The monocyte/high-density lipoprotein cholesterol ratio in patients with primary hypolipoproteinemia

Yıl 2022, Cilt: 3 Sayı: 3, 200 - 205, 26.09.2022

Melisa Şahin Tekin

https://doi.org/10.47582/jompac.1162205

Öz

Aim: Hypolipoproteinemia is low blood lipid levels in adults. Primary hypolipoproteinemia due to genetic mutations is a rare condition. Studies to demonstrate the clinical significance of hypolipoproteinemia are limited. It was aimed to evaluate the clinical and laboratory characteristics of patients with primary hypolipoproteinemia and the monocyte/high-density lipoprotein (HDL) ratio in this study.
Material and Method: Eight patients with primary hypolipoproteinemia and twelve healthy control subjects were compared in terms of lipid profiles, monocyte/HDL ratios, hemogram, acute phase response tests, and liver tests.
Results: Triglycerides (TG), low-density lipoprotein (LDL), and total cholesterol (TC) levels were found to be significantly lower in the patient group than in the control group (p=0.037 and <0.001 for LDL and TC both, respectively). There was no difference between the groups in terms of HDL levels. Lipoprotein (a) (Lp(a)) levels were found to be significantly lower in the patient group compared to the control group (p=0.006). Absolute monocyte count (AMC) was found to be significantly higher in the patient group than in the control group (p=0.002). Monocyte/HDL ratios (MHR) were significantly higher in the patient group than in the control group (p=0.016). There was a negative correlation between MHR and LDL (p=0.001).
Conclusion: AMC and MHR were found higher in patients with primary hypolipoproteinemia than in the healthy control group in this study. Monocytes are involved in all stages of the progression of atherosclerotic disease. HDL is known to have a protective role in atherosclerotic diseases with its anti-inflammatory and antioxidant effects. MHR, which is an index that combines both, has been shown to be a prognostic marker in cardiovascular diseases. This study is the first to investigate MHR in primary hypolipoproteinemia patients. Despite the small sample size and the heterogeneous nature of the patients included high AMC and MHR levels are important findings of the current study. Although patients with hypolipoproteinemia are attributed to a low risk for atherosclerotic diseases, high AMC and MHR are a warning that these patients should be followed carefully due to changes in lipid redistribution in terms of the risk of atherosclerotic disease.

Anahtar Kelimeler

Hypolipoproteinemias, hypobetalipoproteinemias, lipoprotein(a), monocytes, non-alcoholic fatty liver disease

Destekleyen Kurum

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Teşekkür

The author would like to thank Dr. Muzaffer Bilgin, Ph.D. for his help in the statistical analysis.

Primer hipolipoproteinemili hastalarda monosit/yüksek yoğunluklu lipoprotein kolesterol oranı

Öz

Amaç: Hipolipoproteinemi erişkinlerde kan lipid düzeylerindeki düşüklüktür. Genetik mutasyonlara bağlı primer hipolipoproteinemi nadir görülen bir durumdur. Hipolipoproteineminin klinik önemini gösteren çalışmalar sınırlıdır. Bu çalışmada primer hipolipoproteinemili hastaların klinik ve laboratuvar özelliklerinin ve monosit/yüksek yoğunluklu lipoprotein (HDL) oranının değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Primer hipolipoproteinemili sekiz hasta ile on iki sağlıklı kontrol grubunun lipid profilleri, monosit/HDL oranları, hemogram, akut faz yanıt testleri ve karaciğer testleri karşılaştırıldı.
Bulgular: Trigliserid (TG), düşük yoğunluklu lipoprotein (LDL) ve total kolesterol (TK) düzeyleri hasta grubunda kontrol grubuna göre anlamlı derecede düşük bulundu (sırasıyla p=0,037 ve LDL ve TK’nın her ikisi için <0,001). HDL düzeyleri açısından gruplar arasında fark yoktu. Lipoprotein (a) (Lp(a)) düzeyleri hasta grubunda kontrol grubuna göre anlamlı derecede düşük bulundu (p=0,006). Absolü monosit sayısı (AMS) hasta grubunda kontrol grubuna göre anlamlı olarak yüksek bulundu (p=0,002). Monosit/HDL oranları (MHO) hasta grubunda kontrol grubuna göre anlamlı derecede yüksekti (p=0,016). MHO ile LDL arasında negatif korelasyon saptandı (p=0,001).
Sonuç: Bu çalışmada primer hipolipoproteinemili hastalarda AMS ve MHO sağlıklı kontrol grubuna göre daha yüksek bulundu. Monositler, aterosklerotik hastalığın ilerlemesinin tüm aşamalarında yer alır. HDL’nin antiinflamatuar ve antioksidan etkileri ile aterosklerotik hastalıklarda koruyucu rolü olduğu bilinmektedir. Her ikisini birleştiren bir indeks olan MHR’nin kardiyovasküler hastalıklarda prognostik bir belirteç olduğu gösterilmiştir. Bilindiği kadarıyla bu çalışma, primer hipolipoproteinemi hastalarında MHO’yu araştıran ilk çalışmadır. Küçük örneklem büyüklüğüne ve dahil edilen hastaların heterojen doğasına rağmen yüksek AMS ve MHO düzeyleri mevcut çalışmanın en önemli bulgularıdır. Hipolipoproteinemili hastalara aterosklerotik hastalıklar için düşük risk atfedilmesine rağmen, yüksek AMS ve MHO, aterosklerotik hastalık riski açısından lipid redistribüsyonundaki değişiklikler nedeniyle bu hastaların dikkatle izlenmesi gerektiğine dair bir uyarı niteliğindedir.

Anahtar Kelimeler

Hipolipoproteinemiler, hipobetalipoproteinemiler, lipoprotein(a), monositler, non alkolik yağlı karaciğer hastalığı

Kaynakça

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