Karotis Arter Intima-Media Kalınlığının Tahmininde Monosit-HDL Oranı

Yıl 2021, Cilt: 3 Sayı: 3, 184 - 190, 01.09.2021

Sabri Abuş , Erdal Aktürk

https://doi.org/10.37990/medr.889782

Öz

Amaç: Bu çalışmada, artmış monosit sayısının yüksek yoğunluklu lipoprotein düzeylerine oranı (MHO)’nun artmış karotis intima-media kalınlığı (İMK)’yi yordayıp yordamayacağını belirlemeyi amaçladık.
Materyal ve Metot:Kurumumuzun kardiyoloji polikliniğine ayaktan başvuran ardışık tüm olgular bu kesitsel çalışmaya alındı. Kardiyovasküler ve enflamatuar hastalıkları olan olgular hariç tutuldu. Olgular karotis İMK’ye göre iki gruba ayrıldı: karotis İMK>0,9 mm (artmış) ve karotis İMK≤0.9 mm (normal) olanlar. MHO’daki iki grup arasındaki fark, çalışmanın birincil sonuç ölçütüdür.
Bulgular: Artmış İMK’ye sahip olguların MHO’su, normal İMK’ye sahip olgulardan anlamlı olarak daha yüksekti (16,7 ± 5,7’ye karşı 12,8 ± 5,5; p<0,001). Lojistik regresyon analizi, yaşın (OR: 1,202, 95% CI: 1,126-1,284; p<0,001) ve MHR (OR: 1,190, 95% CI: 1,097-1,291; p<0,001)’nin >0,9 mm’lik bir karotis İMK’si için önemli prediktörler olduğunu gösterdi. ROC eğrisi analizi, %72 duyarlılık ve %60,7 özgüllük ile 13,4’lük bir MHO kesme değerinin artmış İMK’nin saptanmasında kullanılabileceğini gösterdi.
Sonuç: Enflamasyon belirteci MHO, subklinik aterosklerozun göstergesi olarak kabul edilen artmış karotis İMK’sini tahmin etmek için basit ve maliyet-etkin bir belirteç olarak kullanılabilir.

Anahtar Kelimeler

Koroner arter hastalığı, monositler, yüksek yoğunluklu lipoprotein, HDL, karotis intima-media kalınlığı

Monocyte to HDL Ratio in The Prediction of Carotid Artery Intima-Media Thickness

Öz

Aim: In this study, we aimed to determine whether an increased monocyte count to high-density lipoprotein (MHR) would predict increased carotid intima-media thickness (IMT).
Material and Method: All consecutive subjects presenting to the cardiology outpatient clinic of our institute were enrolled in this cross-sectional study. Subjects with cardiovascular and inflammatory diseases were excluded. Subjects were divided into two groups according to carotid IMT: those with carotid IMT >0.9 mm (increased) and those with carotid IMT ≤0.9 mm (normal). The difference in MHR between the two groups was the primary outcome measure of the study.
Results: The MHR of the subjects with increased IMT was significantly higher than that of subjects with normal IMT (16.7 ± 5.7 vs. 12.8 ± 5.5, p <0.001). Logistic regression analysis demonstrated that age (OR: 1.202, 95% CI: 1.126-1.284, p<0.001) and MHR (OR: 1.190, 95% CI: 1.097-1.291, p<0.001) were significant predictors for a carotid IMT of >0.9 mm. ROC curve analysis revealed an MHR value of 13.4 as a cut-off in the identification of subjects that had increased IMT, with a sensitivity of 72% and specificity of 60.7%.
Conclusion: The inflammation marker MHR can be used as a simple and cost-effective marker to predict increased carotid IMT which is accepted as the indicator of subclinical atherosclerosis.

Anahtar Kelimeler

Coronary artery disease, monocytes, high‐density lipoprotein, HDL, carotid intima-media thickness

Kaynakça

• 1. Nichols M, Townsend N, Scarborough P, Rayner M. Cardiovascular disease in Europe 2014: epidemiological update. Eur Heart J. 2014; 35(42): 2929.
• 2. Cervellin G, Lippi G. Of MIs and men--a historical perspective on the diagnostics of acute myocardial infarction. Semin Thromb Hemost. 2014; 40(5): 535-43.
• 3. Sanchis-Gomar F, Perez-Quilis C, Leischik R, Lucia A. Epidemiology of coronary heart disease and acute coronary syndrome. Ann Transl Med. 2016; 4(13): 256.
• 4. Polak JF, O'Leary DH. Carotid Intima-Media Thickness as Surrogate for and Predictor of CVD. Glob Heart. 2016; 11(3): 295-312.
• 5. Heuten H, Goovaerts I, Ennekens G, Vrints C. Carotid artery intima-media thickness is associated with coronary artery disease. Acta Cardiol. 2008; 63(3): 309-13.
• 6. Greenland P, Alpert JS, Beller GA, et al. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2010; 56(25): e50-103.
• 7. Acikgoz N, Kurtoğlu E, Yagmur J, Kapicioglu Y, Cansel M, Ermis N. Elevated monocyte to high-density lipoprotein cholesterol ratio and endothelial dysfunction in behçet disease. Angiology. 2018; 69(1): 65-70.
• 8. Bolayir A, Gokce SF, Cigdem B, Bolayir HA, Yildiz OK, Bolayir E, Topaktas SA. Monocyte/high-density lipoprotein ratio predicts the mortality in ischemic stroke patients. Neurol Neurochir Pol. 2018; 52(2): 150-5.
• 9. Authors/Task Force Members, Rydén L, Grant PJ, et al. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). Eur Heart J. 2013; 34(39): 3035-87.
• 10. Piepoli MF, Hoes AW, Agewall S, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016; 37(29): 2315-81.
• 11. Wexler L, Brundage B, Crouse J, et al. Coronary artery calcification: pathophysiology, epidemiology, imaging methods, and clinical implications. A statement for health professionals from the American Heart Association. Writing Group. Circulation. 1996; 94(5): 1175-92.
• 12. Ali M, Girgis S, Hassan A, Rudick S, Becker RC. Inflammation and coronary artery disease: from pathophysiology to Canakinumab Anti-Inflammatory Thrombosis Outcomes Study (CANTOS). Coron Artery Dis. 2018; 29(5): 429-37.
• 13. Gratchev A, Sobenin I, Orekhov A, Kzhyshkowska J. Monocytes as a diagnostic marker of cardiovascular diseases. Immunobiology. 2012; 217(5): 476-82.
• 14. Harrington RA. Targeting inflammation in coronary artery disease. N Engl J Med. 2017; 377(12): 1197-8.
• 15. Ossoli A, Remaley AT, Vaisman B, Calabresi L, Gomaraschi M. Plasma-derived and synthetic high-density lipoprotein inhibit tissue factor in endothelial cells and monocytes. Biochem J. 2016; 473(2): 211-9.
• 16. Heitzer T, Schlinzig T, Krohn K, Meinertz T, Münzel T. Endothelial dysfunction, oxidative stress, and risk of cardiovascular events in patients with coronary artery disease. Circulation. 2001; 104(22): 2673-8.
• 17. Usta A, Avci E, Bulbul CB, Kadi H, Adali E. The monocyte counts to HDL cholesterol ratio in obese and lean patients with polycystic ovary syndrome. Reprod Biol Endocrinol. 2018; 16(1): 34.
• 18. Gomaraschi M, Basilico N, Sisto F, et al. High-density lipoproteins attenuate interleukin-6 production in endothelial cells exposed to pro-inflammatory stimuli. Biochim Biophys Acta. 2005; 1736(2): 136-43.
• 19. Tani S, Matsumoto M, Anazawa T, et al. Development of a model for prediction of coronary atherosclerotic regression: evaluation of high-density lipoprotein cholesterol level and peripheral blood monocyte count. Heart Vessels. 2012; 27(2): 143-50.
• 20. Kundi H, Kiziltunc E, Cetin M, Cicekcioglu H, Cetin ZG, Cicek G, Ornek E. Association of monocyte/HDL-C ratio with SYNTAX scores in patients with stable coronary artery disease. Herz. 2016; 41(6): 523-9.
• 21. Akboga MK, Balci KG, Maden O, et al. Usefulness of monocyte to HDL-cholesterol ratio to predict high SYNTAX score in patients with stable coronary artery disease. Biomark Med. 2016; 10(4): 375-83.
• 22. Akboga MK, Yayla C, Balci KG, et al. Relationship between serum albumin level and monocyte-to-high-density lipoprotein cholesterol ratio with saphenous vein graft disease in coronary bypass. Thorac Cardiovasc Surg. 2017; 65(4): 315-21.
• 23. Açıkgöz SK, Açıkgöz E, Şensoy B, Topal S, Aydoğdu S. Monocyte to high-density lipoprotein cholesterol ratio is predictive of in-hospital and five-year mortality in ST-segment elevation myocardial infarction. Cardiol J. 2016; 23(5): 505-12.
• 24. Tok D, Turak O, Yayla Ç, Ozcan F, Tok D, Çağlı K. Monocyte to HDL ratio in prediction of BMS restenosis in subjects with stable and unstable angina pectoris. Biomark Med. 2016; 10(8): 853-60.
• 25. Balta S, Celik T, Ozturk C, et al. The relation between monocyte to HDL ratio and no-reflow phenomenon in the patients with acute ST-segment elevation myocardial infarction. Am J Emerg Med. 2016; 34(8): 1542-7.
• 26. Cetin MS, Ozcan Cetin EH, Kalender E, Aydin S, Topaloglu S, Kisacik HL, Temizhan A. Monocyte to HDL cholesterol ratio predicts coronary artery disease severity and future major cardiovascular adverse events in acute coronary syndrome. Heart Lung Circ. 2016; 25(11): 1077-86.
• 27. Carpenter M, Sinclair H, Kunadian V. Carotid ıntima media thickness and ıts utility as a predictor of cardiovascular disease: A review of evidence. Cardiol Rev. 2016; 24(2): 70-5.
• 28. Stein JH, Korcarz CE, Hurst RT, et al. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine. J Am Soc Echocardiogr. 2008; 21(2): 93-111.
• 29. Kim GH, Youn HJ. Is carotid artery ultrasound still useful method for evaluation of atherosclerosis? Korean Circ J. 2017; 47(1): 1-8.
• 30. Society of Atherosclerosis Imaging and Prevention Developed in collaboration with the International Atherosclerosis Society. Appropriate use criteria for carotid intima media thickness testing. Atherosclerosis. 2011; 214(1): 43-6.