The role of triglyceride/high-density lipoprotein cholesterol ratio in the prediction of intensive care unit admission in the earthquake victims

Öz

Background: In the study of vascular and metabolic diseases, the ratio of triglycerides to high-density lipoprotein (HDL) cholesterol (TG/HDL) is crucial. Its significance for earthquake victims hasn't been fully investigated, though. This study investigates the relationship between the TG/HDL ratio and critical care unit admission in earthquake victims. Methods: Sixty-four patients were enrolled. Both the laboratory results and the clinical features were documented. The TG/HDL ratio's prognostic value for intensive care unit (ICU) admission was then evaluated using ROC curve analysis. Spearman test was applied to analyze correlation between TG/HDL-c and inflammation markers. Logistic regression analysis was then used to elucidate the independent contribution of the TG/HDL-c ratio to the ICU admission risk. Results: Median age of the cohort was 28 (IQR 17-40) and thirty-seven (57.8%) of the patients were female. 27 patients (42.2%) were admitted to ICU. In the multivariate model, the TG/HDL ratio was associated with higher risk of ICU admission (OR: 1.225, 95% CI: 1.003-1.496, p=0.047). The TG/HDL-c ratio may be a predictor of ICU admissions, according to the ROC curve (AUC: 0.737, 95% CI: 0.610-0.864, p=0.001). The TG/HDL ratio was positively correlated with procalcitonin (r = 0.620, p <0.001), white blood cells (r = 0.253, p = 0.044), and C-reactive protein (r = 0.410, p = 0.001). Conclusion: The present study suggests a potential role for the TG/HDL ratio as a non-invasive and readily available biomarker for the prediction of ICU admission in the earthquake victims.

Anahtar Kelimeler

• earthquake
• crush syndrome
• triglyceride
• high density lipoprotein cholesterol
• inflammation

Kaynakça

1. 1.Naddaf M. Turkey-Syria earthquake: whatscientists know. Nature2023;614:398-399.doi:10.1038/d41586-023-00364-y
2. 2.Efendi GY, Temeltürk RD, Çakmak IB, Dinçer M.Surviving the Immediate Aftermath of a Disaster: APreliminary Investigation of Adolescents' AcuteStress Reactions and Mental Health Needs after the2023 Turkey Earthquakes. Children (Basel)2023;10: 1485. doi:10.3390/children10091485
3. 3.Erdik M, Tümsa M, Pınar A, Altunel E, Zülfikar A. Apreliminary report on the February 6, 2023earthquakes in Türkiye. Research Briefs2023.
4. 4.Srivastava K. Disaster: Challenges andperspectives. Ind Psychiatry J2010;19:1-4.doi:10.4103/0972-6748.77623
5. 5.Kundakci B, Mirioglu A, Tekin M, et al. 6 February2023, orthopedic experience in Kahramanmaraşearthquake and surgical decision in patients withcrush syndrome. J Orthop Surg Res 2023;18:537.doi:10.1186/s13018-023-04001-2
6. 6.Vanholder R, Sever MS, Erek E, Lameire N.Rhabdomyolysis. J Am Soc Nephrol 2000; 11:1553-61.doi:10.1681/asn.V1181553
7. 7.Vanholder R, Sükrü Sever M, Lameire N. Kidneyproblems in disaster situations. Nephrol Ther2021;17s:S27-s36. doi:10.1016/j.nephro.2020.02.009
8. 8.Liu YZ, Wang YX, Jiang CL. Inflammation: TheCommon Pathway of Stress-Related Diseases. FrontHum Neurosci2017; 11:316.doi:10.3389/fnhum.2017.00316

9. 9.Chen L, Deng H, Cui H, et al. Inflammatoryresponses and inflammation-associated diseases inorgans. Oncotarget 2018; 9:7204-18.doi:10.18632/oncotarget.23208
10. 10.Bernardi S, Marcuzzi A, Piscianz E, Tommasini A,Fabris B. The Complex Interplay between Lipids,Immune System and Interleukins in Cardio-Metabolic Diseases. Int J Mol Sci.2018; 19: 4058.doi:10.3390/ijms19124058
11. 11.Ertunc ME, Hotamisligil GS. Lipid signaling andlipotoxicity in metaflammation: indications formetabolic disease pathogenesis and treatment. JLipid Res 2016; 57:2099-114.doi:10.1194/jlr.R066514
12. 12.Cheang I, Zhu X, Lu X, et al. Association ofremnant cholesterol and non-high densitylipoprotein cholesterol with risk of cardiovascularmortality among US general population.Heliyon2022; 8:e10050.doi:10.1016/j.heliyon.2022.e10050
13. 13.Pih GY, Gong EJ, Choi JY, et al. Associations ofSerum Lipid Level with Gastric Cancer Risk,Pathology, and Prognosis. Cancer Res Treat2021;53:445-56. doi:10.4143/crt.2020.599
14. 14.Boizel R, Benhamou PY, Lardy B, et al. Ratio oftriglycerides to HDL cholesterol is an indicator ofLDL particle size in patients with type 2 diabetes andnormal HDL cholesterol levels. Diabetes Care2000;23:1679-85. doi:10.2337/diacare.23.11.1679
15. 15.Pacifico L, Bonci E, Andreoli G, et al. Associationof serum triglyceride-to-HDL cholesterol ratio withcarotid artery intima-media thickness, insulinresistance and nonalcoholic fatty liver disease inchildren and adolescents. Nutr Metab CardiovascDis2014; 24:737-43.doi:10.1016/j.numecd.2014.01.010
16. 16.Yang SH, Du Y, Li XL, et al. Triglyceride to High-Density Lipoprotein Cholesterol Ratio andCardiovascular Events in Diabetics With CoronaryArtery Disease. Am J Med Sci2017;354:117-24.doi:10.1016/j.amjms.2017.03.032
17. 17.Jonas K, Magoń W, Podolec P, Kopeć G.Triglyceride-to-High-Density LipoproteinCholesterol Ratio and Systemic Inflammation inPatients with Idiopathic Pulmonary Arterial Hypertension. Med Sci Monit2019;25:746-53. doi:10.12659/msm.912766
18. 18.Rajagopalan S. Crush Injuries and the CrushSyndrome. Med J Armed Forces India2010; 66:317-20.doi:10.1016/s0377-1237(10)80007-3.
19. 19.Jin H, Lin X, Liu Z, et al. Remote ischemicpostconditioning protects against crush-inducedacute kidney injury via down-regulation ofapoptosis and senescence. Eur J Trauma Emerg Surg2022; 48(6):4585-93. doi:10.1007/s00068-022-01910-5.
20. 20.Yang XY, Song J, Hou SK, et al. Ulinastatinameliorates acute kidney injury induced by crushsyndrome inflammation by modulating Th17/Tregcells. Int Immunopharmacol2020; 81:106265.doi:10.1016/j.intimp.2020.106265
21. 21.Murata I, Abe Y, Yaginuma Y, et al. Astragaloside-IV prevents acute kidney injury and inflammation bynormalizing muscular mitochondrial functionassociated with a nitric oxide protective mechanismin crush syndrome rats. Ann Intensive Care.2017;7:90. doi:10.1186/s13613-017-0313-2.
22. 22.Chen P, Tang Y, He W, et al. PotentialPathophysiological Mechanisms UnderlyingMultiple Organ Dysfunction in Cytokine ReleaseSyndrome. Mediators Inflamm2022; 2022:7137900.doi:10.1155/2022/7137900
23. 23.Khovidhunkit W, Kim MS, Memon RA, et al.Effects of infection and inflammation on lipid andlipoprotein metabolism: mechanisms andconsequences to the host. J Lipid Res. 2004;45:1169-96. doi:10.1194/jlr.R300019-JLR200
24. 24.Wendel M, Paul R, Heller AR. Lipoproteins ininflammation and sepsis. II. Clinical aspects.Intensive Care Med2007; 33:25-35.doi:10.1007/s00134-006-0433-x
25. 25.Peng J, Luo F, Ruan G, Peng R, Li X.Hypertriglyceridemia and atherosclerosis. LipidsHealth Dis2017; 16:233. doi:10.1186/s12944-017-0625-0
26. 26.Parra S, Saballs M, DiNubile M, et al. Low HDL-clevels at admission are associated with greaterseverity and worse clinical outcomes in patientswith COVID-19 disease. Atheroscler Plus 2023;52:1-8.doi:10.1016/j.athplu.2023.01.002
27. 27.Tanaka S, Labreuche J, Drumez E, et al. Low HDLlevels in sepsis versus trauma patients in intensivecare unit. Annals of Intensive Care2017;7:60.doi:10.1186/s13613-017-0284-3
28. 28.Sorokin AV, Karathanasis SK, Yang ZH, et al.COVID-19-Associated dyslipidemia: Implications formechanism of impaired resolution and noveltherapeutic approaches. Faseb j 2020; 34:9843-53.doi:10.1096/fj.202001451
29. 29.Tejera CH, Minnier J, Fazio S, et al. Hightriglyceride to HDL cholesterol ratio is associatedwith increased coronary heart disease among Whitebut not Black adults. Am J Prev Cardiol2021;7:100198. doi:10.1016/j.ajpc.2021.100198
30. 30.Peng F, Lei S, Zhang Q, Zhong Y, Wu S.Triglyceride/High-Density Lipoprotein CholesterolRatio is Associated with the Mortality of COVID-19:A Retrospective Study in China. Int J Gen Med 2022;15:985-96. doi:10.2147/ijgm.S346690