Tip 2 diyabet ile monosit-yüksek dansiteli lipoprotein kolesterol oranı ve karotis intima-media kalınlığı arasındaki ilişki

Year 2019, Volume: 5 Issue: 1, 1168 - 1176, 15.04.2019

Hakan Kaya

https://doi.org/10.30569/adiyamansaglik.486890

Abstract

Amaç: Diyabet ateroskleroz için  majör bir risk faktörüdür.  Dolaşımdaki monosit miktarı yeni
aterosklerotik plak gelişiminde önemli bir rol oynar.  Ayrıca yüksek dansitelilipoprotein (HDL)
kolesterol ve ateroskleroz  arasında
güçlü bir ters  ilişki olduğu
gösterilmiştir. Monosit ile HDL kolesterol oranı ateroskleroz için yeni bir
inflamasyon belirtecidir. Karotisintimamedia kalınlığı (KİMK) koroner arter
hastalığının olduğunu veya olmadığını gösterebilir.

Gereç ve yöntemler:  60 diyabet hastası ve 60 kontrol grubu olarak
toplam 120 hasta iki gruba ayrıldı. Karakteristik özellikler, labaratuvar
parametreleri, KİMK ve monosit ile HDL kolesterol oranları kaydedildi ve iki
grup arasında karşılaştırıldı.

Bulgular: Diyabetik grupta KİMK ve monosit ile HDL
oranı anlamlı derecede yüksek izlendi (p<0.001,p<0,001 sırasıyla). Ayrıca
KİMK kan glukoz düzeyleri ile anlamlı derecede korelasyon gösterdi (r=0.474, p<0.001). Buna karşın,
HDL oranı kontrol grubunda daha yüksekti (p=0,010).

Sonuç: Sonuç olarak, çalışmamda
diyabetik grupta anlamlı olarak daha yüksek MHR ve CIMT düzeyleri tespit ettim ve
böylece kolayca hesaplanan bir indeks olan MHR'nin, Tip 2 DM hastalarında
aterosklerozun bir göstergesi olarak günlük klinik uygulamada
kullanılabileceğini düşünüyorum.

Keywords

Monosit, monosit ile yüksek dansiteli lipoprotein oranı, yüksek dansiteli lipoprotein, karotis intima-media kalınlığı

The relationship between monocyte to HDL cholesterol ratio, carotid intima-media thickness and type 2 diabetes mellitus

Abstract

Aim: Diyabetes mellitus (DM) is a majör risk factor for atheroscleros.
Circulating monocyte count plays an important role for new atherosclerotic
plaque development. Also, there is a strong inverse relationship between high
density lipoprotein cholesterol (HDL) and atherosclerosis. monocyte count/HDL
ratio (MHR) is a novel inflammatory marker for  atheroscleros. Carotid
intima-media thickness (CIMT)   can predict  the presence or
absence of  coronary artery disease (CAD). I aimed to investigate
relationship between  CIMT, MHR and type 2 DM

 Methods: A total of 120 patients were divided into two
groups (with type2 DM group = 60, control group: 60). Baseline characteristics,
laboratory parameters, MHR and  CIMT were recorded and compared between
groups.

Results: The Diabetes group had considerable  higher  CIMT,
MHR  levels compared to the control (p<0.001,p<0,001 respectively ).
Also, CIMT  levels showed significant correlation with
blood glucose level (r=0.474, p<0.001). On the contrary, HDL levels were higher in
the control group (p=0.010).

Conclusion: In conclusion, I found
significantly higher  MHR and CIMT in the
diabetic group and thus I think MHR, which is an easily calculated index, can
be used in the daily clinical practice as an indicator of atherosclerosis in
Type 2 DM patients.

Keywords

Monocyte, monocyte to High density lipoprotein cholesterol ratio, carotid intima-media thickness

References

• 1. Preis SR, Hwang SJ, Coady S, et al. Trends in all-cause and cardiovascular disease mortality among women and men with and without diabetes mellitus in the Framingham Heart Study, 1950 to 2005. Circulation 2009; 119: 1728–1735.
• 2. Kupfer R, Larrubia MR, Bussade I, et al. Predictors of subclinical atherosclerosis evaluated by carotid intima-media thickness in asymptomatic young women with type 1 diabetes mellitus. Arch Endocrinol Metab. 2017;61(2):115-21.
• 3. Tetik SS, Tanrıverdi B. The pathophysiology and risk factors of Atherosclerosis Marmara Pharmaceutical Journal. 2017;21(1):1-9.
• 4. Akyel A, Çelik IE, Öksüz F et al: Red Blood Cell Distribution Width in Saphenous Vein Graft Disease. Canadian Journal of Cardiology 2013;29:448–451.
• 5. Yayla Ç, Canpolat U, Akyel A et al: Association Between Platelet to Lymphocyte Ratio and Saphenous Vein Graft Disease. Angiology 2016;67(2):133-138.
• 6. Tasoglu I, Turak O, Nazli Y et al: Preoperative Neutrophil-Lymphocyte Ratio and Saphenous Vein Graft Patency After Coronary Artery Bypass Grafting. Clin Appl Thromb Hemost 2014;20(8):819-824.
• 7. Woollard KJ, Geissmann F: Monocytes in atherosclerosis: subsets and functions. Nat Rev Cardiol 2010;7(2):77–86.
• 8. Kanbay M, Solak Y, Unal HU et al: Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol 2014;46(8):1619-1625.
• 9. Emerging Risk Factors Collaboration, Sarwar N, Gao P, Seshasai SR, Gobin R, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies.Lancet. 2010;375(9733):221522.
• 10. Malik S, Budoff MJ, Katz R, et al. Impact of subclinical atherosclerosis on cardiovascular disease events in individuals with metabolic syndrome and diabetes: the multi-ethnic study of atherosclerosis. Diabetes Care. 2011;34(10):2285-90.
• 11. Polak JF, Pencina MJ, Pencina KM, et al. Carotid-wall intima-media thickness and cardiovascular events. N Engl J Med. 2011;365(3):213-21.
• 12. de Ferranti SD, de Boer IH, Fonseca V, et al. Type 1 diabetes mellitus and cardiovascular disease: a scientific statement from the American Heart Association and American Diabetes Association. Diabetes Care. 2014;37(10):2843-63.
• 13. Greaves D. r. & Gordon S: The macrophage scavenger receptor at 30 years of age: current knowledge and future challenges. J. Lipid Res 2009;50(Suppl.):282–286.
• 14. Galkina, E. and Ley K: Immune and inflammatory mechanisms of atherosclerosis. Annu. Rev. Immunol 2009;27:165-197.
• 15. Çakmakoğlu B, Çınçın ZB, Daşdemır S, et al. The evaluation gene polimorphisms of monocyte chemotactic protein(MCP-1) a-2518G and CCR2 receptors G190A in coronary artery diseases in diabetic populatios: Deneysel Tıp Araştırma Enstitüsü Dergisi. 2011;1(2):9-13.
• 16.Andr ew J. Murphy, Kevin J. Woollard, Anh Hoang et al: High-Density Lipoprotein Reduces the Human Monocyte Inflammatory Response. Arterioscler ThrombVasc Biol 2008;28:2071-2077.
• 17. Tok D, Turak O, Yayla C, et al. Monocyte to HDL ratio in prediction of BMS restenosis in subjects with stable and unstable angina pectoris. Biomarkers in medicine. 2016;10(8):853-60.
• 18. Cetin EHO, Cetin MS, Canpolat U, et al. Monocyte/HDL-cholesterol ratio predicts the definite stent thrombosis after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Biomarkers. 2015;9(10):967-77.
• 19. Kızıltunç E, Alsancak Y, Sezenöz B, et al. Relationship between monocyte/high-density lipoprotein cholesterol ratio and angiographic severity and extent of coronary artery disease Koşuyolu Heart J 2017;20(1):30-5.
• 20. Canpolat U, Aytemir K, Yorgun H , et al. The role of preprocedural monocyte-to-high-density lipoprotein ratio in prediction of atrial fibrillation recurrence after cryoballoon-based catheter ablation. EP Europace. 2015;17(12):1807-15.