Amaç: Monositin yüksek yoğunluklu lipoprotein kolesterole (HDL-K) oranlanmasıyla hesaplanan MHR değerlerinin artışı, son zamanlarda inflamasyon ve oksidatif stres ölçütü olarak değerlendirilen bir parametredir. Kardiyovasküler hastalıklarla ve karotis arter patolojileriyle ilişkilendirildiği veriler mevcuttur. Bu çalışmanın amacı ‘MHR iskemik inmenin etyolojisinde suçlanan bu patolojilerin ayrımında yönlendirici olabilecek bir parametre olabilir mi?’ sorusuna cevap aramaktır.
Yöntem: Akut iskemik inme tanısıyla tedavi edilen 200 hastanın kaydı retrospektif olarak incelendi. Hastalardan semptomlarının ilk 24 saati içinde nörolojik muayenesi, nöroradyolojik görüntülemesi (difüzyon mrg ve/veya BBT ile) ve monosit ve HDL-K tetkikleri tamamlanmış, yatışı süresince etyolojiye yönelik tetkikleri sonuçlanan, dışlama kriterleri göz önünde tutularak seçilenler, TOAST sınıflamasına göre gruplandırıldı. Ölçülen monosit değerleri, HDL-K değerleri ve monosit/HDL-K oranlanmasıyla elde edilen MHR değerleri TOAST gruplarına, eşlik eden hastalıklara ve cinsiyete göre istatistiksel olarak incelendi.
Bulgular: MHR açısından TOAST grupları arasında istatistiksel olarak anlamlı farklılık gözlenmeksizin erkeklerde ve diyabetik olanlarda MHR değerinde istatistiksel olarak anlamlı yükseklik mevcuttu.
Sonuç: MHR, inmenin etyolojiye bağlı alt grupları arasında herhangi bir farklılık göstermediği için bu grupların tahmininde kullanılması uygun bir parametre değildir
İstatistiksel Analiz Değerlendirmesi ve Yardımları için Prof Dr Yavuz Köksal'a teşekkür ederim
Kaynakça
1-Wu TH, Chien KL, Lin HJ, Hsu HC, Su TC, Chen MF, et al. Total white blood cell count or neutrophil count predict ischemic stroke events among adult Taiwanese: report from a community-based cohort study. BMC Neurol 2013 15; 13:7.
2-Boehme AK, Kumar AD, Lyerly MJ, Gillette MA, Siegler JE, Albright KC, et al. Persistent leukocytosis-is this a persistent problem for patients with acute ischemic stroke? J Stroke Cerebrovasc Dis 2014; 23(7): 1939-43.
3-Furlan JC, Vergouwen MD, Fang J, Silver FL. White blood cell count is an independent predictor of outcomes after acute ischaemic stroke. Eur J Neurol 2014; 21(2): 215-22.
4- Zia E, Melander O, Björkbacka H, Hedblad B, Engström G. Total and differential leucocyte counts in relation to incidence of stroke subtypes and mortality: a prospective cohort study. J Intern Med. 2012; 272(3): 298-304.
5-Chiba T, Umegaki K. Pivotal roles of monocytes/macrophages in stroke. Mediators Inflamm 2013;2013:759103.
6-Gu L, Jian Z, Stary C, Xiong X. T Cells and Cerebral Ischemic Stroke. Neurochem Res 2015; 40(9): 1786-91.
7-Jaipersad AS, Lip GY, Silverman S, Shantsila E. The role of monocytes in angiogenesis and atherosclerosis. J Am Coll Cardiol 2014; 63(1): 1-11.
8-Nagao M, Nakajima H, Toh R, Hirata KI, Ishida T. Cardioprotective Effects of High-Density Lipoprotein Beyond its Anti-Atherogenic Action. J Atheroscler Thromb 2018; 25(10): 985-993.
9-Liu H, Zhan F, Wang Y. Evaluation of monocyte-to-high-density lipoprotein cholesterol ratio and monocyte-to-lymphocyte ratio in ischemic stroke. J Int Med Res 2020; 48(7) :300060520933806.
10-Wang HY, Shi WR, Yi X, Zhou YP, Wang ZQ, Sun YX. Assessing the performance of monocyte to high-density lipoprotein ratio for predicting ischemic stroke: insights from a population-based Chinese cohort. Lipids Health Dis 2019; 18(1):127.
11-Xi J, Men S, Nan J, Yang Q, Dong J. The blood monocyte to high density lipoprotein cholesterol ratio (MHR) is a possible marker of carotid artery plaque. Lipids Health Dis 2022; 21(1):130.
12-Adili A, Wang Y, Zhu X, Cao H, Fan F, Tang X, et al. Preoperative monocyte-to-HDL-cholesterol ratio predicts early recurrence after radiofrequency maze procedure of valvular atrial fibrillation. J Clin Lab Anal 2021; 35(2): e23595.
13-Chen BW, Liu JJ, Xing JH, Liu HD, Wei YZ, Xue XF, et al. Analysis of the Correlation Between the Ratio of Monocytes to High-Density Lipoprotein Cholesterol and in-Stent Restenosis in Patients with Premature Coronary Heart Disease. Clin Appl Thromb Hemost 2022; 28: 10760296221079334.
14-Liu HT, Jiang ZH, Yang ZB, Quan XQ. Monocyte to high-density lipoprotein ratio predict long-term clinical outcomes in patients with coronary heart disease: A meta-analysis of 9 studies. Medicine 2022; 101(33): e30109.
15-Bolayir A, Gokce SF, Cigdem B, Bolayir HA, Yildiz OK, Bolayir E, et al. Monocyte/high-density lipoprotein ratio predicts the mortality in ischemic stroke patients. Neurol Neurochir Pol 2018; 52(2): 150-155.
16-Wang Y, Cheng Y, Song Q, Wei C, Liu J, Wu B, et al. The association between monocyte to high-density lipoprotein ratio and hemorrhagic transformation in patients with acute ischemic stroke. Aging 2020; 12(3): 2498-2506.
17-Chen PH, Gao S, Wang YJ, Xu AD, Li YS, Wang D. Classifying Ischemic Stroke, from TOAST to CISS. CNS Neurosci Ther 2012; 18(6): 452-6.
18-Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, et al. 3rd. 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(1): 35-41.
19-Li Y, Chen D, Sun L, Chen Z, Quan W. Monocyte/High-Density Lipoprotein Ratio Predicts the Prognosis of Large Artery Atherosclerosis Ischemic Stroke. Front Neurol 2021;12 :769217.
20- Mao X, Yu Q, Liao Y, Huang Q, Luo S, Li S, et al Lymphocyte-to-Monocyte Ratio Is Independently Associated with Progressive Infarction in Patients with Acute Ischemic Stroke. Biomed Res Int 2022; 2022:2290524.
21-Amouzegar A, Mirzaasgari Z, Mehrabi A, Malek M, Alaei-Shahmiri F, Najafi L, et al. Association of monocyte/high-density lipoprotein cholesterol ratio and the carotid intima-media thickness in diabetic patients. BMC Endocr Disord 2022; 22(1): 323.
22-Wu D, Lan Y, Xu Y, Xu S, Huang Y, Balmer L, et al. Association of cumulative monocyte to high-density lipoprotein ratio with the risk of type 2 diabetes: a prospective cohort study. Cardiovasc Diabetol 2022; 21(1): 268.
23-Zhou Y, Dan H, Bai L, Jia L, Lu B, Gu G, et al. Continuous Positive Linear Association between the Monocyte to High-Density Lipoprotein Cholesterol Ratio and Hypertension: A Cross-Sectional Study. Int J Hypertens 2022; 2022:8501726.
Comparison of Monocyte/Hdl-C Ratıos in Sub-Groups of Ischemıc Stroke According to Etiology
Abstract
Background/Aim:The increase in (MHR) values calculated by the ratio of monocyte to high-density lipoprotein cholesterol (HDL-C) is a parameter that has recently been evaluated as a measure of inflammation and oxidative stress.There are data associated with cardiovascular diseases and carotid artery pathologies.The aim of this study is to seek an answer to the question "Can MHR be a guiding parameter in the differentiation of these pathologies that are blamed in the etiology of ischemic stroke?"
Methods:The records of 200 patients with the diagnosis of acute ischemic stroke and whose neurological examination, neuroradiological imaging and monocyte and HDL-C examinations were completed within the first 24 hours after the onset of symptoms were evaluated retrospectively. They were grouped according to the TOAST classification.Measured monocyte values, HDL-C values and MHR values obtained by monocyte/HDL-C ratio were analyzed statistically according to TOAST groups, comorbid diseases and gender.
Results:There was a statistically significant increase in MHR in male and in diabetics, without any statistically significant difference between TOAST groups in terms of MHR.
Conclusion:MHR is not an appropriate parameter to use in the estimation of these groups, as it does not show any difference between the subgroups of stroke depending on the etiology.
1-Wu TH, Chien KL, Lin HJ, Hsu HC, Su TC, Chen MF, et al. Total white blood cell count or neutrophil count predict ischemic stroke events among adult Taiwanese: report from a community-based cohort study. BMC Neurol 2013 15; 13:7.
2-Boehme AK, Kumar AD, Lyerly MJ, Gillette MA, Siegler JE, Albright KC, et al. Persistent leukocytosis-is this a persistent problem for patients with acute ischemic stroke? J Stroke Cerebrovasc Dis 2014; 23(7): 1939-43.
3-Furlan JC, Vergouwen MD, Fang J, Silver FL. White blood cell count is an independent predictor of outcomes after acute ischaemic stroke. Eur J Neurol 2014; 21(2): 215-22.
4- Zia E, Melander O, Björkbacka H, Hedblad B, Engström G. Total and differential leucocyte counts in relation to incidence of stroke subtypes and mortality: a prospective cohort study. J Intern Med. 2012; 272(3): 298-304.
5-Chiba T, Umegaki K. Pivotal roles of monocytes/macrophages in stroke. Mediators Inflamm 2013;2013:759103.
6-Gu L, Jian Z, Stary C, Xiong X. T Cells and Cerebral Ischemic Stroke. Neurochem Res 2015; 40(9): 1786-91.
7-Jaipersad AS, Lip GY, Silverman S, Shantsila E. The role of monocytes in angiogenesis and atherosclerosis. J Am Coll Cardiol 2014; 63(1): 1-11.
8-Nagao M, Nakajima H, Toh R, Hirata KI, Ishida T. Cardioprotective Effects of High-Density Lipoprotein Beyond its Anti-Atherogenic Action. J Atheroscler Thromb 2018; 25(10): 985-993.
9-Liu H, Zhan F, Wang Y. Evaluation of monocyte-to-high-density lipoprotein cholesterol ratio and monocyte-to-lymphocyte ratio in ischemic stroke. J Int Med Res 2020; 48(7) :300060520933806.
10-Wang HY, Shi WR, Yi X, Zhou YP, Wang ZQ, Sun YX. Assessing the performance of monocyte to high-density lipoprotein ratio for predicting ischemic stroke: insights from a population-based Chinese cohort. Lipids Health Dis 2019; 18(1):127.
11-Xi J, Men S, Nan J, Yang Q, Dong J. The blood monocyte to high density lipoprotein cholesterol ratio (MHR) is a possible marker of carotid artery plaque. Lipids Health Dis 2022; 21(1):130.
12-Adili A, Wang Y, Zhu X, Cao H, Fan F, Tang X, et al. Preoperative monocyte-to-HDL-cholesterol ratio predicts early recurrence after radiofrequency maze procedure of valvular atrial fibrillation. J Clin Lab Anal 2021; 35(2): e23595.
13-Chen BW, Liu JJ, Xing JH, Liu HD, Wei YZ, Xue XF, et al. Analysis of the Correlation Between the Ratio of Monocytes to High-Density Lipoprotein Cholesterol and in-Stent Restenosis in Patients with Premature Coronary Heart Disease. Clin Appl Thromb Hemost 2022; 28: 10760296221079334.
14-Liu HT, Jiang ZH, Yang ZB, Quan XQ. Monocyte to high-density lipoprotein ratio predict long-term clinical outcomes in patients with coronary heart disease: A meta-analysis of 9 studies. Medicine 2022; 101(33): e30109.
15-Bolayir A, Gokce SF, Cigdem B, Bolayir HA, Yildiz OK, Bolayir E, et al. Monocyte/high-density lipoprotein ratio predicts the mortality in ischemic stroke patients. Neurol Neurochir Pol 2018; 52(2): 150-155.
16-Wang Y, Cheng Y, Song Q, Wei C, Liu J, Wu B, et al. The association between monocyte to high-density lipoprotein ratio and hemorrhagic transformation in patients with acute ischemic stroke. Aging 2020; 12(3): 2498-2506.
17-Chen PH, Gao S, Wang YJ, Xu AD, Li YS, Wang D. Classifying Ischemic Stroke, from TOAST to CISS. CNS Neurosci Ther 2012; 18(6): 452-6.
18-Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, et al. 3rd. 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(1): 35-41.
19-Li Y, Chen D, Sun L, Chen Z, Quan W. Monocyte/High-Density Lipoprotein Ratio Predicts the Prognosis of Large Artery Atherosclerosis Ischemic Stroke. Front Neurol 2021;12 :769217.
20- Mao X, Yu Q, Liao Y, Huang Q, Luo S, Li S, et al Lymphocyte-to-Monocyte Ratio Is Independently Associated with Progressive Infarction in Patients with Acute Ischemic Stroke. Biomed Res Int 2022; 2022:2290524.
21-Amouzegar A, Mirzaasgari Z, Mehrabi A, Malek M, Alaei-Shahmiri F, Najafi L, et al. Association of monocyte/high-density lipoprotein cholesterol ratio and the carotid intima-media thickness in diabetic patients. BMC Endocr Disord 2022; 22(1): 323.
22-Wu D, Lan Y, Xu Y, Xu S, Huang Y, Balmer L, et al. Association of cumulative monocyte to high-density lipoprotein ratio with the risk of type 2 diabetes: a prospective cohort study. Cardiovasc Diabetol 2022; 21(1): 268.
23-Zhou Y, Dan H, Bai L, Jia L, Lu B, Gu G, et al. Continuous Positive Linear Association between the Monocyte to High-Density Lipoprotein Cholesterol Ratio and Hypertension: A Cross-Sectional Study. Int J Hypertens 2022; 2022:8501726.