İnflamatuar bir belirteç olarak monosit-HDL oranı: kan basıncı modellerini yansıtır mı ?

Abstract

ÖZ Arka plan: Monosit-yüksek yoğunluklu lipoprotein kolesterol oranı (MHO), kardiyovasküler riskle ilişkili yeni bir inflamatuar belirteç olarak ortaya çıkmıştır. Hem hipertansiyon hemde non-dipper paternin kardiyovasküler morbidite ve mortalite artışına katkıda bulunduğu bilinmektedir. Ancak, MHO ile sirkadiyen kan basıncı değişimleri arasındaki potansiyel ilişki hala belirsizliğini korumaktadır. Amaç: Hipertsnsiyonu olan ve olmayan bireylerde 24 saatlik ayaktan kan basıncı ölçümü (AKBÖ) ile değerlendirilen dipper paterni ile MHO arasındaki ilişkiyi araştırmak. Yöntemler: Çalışmaya AKBÖ uygulanan toplam 160 yetişkin (ortalama yaş 52,7 ± 12.1 yıl; %41.9 erkek) dahil edildi. Katlımcılar hipertansif durumları ve dipper paternlerine göre dört alt gruba ayrıldı;normotansif dipper,normotansif non-dipper,hipertansif dipper,hipertansif dipper olmayan. MHO değerleri bu gruplar arasında karşılaştırıldı. MHO’nın normal olmayan dağılımı nedeniyle, istatistiksel analizler parametrik olmayan yöntemler kullanılarak gerçekleştirildi. Bulgular: Hipertansif ve normotansif katılımcılar (p:0.319) veya dört alt grup (p:0.436) arasında MHO’da istatistiksel olarak anlamlı bir fark izlenmedi. Benzer şekilde, tüm katılımcılar arasında MHO ile dipper paterni arasında anlamlı bir ilişki yoktu (p:0,714). Sonuç: MHO’nın hipertansif durum veya sirkadiyen kan basıncı varyasyon paternleriyle ilişkili görünmemektedir. MHO’nın kan basıncı fizyolojisindeki potansiyel rolünü açılığa kavuşturmak için daha büyük kohortlar ve uzunlamasına tasarımlarla daha fazla çalışmaya ihtiyaç vardır.

Keywords

• Monosit-HDL oanı
• Ambulatuar Kan Basıncı
• Hipertansiyon
• Dipper
• Dipper Olmayan

Monocyte-to-HDL ratio as an inflammatory marker: does it reflect blood pressure patterns?

Abstract

Aims: The monocyte-to-high-density lipoprotein cholesterol ratio (MHR) has emerged as a novel inflammatory marker associated with cardiovascular risk. Both hypertension (HT) and non-dipping blood pressure patterns are known to contribute to increased cardiovascular morbidity and mortality. However, the potential association between MHR and circadian blood pressure variations remains unclear. To investigate the relationship between MHR and dipper pattern status, as assessed by 24 hour ambulatory blood pressure monitoring (ABPM), in individuals with and without HT. Methods: A total of 160 adults (mean age 52.7±12.1 years; 41.9% male) who underwent ABPM were included in the study. Participants were divided into four subgroups based on their hypertensive status and dipping pattern: normotensive dipper, normotensive non-dipper, hypertensive dipper, and hypertensive non-dipper. MHR values were compared among these groups. Due to the non-normal distribution of MHR, statistical analyses were performed using non-parametric methods. Results: No statistically significant difference in MHR was observed between hypertensive and normotensive participants (p=0.319) or among the four subgroups (p=0.436). Similarly, there was no significant association between MHR and the dipper pattern across all participants (p=0.714). Conclusion: MHR does not appear to be associated with hypertensive status or circadian blood pressure variation patterns. Further studies with larger cohorts and longitudinal designs are needed to clarify the potential role of MHR in blood pressure physiology.

Keywords

• Monocyte to HDL cholesterol ratio
• ambulatory blood pressure monitoring
• hypertension
• dipper pattern
• non dipper pattern

References

1. Hong LZ, Sen WK. Hypertension in chronic kidney disease. Vol. 2, The Kidney Book: A Practical Guide on Renal Medicine. 2023. doi:10.1080/15548627.2015.1100356
2. Dadlani A, Madan K, Sawhney JPS. Ambulatory blood pressure monitoring in clinical practice. Indian Heart J. 2019;71(1):91-97. doi:10.1016/j.ihj. 2018.11.015
3. O’Brien E, White WB, Parati G, et al. Ambulatory blood pressure monitoring in the 21st century. J Clin Hypertens. 2018;20(7):1108-1111. doi:10.1111/jch.13275
4. Kidawara Y, Kadoya M, Igeta M, et al. Nocturnal hypertension and left ventricular diastolic dysfunction in patients with diabetes with the absence of heart failure: prospective cohort HSCAA study. Hypertension. 2024;81(1):172-182. doi:10.1161/HYPERTENSİONAHA.123.21304
5. O’Brien E, Kario K, Staessen JA, et al. Patterns of ambulatory blood pressure: clinical relevance and application. J Clin Hypertens. 2018;20(7): 1112-1115. doi:10.1111/jch.13277
6. Hermida RC, Mojón A, Hermida-Ayala RG, et al. Extent of asleep blood pressure reduction by hypertension medications is ingestion-time dependent: systematic review and meta-analysis of published human trials. Sleep Med Rev. 2021;59:101454. doi:10.1016/j.smrv.2021.101454
7. Tilea I, Petra D, Ardeleanu E, et al. Treatment adherence among adult hypertensive patients: a cross-sectional retrospective study in primary care in Romania. Patient Prefer Adherence. 2018;12:625-635. doi:10.2147/PPA.S162965
8. Gembillo G, Siligato R, Cernaro V, et al. Monocyte to HDL ratio: a novel marker of resistant hypertension in CKD patients. Int Urol Nephrol. 2022;54(2):395-403. doi:10.1007/s11255-021-02904-9

9. Tomasz J Guzik TJ, Nosalski R , Maffia P, Drummond GR. Immune and inflammatory mechanisms in hypertension. Nat Rev Cardiol. 2024; 21(6):396-416. doi:10.1038/s41569-023-00964-1
10. Attiq A, Afzal S, Ahmad W, et al. Hegemony of inflammation in atherosclerosis and coronary artery disease. Eur J Pharmacol. 2024;966: 176338. doi:10.1016/j.ejphar.2024.176338
11. Barter PJ, Nicholls S, Rye KA, et al. Antiinflammatory properties of HDL. Circ Res. 2004;95(8):764-772. doi:10.1161/01.RES.0000146094.59640.13
12. Bobryshev YV, Ivanova EA, Chistiakov DA, et al. Macrophages and their role in atherosclerosis: pathophysiology and transcriptome analysis. Biomed Res Int. 2016;2016:9582430. doi:10.1155/2016/9582430
13. Demir V, Samet Y, Akboga MK. Association of lymphocyte-monocyte ratio and monocyte-to-high-density lipoprotein ratio with the presence and severity of rheumatic mitral valve stenosis. Biomark Med. 2017;11(8): 657-664. doi:10.2217/bmm-2017-0036
14. Arefhosseini S, Aghajani T, Tutunchi H, et al. Association of systemic inflammatory indices with anthropometric measures, metabolic factors, and liver function in non-alcoholic fatty liver disease. Sci Rep. 2024;14(1):1-10. doi:10.1038/s41598-024-63381-5
15. Yayla KG, Canpolat U, Yayla Ç, et al. A novel marker of impaired aortic elasticity in never treated hypertensive patients: monocyte/high-density lipoprotein cholesterol ratio. Acta Cardiol Sin. 2017;33(1):41-49. doi:10. 6515/acs20160427a
16. Korkmaz ŞA, Kızgın S. Neutrophil/high-density lipoprotein cholesterol (HDL), monocyte/HDL and platelet/HDL ratios are increased in acute mania as markers of inflammation, even after controlling for confounding factors. Curr Med Res Opin. 2023;39(10):1383–90. doi:10.1080/03007995.2023.2260302
17. Kayhan S, Kirnap NG, Tastemur M. Increased monocyte to HDL cholesterol ratio in vitamin B12 deficiency: is it related to cardiometabolic risk? Int J Vitam Nutr Res. 2021;91(5-6):419-426. doi:10.1024/0300-9831/a000668
18. Pruc M, Kubica J, Banach M, et al. Prognostic value of the monocyte-to-high-density lipoprotein-cholesterol ratio in acute coronary syndrome patients: a systematic review and meta-analysis. Kardiol Pol. 2025;83(1): 52-61. doi:10.33963/v.phj.102773
19. Gkantzios A, Tsiptsios D, Karapepera V, et al. Monocyte to HDL and neutrophil to HDL ratios as potential ischemic stroke prognostic biomarkers. Neurol Int. 2023;15(1):301-317. doi:10.3390/neurolint15010019
20. Kayikçioğlu H, Akbuğa K. Relationship between C-reaktive protein/albümin ratio and dipper7non-dipper pattern in normotensive individuals. Blood Pressure Monitoring. 2022;27(5):310-313. doi:10.1097/MBP.0000000000000604
21. Sunbul M, Gerin F, Durmus E, et al. Neutrophil to lymphocyte and platelet to lymphocyte ratio in patients with dipper versus non-dipper hypertension. Clin Exp Hypertens. 2014;36(4):217-221. doi:10.3109/10641963.2013.804547
22. Madhur MS, Elijovich F, Alexander MR, et al. Hypertension: do inflammation and immunity hold the key to solving this epidemic? Circ Res. 2021;128(7):908-933. doi:10.1161/CIRCRESAHA.121.318052
23. Navab M, Berliner JA, Subbanagounder G, et al. HDL and the inflammatory response induced by LDL-derived oxidized phospholipids. Arterioscler Thromb Vasc Biol. 2001;21(4):481-488. doi:10. 1161/01.atv.21.4.481
24. Kaplangoray M, Toprak K, Caglayan C, et al. Could the systemic inflammatory response index be a marker for the non-dipper pattern in newly diagnosed hypertensive patients? Cardiovasc Toxicol. 2025;25(4): 559-569. doi:10.1007/s12012-025-09977-3
25. Wang L, Liu Y, Shi W, et al. Value of the monocyte-to-high-density lipoprotein cholesterol ratio in refining the detection of prevalent heart failure: insights from the NHANES 1999–2018. Lipids. 2024;59(4):93-100. doi:10.1002/lipd.12395
26. Liu HT, Jiang ZH, Yang ZB, et al. Monocyte to high-density lipoprotein ratio predict long-term clinical outcomes in patients with coronary heart disease: a meta-analysis of 9 studies. Med (United States). 2022;101(33): E30109. doi:10.1097/MD.0000000000030109
27. Cetin MS, Ozcan Cetin EH, Kalender E, et al. Monocyte to HDL cholesterol ratio predicts coronary artery disease severity and future major cardiovascular adverse events in acute coronary syndrome. Hear Lung Circ. 2016;25(11):1077-1086. doi:10.1016/j.hlc.2016.02.023
28. Shin J, Kario K, Chia YC, et al. Current status of ambulatory blood pressure monitoring in Asian countries: a report from the HOPE Asia Network. J Clin Hypertens. 2020;22(3):384-390. doi:10.1111/jch.13058