MONOSİT / YÜKSEK YOĞUNLUKLU LİPOPROTEİN KOLESTEROL ORANININ YAŞLI HASTALARDA DİYABETİN ŞİDDETİNİN PREDİKTİF BİR BELİRTECİ OLARAK DEĞERLENDİRİLMESİ

Öz

Amaç: Diabetes mellitus (DM), sıklığı yaşla birlikte artan, kronik hiperglisemi ve inflamasyon ile karakterize bir hastalıktır. Monosit/ yüksek yoğunluklu lipoprotein kolesterol oranı (MHR), çeşitli hastalıklarla ilişkili, son zamanlarda ortaya çıkan inflamatuar bir biyobelirteçtir. Yaşlı hastalarda DM'nin ciddiyetini belirlemede inflamasyona dayalı bir belirteç olan MHR'nin kullanımının faydasını araştırmayı amaçladık. Gereç ve Yöntem: Çalışmamızı retrospektif, kesitsel bir yapıda tasarladık. Araştırmanın populasyonu oluşturmak için, 01 Eylül 2022 - 01 Mart 2023 tarihleri arasında İstanbul Medipol Üniversitesi Hastanesi endokrinoloji polikliniğine başvuran 60 yaş üstü diyabetik hastalar uygunluk açısından değerlendirildi. Veriler elektronik tıbbi kayıtlardan toplandı. Yaş, cinsiyet ve laboratuvar bulguları kaydedildi. Bulgular: Toplam 148 yaşlı katılımcı (70 kadın, 78 erkek, ortalama yaş 69,17±5,74 yıl) analize dahil edildi. Yetersiz glisemik kontrolü olan hastalarda (HbA1c ≥%7) MHR, lökosit, nötrofil, lenfosit, monosit sayıları daha yüksek iken, yüksek yoğunluklu lipoprotein kolesterol (HDL-C) düzeyleri daha düşük saptandı (p <0,001, her ikisi için de). HbA1c ve MHR arasında orta derecede güçlü bir korelasyon vardı (r = 0,611, p <0,001). Düşük HDL-C ((OR = 0,88, (%95 CI: 0,82–0,94), p<0,001) (Model 1)) ve yüksek MHR ((OR: 1,45, %95 CI: 1,27-1,65, p <0,001) (Model 4)) bağımsız olarak yüksek HbA1c değerleri ile ilişkili bulundu. Sonuç: HDL-c ve MHR, diyabetik yaşlı hastalarda artmış HbA1c' yi öngörmede bağımsız faktörlerdi. Düşük HDL kolesterol düzeyleri, monosit sayılarına kıyasla artmış HbA1c'yi öngörme şiddetinde daha anlamlı bir role sahipti.

Anahtar Kelimeler

• Monosit/yüksek yoğunluklu lipoprotein oranı
• inflamasyon
• diabetes mellitus
• HbA1c
• yaşlı hasta

EVALUATION OF MONOCYTE TO HIGH-DENSITY LIPOPROTEIN CHOLESTEROL RATIO AS A PREDICTIVE MARKER OF DIABETES MELLITUS SEVERITY IN OLDER PATIENTS

Öz

Objective: Diabetes mellitus (DM) is a disease characterized by chronic hyperglycemia and inflammation, the frequency of which increases with age. The monocyte to high-density lipoprotein cholesterol ratio (MHR) is a recently emerging inflammatory biomarker associated with various diseases. We aimed to investigate the utility of the MHR as a clinically useful inflammation- based marker in determining the severity of DM in older patients. Material and Method: We designed our study in a retrospective, cross-sectional structure. The participants were assessed for eligibility from the population aged over 60 years of diabetic patients who were admitted to the Istanbul Medipol University Hospital endocrinology outpatient clinic between September 1st 2022, and March 1st, 2023. Data were collected from electronic medical records. Age, gender, and laboratory findings were recorded. Result: Overall, 148 older participants (70 females, 78 males, mean age 69.17±5.74 years) were included in the analysis. MHR, white blood cell, neutrophil, lymphocyte, and monocyte counts were higher, while high-density lipoprotein cholesterol (HDL-C) levels were lower in patients with inadequate glycemic control (HbA1c ≥7%) (p <0.001, for both of them). There was a moderately strong correlation between HbA1c and MHR (r = 0.611, p <0.001). Lower HDL-C ((OR = 0.88, (95% CI: 0.82–0.94), p < 0.001) (Model 1)) and higher MHR ((OR: 1.45, 95% CI: 1.27-1.65, p < 0.001) (Model 4)) were independently associated with increased HbA1c. Conclusion: HDL-C and MHR were independent factors in predicting an increased HbA1c in older diabetic patients. Lower HDL-C levels had a more significant role in the severity of predicting increased HbA1c compared to the monocyte counts.

Anahtar Kelimeler

• Monocyte to high-density lipoprotein cholesterol ratio
• inflammation
• diabetes mellitus
• HbA1c
• older patient

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