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Xanthelasma Palpebrarum is Associated with Higher Levels of Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratio

Year 2018, , 63 - 69, 26.03.2018
https://doi.org/10.31832/smj.370441

Abstract

Background:
According
to many epidemiologic studies, Xanthelasma Palpebrarum (XP) is thought to be a
determinant of an increased risk of atherosclerosis. Many studies have show
that inflammation plays an important role in the progress of atherosclerosis. Platelet
to lymphocyte ratio (PLR) and Neutrophil to lymphocyte ratio (NLR) is a marker
of systemic inflammation that correlates with mortality and cardiac events in
several cardiovascular diseases. We aimed to investigate the relationship
between PLR, NLR and XP in this study.

Methods: Sixty-six  subjects with XP and age and sex matched 66 control
subjects were enrolled in the present study.
Patients with known atherosclerotic vascular diseases
were excluded. Baseline characteristics such as presence of hypertension,
diabetes mellitus, hyperlipidemia, cigarette smoking history, medications and
hematological parameters were compared between the two groups.

Results: Subjects
with XP had higher levels of total cholesterol (
217±54 mg/dl vs. 197±41mg/dl, p=0.04), low density lipoprotein cholesterol  (143±45 mg/dl vs. 120±33 mg/dl, p=0.002), triglyceride levels (174±91 vs. 149±95, p=0.02), NLR (1.8±0.8 vs. 1.5±0.5,
p=0.004) and
PLR (117±35 vs. 100±29,
p=0.004)  than those in control subjects.







Conclusion: In the present study we
found that NLR and PLR levels, which are indicative of systemic inflammation
and multiple adverse cardiovascular outcomes, were higher in the XP patients.
This suggests that XP patients may need a close follow-up for cardiac risk
factors. 

References

  • Referans 1. Christoffersen M, Frikke-Schmidt R, Schnohr P, Jensen GB, Nordestgaard BG, Tybjærg-Hansen A. Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort study. BMJ. 2011; 343: d5497.
  • Referans 2. Pandhi D, Gupta P, Singal A, Tondon A, Sharma S, Madhu SV. Xanthelasma palpebrarum: a marker of premature atherosclerosis (risk of atherosclerosis in xanthelasma). Postgrad Med J. 2012; 88: 198-204.
  • Referans 3. Bergman R. Xanthelasma palpebrarum and risk of atherosclerosis. Int J Dermatol. 1998; 37:343-5.
  • Referans 4. Akyüz AR, Turan T, Erkuş ME, Gürbak İ, Kul S, Korkmaz L, et al. Xanthelasma palpebrarum associated with increased cardio-ankle vascular index in asymptomatic subjects. Wien Klin Wochenschr. 2016 Mar 14. [Epub ahead of print]
  • Referans 5. A. Jain, P. Goyal, P. K. Nigam, H. Gurbaksh, R. C. Sharma, “Xanthelasma palpebrarum-clinical and biochemical profile in a tertiary care hospital of Delhi,”The Indian Journal of Clinical Biochemistry, vol. 22, no. 2, pp. 151–153, 2007.
  • Referans 6. Demir K, Avci A, Altunkeser BB, Yilmaz A, Keles F, Ersecgin A. The relation between neutrophil-to-lymphocyte ratio and coronary chronic total occlusions. BMC Cardiovasc Disord. 2014; 14: 130.
  • Referans 7. Polano MK, Freedberg IM. Cutaneous lesions in nutritional, metabolic and heritable disorders. In: Fitzpatrick TB, Eisen AZ, eds. Fitzpatrick’s Dermatology in General Medicine New York: McGraw-Hill, 2003: 1466–1474.
  • Referans 8. Montgomery H, Osterberg A. Xanthomatosis: correlation of clinical, histopathologic, and chemical studies of cutaneous xanthoma. Arch Dermatol 1938; 37 : 373–401.
  • Referans 9. Vacca JB, Knight WA, Broun GO. Clinical observations regarding xanthelasma. Ann Intern Med 1959; 51 : 1019-31.
  • Referans 10. Segal P, Insull W, Chambless LE, Stinnett S, LaRosa JC, Weissfeld L, et al. The association of dyslipoproteinemia with corneal arcus and xanthelasma. Circulation 1986; 73: 108-18.
  • Referans 11. Ozdol S, Sahin S, Tokgozoglu L. Xanthelasma palpebrarum and its relation to atherosclerotic risk factors and lipoprotein (a). Int J Dermatol. 2008; 47: 785-9.
  • Referans 12. Gomez M, Gonzales MJ, de Moragas JM, Serrat J, Gónzalez-Sastre F, Pérez M. Apolipoprotein-E phenotypes, lipoprotein composition, and xanthelasmas. Arch Dermatol 1988; 124: 1230-4.
  • Referans 13. Bergman R. The pathogenesis and clinical significance of xanthelasma palpebrarum. J Am Acad Dermatol 1994; 30: 236-42.
  • Referans 14. Guasti L, Dentali F, Castiglioni L, Maroni L, Marino F, Squizzato A, et al. Neutrophils and clinical outcomes in patients with acute coronary syndromes and/or cardiac revascularisation. A systematic review on more than 34,000 subjects. Thromb Haemost 2011, 106: 591-9.
  • Referans 15. Uthamalingam S, Patvardhan EA, Subramanian S, Ahmed W, Martin W, Daley M, et al. Utility of the neutrophil to lymphocyte ratio in predicting long-term outcomes in acute decompensated heart failure. Am J Cardiol 2011, 107: 433-8.
  • Referans 16. Cooper HA, Exner DV, Waclawiw MA, Domanski MJ. White blood cell count and mortality in patients with ischemic and nonischemic left ventricular systolic dysfunction (an analysis of the Studies Of Left Ventricular Dysfunction [SOLVD]) Am J Cardiol 1999; 84: 252-7.
  • Referans 17. Floudas CS, Yiakoumis X, Tsironi M, Aessopos A. Reversible Normolipemic Xanthelasma Palpebrarum Associated with Inflammation in Castleman's Disease. European Journal of Inflammation 2008; 6: 95-98
  • Referans 18. Sunbul M, Gerin F, Durmus E, Kivrak T, Sari I, Tigen K, et al. Neutrophil to lymphocyte and platelet to lymphocyte ratio in patients with dipper versus non-dipper hypertension. Clin Exp Hypertens 2014; 36: 217-21.
  • Referans 19. Açar G, Kalkan ME, Avci A, Alizade E, Tabakci MM, Toprak C, et al. The relation of platelet-lymphocyte ratio and coronary collateral circulation in patients with stable angina pectoris and chronic total occlusion. Clin Appl Thromb Hemost 2015; 21: 462-8.
  • Referans 20. Gary T, Pichler M, Belaj K, Hafner F, Gerger A, Froehlich H, et al. Platelet-to-lymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients. PLoS One 2013;8:e67688.

Xanthelasma Palpebrarum Artmış Nötrofil/Lenfosit ve Platelet/Lenfosit Oranı ile İlişkilidir

Year 2018, , 63 - 69, 26.03.2018
https://doi.org/10.31832/smj.370441

Abstract

Giriş: Epidemiyolojik
çalışmalarda, Xanthelasma Palpebrarum (XP) artmış ateroskleroz riskinin
belirleyicisi olduğu görülmüştür. Birçok çalışma, inflamasyonun ateroskleroz
gelişiminde önemli bir rol oynadığını göstermektedir. Trombosit / lenfosit
oranı ve nötrofil / lenfosit oranı , çeşitli kardiyovasküler hastalıklarda
mortalite ve kardiyak olaylarla ilişkili olan sistemik inflamasyonun bir
işaretidir. Bu çalışmada, trombosit / lenfosit oranı ve nötrofil / lenfosit
oranı ile XP arasındaki ilişkiyi araştırmayı amaçladık.

Metod: Çalışmaya
66 XP olan ve yaş, cinsiyet eşleştirilmiş 66 kontrol hasta alındı. Bilinen
aterosklerotik vasküler hastalığı olanlar çalışma dışı bırakıldı. Her iki
grupta hipertansiyon, diabetes mellitus, hiperlipidemi, sigara kullanımı
öyküsü, medikal tedavi öyküsü ve hematolojik parametreler gibi temel özellikler
karşılaştırıldı.

Sonuç: XP
olan olguların total kolestrol seviyeleri (217 ± 54 mg / dl'a karşılık 197 ± 41
mg / dl, p = 0.04), düşük yoğunluklu lipoprotein kolesterol düzeyleri (143 ± 45
mg / dl'ye karşı 120 ± 33 mg / dl, p = 0.002), trigliserit düzeyleri (174 ± 91
karşı 149 ± 95, p = 0.02), nötrofil/lenfosit 
(1.8 ± 0.8'e karşı 1.5 ± 0.5, p = 0.004) ve platelet/lenfosit (117 ±
35'e karşı 100 ± 29, p = 0.004) kontrol gruptan daha yüksekti.

Tartışma: Bu
çalışmada, XP hastalarında sistemik inflamasyon ve istenmeyen kardiyovasküler
sonuçların göstergesi olan nötrofil/lenfosit oranı ve platelet/lenfosit oranı
düzeylerinin daha yüksek olduğunu bulduk. Bu, XP hastalarının kardiyak risk
faktörleri için yakın izlem gerektirebileceğini göstermektedir.









 

References

  • Referans 1. Christoffersen M, Frikke-Schmidt R, Schnohr P, Jensen GB, Nordestgaard BG, Tybjærg-Hansen A. Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort study. BMJ. 2011; 343: d5497.
  • Referans 2. Pandhi D, Gupta P, Singal A, Tondon A, Sharma S, Madhu SV. Xanthelasma palpebrarum: a marker of premature atherosclerosis (risk of atherosclerosis in xanthelasma). Postgrad Med J. 2012; 88: 198-204.
  • Referans 3. Bergman R. Xanthelasma palpebrarum and risk of atherosclerosis. Int J Dermatol. 1998; 37:343-5.
  • Referans 4. Akyüz AR, Turan T, Erkuş ME, Gürbak İ, Kul S, Korkmaz L, et al. Xanthelasma palpebrarum associated with increased cardio-ankle vascular index in asymptomatic subjects. Wien Klin Wochenschr. 2016 Mar 14. [Epub ahead of print]
  • Referans 5. A. Jain, P. Goyal, P. K. Nigam, H. Gurbaksh, R. C. Sharma, “Xanthelasma palpebrarum-clinical and biochemical profile in a tertiary care hospital of Delhi,”The Indian Journal of Clinical Biochemistry, vol. 22, no. 2, pp. 151–153, 2007.
  • Referans 6. Demir K, Avci A, Altunkeser BB, Yilmaz A, Keles F, Ersecgin A. The relation between neutrophil-to-lymphocyte ratio and coronary chronic total occlusions. BMC Cardiovasc Disord. 2014; 14: 130.
  • Referans 7. Polano MK, Freedberg IM. Cutaneous lesions in nutritional, metabolic and heritable disorders. In: Fitzpatrick TB, Eisen AZ, eds. Fitzpatrick’s Dermatology in General Medicine New York: McGraw-Hill, 2003: 1466–1474.
  • Referans 8. Montgomery H, Osterberg A. Xanthomatosis: correlation of clinical, histopathologic, and chemical studies of cutaneous xanthoma. Arch Dermatol 1938; 37 : 373–401.
  • Referans 9. Vacca JB, Knight WA, Broun GO. Clinical observations regarding xanthelasma. Ann Intern Med 1959; 51 : 1019-31.
  • Referans 10. Segal P, Insull W, Chambless LE, Stinnett S, LaRosa JC, Weissfeld L, et al. The association of dyslipoproteinemia with corneal arcus and xanthelasma. Circulation 1986; 73: 108-18.
  • Referans 11. Ozdol S, Sahin S, Tokgozoglu L. Xanthelasma palpebrarum and its relation to atherosclerotic risk factors and lipoprotein (a). Int J Dermatol. 2008; 47: 785-9.
  • Referans 12. Gomez M, Gonzales MJ, de Moragas JM, Serrat J, Gónzalez-Sastre F, Pérez M. Apolipoprotein-E phenotypes, lipoprotein composition, and xanthelasmas. Arch Dermatol 1988; 124: 1230-4.
  • Referans 13. Bergman R. The pathogenesis and clinical significance of xanthelasma palpebrarum. J Am Acad Dermatol 1994; 30: 236-42.
  • Referans 14. Guasti L, Dentali F, Castiglioni L, Maroni L, Marino F, Squizzato A, et al. Neutrophils and clinical outcomes in patients with acute coronary syndromes and/or cardiac revascularisation. A systematic review on more than 34,000 subjects. Thromb Haemost 2011, 106: 591-9.
  • Referans 15. Uthamalingam S, Patvardhan EA, Subramanian S, Ahmed W, Martin W, Daley M, et al. Utility of the neutrophil to lymphocyte ratio in predicting long-term outcomes in acute decompensated heart failure. Am J Cardiol 2011, 107: 433-8.
  • Referans 16. Cooper HA, Exner DV, Waclawiw MA, Domanski MJ. White blood cell count and mortality in patients with ischemic and nonischemic left ventricular systolic dysfunction (an analysis of the Studies Of Left Ventricular Dysfunction [SOLVD]) Am J Cardiol 1999; 84: 252-7.
  • Referans 17. Floudas CS, Yiakoumis X, Tsironi M, Aessopos A. Reversible Normolipemic Xanthelasma Palpebrarum Associated with Inflammation in Castleman's Disease. European Journal of Inflammation 2008; 6: 95-98
  • Referans 18. Sunbul M, Gerin F, Durmus E, Kivrak T, Sari I, Tigen K, et al. Neutrophil to lymphocyte and platelet to lymphocyte ratio in patients with dipper versus non-dipper hypertension. Clin Exp Hypertens 2014; 36: 217-21.
  • Referans 19. Açar G, Kalkan ME, Avci A, Alizade E, Tabakci MM, Toprak C, et al. The relation of platelet-lymphocyte ratio and coronary collateral circulation in patients with stable angina pectoris and chronic total occlusion. Clin Appl Thromb Hemost 2015; 21: 462-8.
  • Referans 20. Gary T, Pichler M, Belaj K, Hafner F, Gerger A, Froehlich H, et al. Platelet-to-lymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients. PLoS One 2013;8:e67688.
There are 20 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Selim Kul 0000-0001-8329-4603

Ali Rıza Akyüz 0000-0003-3327-7850

Publication Date March 26, 2018
Submission Date December 24, 2017
Published in Issue Year 2018

Cite

AMA Kul S, Akyüz AR. Xanthelasma Palpebrarum is Associated with Higher Levels of Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratio. Sakarya Tıp Dergisi. March 2018;8(1):63-69. doi:10.31832/smj.370441

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