Stabil KOAH’lılarda monosit-HDL oranı ile hastalık süreci ve solunum fonksiyonları arasındaki ilişki ve pulmoner hipertansiyon

Year 2023, Volume: 48 Issue: 3, 868 - 878, 30.09.2023

Efraim Güzel , Burak Mete , Sedat Kuleci , Yasemin Saygideger , Oya Baydar Toprak

https://doi.org/10.17826/cumj.1315487

Abstract

Amaç: Monositler ve yüksek yoğunluklu lipoprotein-kolesterol (HDL-C) inflamasyonda görevi olan moleküllerdir ve inflamasyon kronik obstrüktif akciğer hastalığı (KOAH) patogenezinde önemli bir role sahiptir. Çalışmanın temel amacı, KOAH'ta monosit/HDL oranının (MHO) solunum fonksiyonları ve pulmoner hipertansiyon (PH) ile ilişkisini araştırmaktır.
Gereç ve Yöntem: Polikliniğe başvuran KOAH tanılı 40 yaş üstü 239 hastanın retrospektif verileri daha önce kayıt altına alınan anket formları ve hastane veri tabanından temin edilerek çalışma gerçekleştirildi. Verileri eksik hastalar çalışma dışı bırakıldı. Hastalar MHO yüksek olan ve olmayan şeklinde 2 gruba ayrıldı. MHO yüksekliğinin KOAH ve solunum fonksiyon testleri ile ilişkisi analiz edildi. İkinci aşamada KOAH’lılarda PH varlığı için analizler yapıldı.
Bulgular: Hastaların ortanca yaşı 62,22 ± 9,37 yaş ve %88,7'si erkekti. Yapılan analizlerde yüksek MHO ile KOAH arasında sigara dışında istatistiksel olarak anlamlılık bulunmamasına rağmen, bronkodilatasyon sonrası (post-BD) FEV1/FVC ile MHO arasında negatif bir korelasyon bulunmuştur. Ayrıca mutlak monosit değeri ile RV/TLC arasındaki negatif korelasyon da anlamlı bulunmuştur. Diğer yandan ileri yaşın (OR=0.949, 95% CI (0.915, 0.984)), üçten fazla komorbidite varlığının (OR=2.174, 95% CI (1.045, 4.521)) ve vücut kitle indeksi (VKİ) <25 olmasının (OR=0.419, 95% CI (0.219, 0.804)) KOAH hastalarında PH için risk faktörü olabileceği bulunmuştur.
Sonuç: Çalışmamızda MHO'nin KOAH ile ilişkisi net olarak kanıtlanamamış, ancak MHO’nin solunum fonksiyonları üzerine etkisi olabileceği bulunmuştur. Bunun yanında ileri yaş, çoklu komorbidite ve düşük vücut ağırlığının PH için önemli bir risk oluşturabileceği tespit edilmiştir. Ancak bu konuların çok merkezli daha geniş hasta gruplarında çalışılması ve doğrulanması gerekmektedir.

Keywords

KOAH, HDL-C, MHO, monositler, pulmoner hipertansiyon, solunum fonksiyon testi

Relationship between monocyte-HDL ratio and disease process and pulmonary functions and pulmonary hypertension in stable COPD patients

Abstract

Purpose: Inflammation is a major factor in the pathophysiology of chronic obstructive pulmonary disease (COPD), and molecules implicated in inflammation include monocytes and high-density lipoprotein-cholesterol (HDL-C). The primary goal of the study was to look at the relationship between pulmonary function and pulmonary hypertension (PH) in COPD and the monocyte to HDL ratio (MHR).
Materials and Methodsː The study was conducted by acquiring retrospective data from previously recorded questionnaires and hospital databases for 239 individuals over the age of 40 with a diagnosis of COPD who admitted to the outpatient clinic. Patients whose data were missing were not included in the analysis. Two groups of patients were created: those with high MHO levels and those without. Analysis was done on the correlation between high MHO and COPD and pulmonary function tests. The presence of PH in COPD patients was analyzed in the second stage.
Resultsː The median age of the patients was 62.22 ± 9.37 year and 88.7% of them were male. With the exception of smoking, there was no statistically significant link between high MHR and COPD in the analyses, however there was a negative connection between post-bronchodilation (post-BD) FEV1/FVC and MHR. Additionally, the statistically significant negative association was found between the absolute monocyte value and RV/TLC. However, older age (OR=0.949, 95% CI (0.915, 0.984)), having more than three comorbidities (OR=2.174, 95% CI (1.045, 4.521)), and having a body mass index (BMI) below 25 have all been linked to an increased risk of PH in COPD patients.
Conclusionː Although the link between MHR and COPD was not conclusively established, it was linked to pulmonary functions. The study that was presented also came to the conclusion that PH may be significantly increased by advanced age, numerous comorbidities, and low body weight. These problems must be investigated and validated in larger, multicenter patient populations.

Keywords

COPD, HDL-C, MHR, monocytes, pulmonary hypertension, pulmonary function test

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