • Konrad E, Güralp O, Shaalan W, Elzarkaa AA, Moftah R, Alemam D, Malik E, Soliman AA. Correlation of elevated levels of lipoprotein(a), high-density lipoprotein and low-density lipoprotein with severity of preeclampsia: A prospective longitudinal study. Obstet Gynaecol. 2020;40(1):53-58. doi: 10.1080/01443.615.2019.1603214.
  • Khaire AA, Thakar SR, Wagh GN, Joshi SR. Placental lipid metabolism in preeclampsia. Hypertens 2021 Jan;39(1):127-134.
  • Kanbay M, Solak Y, Unal HU, Kurt YG, Gok M, Cetinkaya H, Karaman M, Oguz Y, Eyileten T, Vural A, Covic A, Goldsmith D, Turak O, Yilmaz MI. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol. 2014;46(8):1619-25. doi: 10.1007/ s11255.014.0730-1.
  • Ucar FM. A potential marker of bare metal stent restenosis: monocyte count-to-HDL cholesterol ratio. BMC Cardiovasc Disord 2016;16:186.
  • Sun M, Liang C, Lin H, Meng Y, Tang Q, Shi X, Zhang E, Tang Q. Monocyte to HDL cholesterol ratio as a marker of the presence and severity of obstructive sleep apnea in hypertensive patients. Sci Rep. 2021;11(1):15821. doi: 10.1038/ s41598.021.95095-3.
  • You S, Zhong C, Zheng D, Xu J, Zhang Xia, Liu H, Zhang Y, Shi J, Huang Z, Cao Y, Liu CF. Monocyte to HDL cholesterol ratio is associated with discharge and 3-month outcome in patients with acute intracerebral hemorrhage. J Neurol Sci. 2017;372:157–161. doi: 10.1016/j.jns.2016.11.022.
  • Usta A, Avci E, Bulbul CB, Kadi H, Adali E. The monocyte counts to HDL cholesterol ratio in obese and lean patients with polycystic ovary syndrome. Reprod Biol Endocrinol. 2018;16(1):34. doi: 10.1186/s12958.018.0351-0.
  • Onat T, Demir Caltekin M, Turksoy VA, Baser E, Kirmizi DA, Kara M, Yalvac ES. The relationship between heavy metal exposure, trace element level, and monocyte to HDL cholesterol ratio with gestational diabetes mellitus. Biol Trace Elem Res. 2021;199(4):1306-1315. doi: 10.1007/s12011.020.02499-9.
  • Selcuk M, Yildirim E, Saylik F. Comparison of monocyte with high density lipoprotein cholesterol ratio in dipper and nondipper hypertensive patients. Biomark Med 2019 Oct;13(15):1289-1296.
  • Gembillo G, Siligato R, Cernaro V, Satta E, Conti G, Salvo A, Romeo A, Calabrese V, Sposito G, Ferlazzo G, Santoro D. Monocyte to HDL ratio: A novel marker of resistant hypertension in CKD patients. Int Urol Nephrol. 2022;54(2):395-403.
  • Celik E, Turkcuoglu I, Ata B, Karaer A, Kırıcı P, Eraslan S, Taşkapan Ç, Berker B. Metabolic and carbohydrate characteristics of different phenotypes of polycystic ovary syndrome. J Turkish German Gynecol Assoc. 2016;17(4):201-208.
  • Herkiloglu D, Gokce S. Correlation of monocyte/HDL ratio (MHR) with inflammatory parameters in obese patients diagnosed with polycystic ovary syndrome. Ginekol Pol. 2021;92(8):537-543.
  • Dincgez Cakmak B, Dundar B, Ketenci Gencer F, Boyama BA, Yildiz DE. TWEAK and monocyte to HDL ratio as a predictor of metabolic syndrome in patients with polycystic ovary syndrome. Gynecol Endocrinol. 2019;35(1):66-71.
  • Melekoğlu R, Yaşar Ş, Çelik ZN, Özdemir H. Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross-sectional, case-control study. Turk J Obstet Gynecol. 2022;19(1):7-20.
There are 38 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Şule Yıldırım Köpük 0000-0002-5020-8323

Nida Naci 0000-0003-2788-3256

Canan Özcan 0000-0002-9101-6053

İpek Ulu 0000-0002-8873-9533

Publication Date December 30, 2022
Submission Date March 29, 2022
Published in Issue Year 2022

Cite

APA Yıldırım Köpük, Ş., Naci, N., Özcan, C., Ulu, İ. (2022). Monocyte to HDL Ratio in Preeclamptic Patients: Can It Be a Predictive Marker?. Clinical and Experimental Health Sciences, 12(4), 835-839. https://doi.org/10.33808/clinexphealthsci.1094774
AMA Yıldırım Köpük Ş, Naci N, Özcan C, Ulu İ. Monocyte to HDL Ratio in Preeclamptic Patients: Can It Be a Predictive Marker?. Clinical and Experimental Health Sciences. December 2022;12(4):835-839. doi:10.33808/clinexphealthsci.1094774
Chicago Yıldırım Köpük, Şule, Nida Naci, Canan Özcan, and İpek Ulu. “Monocyte to HDL Ratio in Preeclamptic Patients: Can It Be a Predictive Marker?”. Clinical and Experimental Health Sciences 12, no. 4 (December 2022): 835-39. https://doi.org/10.33808/clinexphealthsci.1094774.
EndNote Yıldırım Köpük Ş, Naci N, Özcan C, Ulu İ (December 1, 2022) Monocyte to HDL Ratio in Preeclamptic Patients: Can It Be a Predictive Marker?. Clinical and Experimental Health Sciences 12 4 835–839.
IEEE Ş. Yıldırım Köpük, N. Naci, C. Özcan, and İ. Ulu, “Monocyte to HDL Ratio in Preeclamptic Patients: Can It Be a Predictive Marker?”, Clinical and Experimental Health Sciences, vol. 12, no. 4, pp. 835–839, 2022, doi: 10.33808/clinexphealthsci.1094774.
ISNAD Yıldırım Köpük, Şule et al. “Monocyte to HDL Ratio in Preeclamptic Patients: Can It Be a Predictive Marker?”. Clinical and Experimental Health Sciences 12/4 (December 2022), 835-839. https://doi.org/10.33808/clinexphealthsci.1094774.
JAMA Yıldırım Köpük Ş, Naci N, Özcan C, Ulu İ. Monocyte to HDL Ratio in Preeclamptic Patients: Can It Be a Predictive Marker?. Clinical and Experimental Health Sciences. 2022;12:835–839.
MLA Yıldırım Köpük, Şule et al. “Monocyte to HDL Ratio in Preeclamptic Patients: Can It Be a Predictive Marker?”. Clinical and Experimental Health Sciences, vol. 12, no. 4, 2022, pp. 835-9, doi:10.33808/clinexphealthsci.1094774.
Vancouver Yıldırım Köpük Ş, Naci N, Özcan C, Ulu İ. Monocyte to HDL Ratio in Preeclamptic Patients: Can It Be a Predictive Marker?. Clinical and Experimental Health Sciences. 2022;12(4):835-9.

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