AKUT İSKEMİK İNME HASTALARINDA YENİ BİR MARKIR: MONOSİT/HDL ORANI

Year 2020, Volume: 12 Issue: 1, 118 - 123, 02.03.2020

Aybala Neslihan Alagöz , Bilgehan Atılgan Acar , Belma Güngen Yeşim Aras , Türkan Acar

https://doi.org/10.18521/ktd.632555

Abstract

Amaç:

İnme,
dünyada major bir morbidite ve mortalite sebebidir. İskemik inmede genellikle inflamasyon
ve oksidatif strese bağlı hücre ölümü görülür. Nörolojik hastalıklarda
inflamasyonun rolü giderek daha da belirginleşmektedir. Çalışmamızda inmede
inflamasyon teorisini destekleyebilen ve klinik uygulamada kullanılabilecek
monosit / HDL oranını (MHO) inceledik.

Gereç ve Yöntem:

Çalışmamızda
91 akut iskemik inme hastası (47 kadın ve 44 erkek) ve 50 sağlıklı kontrol
kaydedildi.

Bulgular:

Hasta
grubunda MHO yüksek idi ve yüksek duyarlılıkta C-reaktif protein (hsCRP) ile
korele idi. MHO, Ulusal Sağlık Enstitüleri İnme Ölçeği (NIHSS) skoru yüksek
olan hastalarda, düşük NIHSS'li (p = 0.050) olanların yanı sıra, ve de daha
büyük bir infarkt alanı olanlarda daha küçük infarkt alanına sahip olanlara (p
= 0.050) göre daha yüksekti. MHO, yeni bir belirteç olarak, akut iskemik inme
hastalarında, hem klinik durum hem de infarkt alanı ile koreledir.

Sonuç:

91
akut iskemik inme hastasının, bu cross-sectional çalışması, inflamasyon belirteçlerinin
ve MHO'nin; klinik durum ve hatta radyolojik parametrelerle korele olduğunu
göstermektedir.

 

 

Keywords

akut iskemik inme, monosit/HDL oranı, inflamasyon, yeni markır

A New Marker in Acute Ischemic Stroke Patients: Monocyte / HDL Ratio

Abstract

Objective: Stroke is a major cause of global morbidity and mortality. Ischemic stroke
is usually marked by cell death associated with inflammation and oxidative
stress, and the role of inflammation in neurological diseases has become
increasingly obvious. In our study, we studied the monocyte / HDL ratio (MHR)
which can support the theory of inflammation in stroke and can be used in
clinical practice. MHR can be used a prognostic marker in stroke patients base
on this theory.

Method: Our study registered 91 acute ischemic stroke patients (47 females and 44
males) and 50 healthy controls.

Results: MHR was elevated in the patient group and correlated with high-sensitivity C-reactive
protein (hsCRP). MHR was higher in patients with high a National Institutes of
Health Stroke Scale (NIHSS) than those with a low NIHSS (p=0.050) as well as in
patients with a larger infarct area and in than those with a smaller area
(p=0.050). The MHR correlated with both the clinical condition and infarct area
in acute ischemic stroke patients, which underscores the value of MHR as a new
marker.

Conclusion: This cross-sectional study of 91 acute ischemic stroke patients indicates
that inflammation markers and MHR are correlated with clinical status and even
radiological parameters.

Keywords

acute ischemic stroke, monocyte/HDL ratio, İnflammation, New Marker

References

• 1.Sengupta D, Bardhan J, Baran A, Mahapatra S, Banerjee J, Rout JK. Correlation between lipid profile and carotid intima media thickness in cerebral ischemia. Indian J PhysiolPharmacol. 2014 Oct-Dec;58(4):354-64.
• 2.Chehaibi K, Trabelsi I, Mahdouani K, Slimane MN. Correlation of oxidative stress parameters and inflammatory markers in ischemic stroke patients. J Stroke Cerebrovasc Dis. 2016 Nov;25(11):2585-2593.
• 3.Lénárt N, Brough D, Dénes Á. Inflammasomes link vascular disease with neuroinflammation and brain disorders. J Cereb Blood Flow Metab. 2016 Oct;36(10):1668-1685.
• 4.Taleb S. Inflammation in atherosclerosis. Arch Cardiovasc Dis. 2016 Aug 29. pii: S1875-2136(16)30112-7.
• 5.Canpolat U, Çetin EH, Cetin S, et al. Association of monocyte-to-HDL cholesterol ratio with slow coronary flow is linked to systemic inflammation. ClinApplThrombHemost. 2016 Jul;22(5):476-82.
• 6.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; 80(5):1156-1164.
• 7.Kanbay M, Solak Y, Unal HU, et al. Monocyte count/HDL-C ratio and cardiovascular events in patients with chronic kidney disease. IntUrolNephrol. 2014;46(8): 1619-1625.
• 8.Bolayır A,Gokce SF, Cigdem B, et al. Monocyte/high density lipoprotein ratio predicts the mortality in ischemic stroke patients. Neurol Neurochir Pol. 2018 Mar;52(2):150-155. doi: 10.1016/j.pjnns.2017.08.011. Epub 2017 Aug 24.
• 9. Adams HP, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, Marsh EE. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of ORG 10172 in Acute Stroke Treatment. Stroke. 1993; 24:35–41.
• 10. Brott T, Adams HP, Jr., Olinger CP et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke 1989;20(7):864-70.
• 11.Minić GA. Leucocyte count indicates carotid plaque instability in stroke patients. Vojnosanit Pregl. 2016 Jun;73(6):515-25.
• 12.Matsuo R, Ago T, Hata J, et al. Plasma C-reactive protein and clinical outcomes after acute ischemic stroke: A prospective observational study. PLoS One. 2016 Jun 3;11(6):e0156790.
• 13.Leuschner F, Rauch PJ, Ueno T et al. Rapid monocyte kinetics in acute myocardial infarction are sustained by extramedullary monocytopoiesis. J Exp Med. 2012 Jan 16;209(1):123-37.
• 14.Ghattas A, Griffiths HR, Devitt A, Lip GY, Shantsila E. Monocytes in coronary artery disease and atherosclerosis: Where are we now? J Am CollCardiol. 2013;62(17):1541-1551.
• 15.Murphy AJ, Chin-Dusting JP, Sviridov D, Woollard KJ. The anti-inflammatory effects of high density lipoproteins. Curr Med Chem. 2009;16(6):667-675.
• 16.Murphy AJ, Woollard KJ. High-density lipoprotein: A potent inhibitor of inflammation. ClinExpPharmacol Physiol. 2010;37(7): 710-718.
• 17.Yvan-Charvet L, Pagler T, Gautier EL, et al. ATP-binding cassette transporters and HDL suppress hematopoietic stem cell proliferation. Science. 2010;328(5986):1689-1693.
• 18.Murphy AJ, Woollard KJ, Hoang A et al. High-density lipoprotein reduces the human monocyte inflammatory response. Arterioscler Thromb Vasc Biol. 2008 Nov; 28(11): 2071-7.
• 19.Wang N, Lan D, Chen W, Matsuura F, Tall AR. ATP-binding cassette transporters G1 and G4 mediate cellular cholesterol efflux to high-density lipoproteins. Proc Natl Acad Sci USA. 2004 Jun 29;101(26):9774-9.
• 20.Westerterp M, Gourion-Arsiquaud S, Murphy AJ, et al. Regulation of hematopoietic stem and progenitor cell mobilization by cholesterol efflux pathways. Cell Stem Cell. 2012 Aug 3;11(2):195-206.
• 21.Qiao JH, Tripathi J, Mishra NK, et al. Role of macrophage colony-stimulating factor in atherosclerosis: studies of osteopetrotic mice. Am J Pathol. 1997 May;150(5):1687-99.
• 22.Mestas J, Ley K. Monocyte-endothelial cell interactions in the development of atherosclerosis.Trends Cardiovasc Med. 2008 Aug;18(6):228-32.
• 23.Woollard KJ, Geissmann F. Monocytes in atherosclerosis: Subsets and functions. Nat Rev Cardiol. 2010 Feb;7(2):77-86. Rev.
• 24.Palmerini T, Coller BS, Cervi V, et al. Monocyte-derived tissue factor contributes to stent thrombosis in an in vitro system. J Am Coll Cardiol. 2004 Oct 19;44(8):1570-7.
• 25.Cicek G, Kundi H, Bozbay M, Yayla C, Uyarel H. The relationship between admission monocyte HDL-C ratio with short-term and long-term mortality among STEMI patients treated with successful primary PCI. Coron Artery Dis. 2016 May;27(3):176-84.
• 26. Algin A, Inan I. The role of radiologic, clinical and biochemical parameters in prediction of stroke mortality. Neurosciences (Riyadh). 2019 Apr;24(2):110-114.
• 27. Yaghi S, Herber C, Boehme AK, Andrews H, Willey JZ, Rostanski SK, et al. The Association between Diffusion MRI-Defined Infarct Volume and NIHSS Score in Patients with Minor Acute Stroke. J Neuroimaging 2017; 27: 388-391.