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Nötrofil/lenfosit oranı diyabetik hastalarda epikardiyal yağ doku kalınlığının bağımsız bir belirleyicisidir.

Year 2019, Volume: 44 Issue: 4, 1333 - 1338, 29.12.2019
https://doi.org/10.17826/cumj.531969

Abstract

Amaç: Çalışmamızda diyabetik ve diyabetik olmayan hastalarda nötrofil/lenfosit oranı (NLR), platelet/lenfosit oranı (PLR) ve Eeikardiyal yağ dokusu kalınlığını (EFT) karşılaştırmayı ve diyabetik hastalarda EFT’yi etkileyen faktörleri belirlemeyi amaçladık.

Gereç ve Yöntem: Bu kesitsel çalışmada polikliniğimize başvuran ve diyabeti olan 92 hasta ile birlikte, diyabeti olmayan 40 sağlıklı gönüllü çalışmaya dahil edildi. Tüm katılımcıların özgeçmişi, boy, kilo, vücut kütle indeksleri (BMI), sigara alışkanlıkları, fizik muayene bulguları, biyokimyasal ve hematolojik sonuçları ve ekokardiografi bulguları kaydedildi. Bu değerler iki grup arasında istatistiksel olarak karşılaştırıldı. 

Bulgular: Gruplar yaş, cinsiyet, sigara alışkanlığı, diyastolik kan basıncı, total kolesterol, high-density lipoprotein (HDL), low-density lipoprotein ve PLR açısından benzerdi. BMI, hipertansiyon, sistolik kan basıncı, serum glukoz, HbA1C, serum kreatinin, trigliserid, total kolesterol/HDL oranı, NLR ve EFT diyabetik hastalarda kontrol grubuna göre istatistiksel olarak anlamlı şekilde yüksek, ejeksiyon fraksiyonu ise anlamlı olarak düşüktü. NLR ve BMI diyabetik hastalarda EFT’nin bağımsız prediktörü olarak tespit edildi.

Sonuç: Ekokardiografik EFT ölçümü, basit hematolojik parametrelerden biri olan NLR ve son olarak BMI diyabetik hastalarda kardiovasküler risk değerlendirilmesinde kullanılabilir. 


References

  • 1. Doupis J, Lyons TE, Wu S, Gnardellis C, Dinh T, Veves A. Microvascular reactivity and inflammatory cytokines in painful and painless peripheral diabetic neuropathy. The Journal of Clinical Endocrinology & Metabolism. 2009;94(6):2157-63.2. Fujita T, Hemmi S, Kajiwara M, Yabuki M, Fuke Y, Satomura A, et al. Complement‐mediated chronic inflammation is associated with diabetic microvascular complication. Diabetes/metabolism research and reviews. 2013;29(3):220-6.3. Coutinho M, Gerstein HC, Wang Y, Yusuf S. The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. Diabetes care. 1999;22(2):233-40.4. Wang T, Liu Q, Liu C, Sun L, Li D, Liu A, et al. Correlation of echocardiographic epicardial fat thickness with severity of coronary artery disease in patients with acute myocardial infarction. Echocardiography (Mount Kisco, NY). 2014;31(10):1177-81.5. Wu Y, Zhang A, Hamilton DJ, Deng T. Epicardial Fat in the Maintenance of Cardiovascular Health. Methodist DeBakey cardiovascular journal. 2017;13(1):20-4.6. Nunez J, Nunez E, Bodi V, Sanchis J, Minana G, Mainar L, et al. Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction. Am J Cardiol. 2008;101(6):747-52.7. Tamhane UU, Aneja S, Montgomery D, Rogers E-K, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. The American journal of cardiology. 2008;102(6):653-7.8. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography. 2015;28(1):1-39.e14.9. Szuszkiewicz-Garcia MM, Davidson JA. Cardiovascular disease in diabetes mellitus: risk factors and medical therapy. Endocrinology and metabolism clinics of North America. 2014;43(1):25-40.10. Bhat T, Teli S, Rijal J, Bhat H, Raza M, Khoueiry G, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert review of cardiovascular therapy. 2013;11(1):55-9.11. Tsai JC, Sheu SH, Chiu HC, Chung FM, Chang DM, Chen MP, et al. Association of peripheral total and differential leukocyte counts with metabolic syndrome and risk of ischemic cardiovascular diseases in patients with type 2 diabetes mellitus. Diabetes Metab Res Rev. 2007;23(2):111-8.12. Azab B, Chainani V, Shah N, McGinn JT. Neutrophil-lymphocyte ratio as a predictor of major adverse cardiac events among diabetic population: a 4-year follow-up study. Angiology. 2013;64(6):456-65.13. Valensi P, Avignon A, Sultan A, Chanu B, Nguyen MT, Cosson E. Atherogenic dyslipidemia and risk of silent coronary artery disease in asymptomatic patients with type 2 diabetes: a cross-sectional study. 2016;15(1):104.14. Raffield LM, Hsu FC, Cox AJ, Carr JJ, Freedman BI, Bowden DW. Predictors of all-cause and cardiovascular disease mortality in type 2 diabetes: Diabetes Heart Study. Diabetology & metabolic syndrome. 2015;7:58.15. Onat A, Yildirim B, Erer B, Başar Ö, Çetinkaya A, Ceyhan K, et al. Total kolesterol/HDL-kolesterol oranı koroner hastalığın en iyi lipid öngördürücüsü: Trigliserid ortalama düzeyimiz yılda 1 mg yükselme gösteriyor. TÜRK KARDİYOLOJİ DERNEĞİ ARŞİVİ. 2001;29(6):334-43.16. Xiao G, Zhu S, Xiao X, Yan L, Yang J, Wu G. Comparison of laboratory tests, ultrasound, or magnetic resonance elastography to detect fibrosis in patients with nonalcoholic fatty liver disease: A meta-analysis. Hepatology (Baltimore, Md). 2017;66(5):1486-501.17. Sargeant LA, Bennett FI, Forrester TE, Cooper RS, Wilks RJ. Predicting incident diabetes in Jamaica: the role of anthropometry. Obesity research. 2002;10(8):792-8.18. Garcia-Labbe D, Ruka E, Bertrand OF, Voisine P, Costerousse O, Poirier P. Obesity and coronary artery disease: evaluation and treatment. The Canadian journal of cardiology. 2015;31(2):184-94.19. Lee JJ, Pedley A, Hoffmann U, Massaro JM, Fox CS. Association of Changes in Abdominal Fat Quantity and Quality With Incident Cardiovascular Disease Risk Factors. Journal of the American College of Cardiology. 2016;68(14):1509-21.20. Fitzgibbons TP, Czech MP. Epicardial and perivascular adipose tissues and their influence on cardiovascular disease: basic mechanisms and clinical associations. Journal of the American Heart Association. 2014;3(2):e000582.21. Gonzalez N, Moreno-Villegas Z, Gonzalez-Bris A, Egido J, Lorenzo O. Regulation of visceral and epicardial adipose tissue for preventing cardiovascular injuries associated to obesity and diabetes. Cardiovascular diabetology. 2017;16(1):44.22. Akbas EM, Hamur H, Demirtas L, Bakirci EM, Ozcicek A, Ozcicek F, et al. Predictors of epicardial adipose tissue in patients with type 2 diabetes mellitus. Diabetology & metabolic syndrome. 2014;6:55.23. Ozcicek A, Ozcicek F, Yildiz G, Timuroglu A, Demirtas L, Buyuklu M, et al. Neutrophil-to-lymphocyte ratio as a possible indicator of epicardial adipose tissue in patients undergoing hemodialysis. Archives of medical science : AMS. 2017;13(1):118-23.

Neutrophil-to-lymphocyte ratio independently predicts the epicardial fat thickness in diabetic patients

Year 2019, Volume: 44 Issue: 4, 1333 - 1338, 29.12.2019
https://doi.org/10.17826/cumj.531969

Abstract

Purpose: The aim of this study was to investigate neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and epicardial fat thickness (EFT)  in diabetic and non-diabetic patients, and to determine the factors affecting EFT in diabetic patients.

Materials and Methods: In this cross-sectional study, 92 diabetic patients and 40 healthy volunteers without diabetes, admitted to our outpatient clinic, were included. Demographic data, anthropometric measurements, biochemical and hematological results, echocardiography findings and EFT were recorded. NLR and PLR were calculated. These values were compared statistically between the two groups.

Results: The two groups were similar in terms of age, gender, smoking status, diastolic blood pressure, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein and PLR. Body mass index (BMI), frequency of hypertension, systolic blood pressure, serum glucose, HbA1C, serum creatinine, triglyceride, total cholesterol/HDL, NLR and EFT were significantly higher in the diabetic group than the control group. Ejection fraction was significantly lower in diabetic group than the controls. NLR and BMI were independent predictors of EFT in diabetic patients.

Conclusion: We suggest that echocardiographic EFT measurement, NLR and BMI might be useful in the evaluation of cardiovascular risk in diabetic patients.


References

  • 1. Doupis J, Lyons TE, Wu S, Gnardellis C, Dinh T, Veves A. Microvascular reactivity and inflammatory cytokines in painful and painless peripheral diabetic neuropathy. The Journal of Clinical Endocrinology & Metabolism. 2009;94(6):2157-63.2. Fujita T, Hemmi S, Kajiwara M, Yabuki M, Fuke Y, Satomura A, et al. Complement‐mediated chronic inflammation is associated with diabetic microvascular complication. Diabetes/metabolism research and reviews. 2013;29(3):220-6.3. Coutinho M, Gerstein HC, Wang Y, Yusuf S. The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. Diabetes care. 1999;22(2):233-40.4. Wang T, Liu Q, Liu C, Sun L, Li D, Liu A, et al. Correlation of echocardiographic epicardial fat thickness with severity of coronary artery disease in patients with acute myocardial infarction. Echocardiography (Mount Kisco, NY). 2014;31(10):1177-81.5. Wu Y, Zhang A, Hamilton DJ, Deng T. Epicardial Fat in the Maintenance of Cardiovascular Health. Methodist DeBakey cardiovascular journal. 2017;13(1):20-4.6. Nunez J, Nunez E, Bodi V, Sanchis J, Minana G, Mainar L, et al. Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction. Am J Cardiol. 2008;101(6):747-52.7. Tamhane UU, Aneja S, Montgomery D, Rogers E-K, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. The American journal of cardiology. 2008;102(6):653-7.8. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography. 2015;28(1):1-39.e14.9. Szuszkiewicz-Garcia MM, Davidson JA. Cardiovascular disease in diabetes mellitus: risk factors and medical therapy. Endocrinology and metabolism clinics of North America. 2014;43(1):25-40.10. Bhat T, Teli S, Rijal J, Bhat H, Raza M, Khoueiry G, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert review of cardiovascular therapy. 2013;11(1):55-9.11. Tsai JC, Sheu SH, Chiu HC, Chung FM, Chang DM, Chen MP, et al. Association of peripheral total and differential leukocyte counts with metabolic syndrome and risk of ischemic cardiovascular diseases in patients with type 2 diabetes mellitus. Diabetes Metab Res Rev. 2007;23(2):111-8.12. Azab B, Chainani V, Shah N, McGinn JT. Neutrophil-lymphocyte ratio as a predictor of major adverse cardiac events among diabetic population: a 4-year follow-up study. Angiology. 2013;64(6):456-65.13. Valensi P, Avignon A, Sultan A, Chanu B, Nguyen MT, Cosson E. Atherogenic dyslipidemia and risk of silent coronary artery disease in asymptomatic patients with type 2 diabetes: a cross-sectional study. 2016;15(1):104.14. Raffield LM, Hsu FC, Cox AJ, Carr JJ, Freedman BI, Bowden DW. Predictors of all-cause and cardiovascular disease mortality in type 2 diabetes: Diabetes Heart Study. Diabetology & metabolic syndrome. 2015;7:58.15. Onat A, Yildirim B, Erer B, Başar Ö, Çetinkaya A, Ceyhan K, et al. Total kolesterol/HDL-kolesterol oranı koroner hastalığın en iyi lipid öngördürücüsü: Trigliserid ortalama düzeyimiz yılda 1 mg yükselme gösteriyor. TÜRK KARDİYOLOJİ DERNEĞİ ARŞİVİ. 2001;29(6):334-43.16. Xiao G, Zhu S, Xiao X, Yan L, Yang J, Wu G. Comparison of laboratory tests, ultrasound, or magnetic resonance elastography to detect fibrosis in patients with nonalcoholic fatty liver disease: A meta-analysis. Hepatology (Baltimore, Md). 2017;66(5):1486-501.17. Sargeant LA, Bennett FI, Forrester TE, Cooper RS, Wilks RJ. Predicting incident diabetes in Jamaica: the role of anthropometry. Obesity research. 2002;10(8):792-8.18. Garcia-Labbe D, Ruka E, Bertrand OF, Voisine P, Costerousse O, Poirier P. Obesity and coronary artery disease: evaluation and treatment. The Canadian journal of cardiology. 2015;31(2):184-94.19. Lee JJ, Pedley A, Hoffmann U, Massaro JM, Fox CS. Association of Changes in Abdominal Fat Quantity and Quality With Incident Cardiovascular Disease Risk Factors. Journal of the American College of Cardiology. 2016;68(14):1509-21.20. Fitzgibbons TP, Czech MP. Epicardial and perivascular adipose tissues and their influence on cardiovascular disease: basic mechanisms and clinical associations. Journal of the American Heart Association. 2014;3(2):e000582.21. Gonzalez N, Moreno-Villegas Z, Gonzalez-Bris A, Egido J, Lorenzo O. Regulation of visceral and epicardial adipose tissue for preventing cardiovascular injuries associated to obesity and diabetes. Cardiovascular diabetology. 2017;16(1):44.22. Akbas EM, Hamur H, Demirtas L, Bakirci EM, Ozcicek A, Ozcicek F, et al. Predictors of epicardial adipose tissue in patients with type 2 diabetes mellitus. Diabetology & metabolic syndrome. 2014;6:55.23. Ozcicek A, Ozcicek F, Yildiz G, Timuroglu A, Demirtas L, Buyuklu M, et al. Neutrophil-to-lymphocyte ratio as a possible indicator of epicardial adipose tissue in patients undergoing hemodialysis. Archives of medical science : AMS. 2017;13(1):118-23.
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Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research
Authors

Yaşar Turan 0000-0002-2796-899X

Elif Turan 0000-0002-8228-6932

Publication Date December 29, 2019
Acceptance Date April 9, 2019
Published in Issue Year 2019 Volume: 44 Issue: 4

Cite

MLA Turan, Yaşar and Elif Turan. “Neutrophil-to-Lymphocyte Ratio Independently Predicts the Epicardial Fat Thickness in Diabetic Patients”. Cukurova Medical Journal, vol. 44, no. 4, 2019, pp. 1333-8, doi:10.17826/cumj.531969.