Diyabetik Nöropatisi Olan Kişilerde Monosit/HDL Kolesterol Oranı ile Kardiyovasküler Risk Arasındaki İlişki
Öz
Bu çalışmada diyabetin mikrovasküler komplikasyonlarından olan diyabetik
nöropatisi olan hastalarda monosit/HDL kolesterol oranı (MHR)’nin
kardiyovasküler risk belirteci olup olamayacağının araştırılması amaçlanmıştır.
Dahiliye polikliniğimizdeki Ocak 2018- Eylül 2018 tarihleri arasındaki
hastalardan 30 diyabetik nöropatisi (DN) olan diabetes mellitus (DM) hastası, 29
DN olmayan DM hastası ve aynı yaş ve cinsiyette 30 DM olmayan sağlıklı
retrospektif olarak çalışmaya alındı. Yaş, cinsiyet, vücut kitle indeksi (BMI),
sigara, DM süresi, hipertansiyon, hemogramdaki monosit sayısı, glikozile
hemoglobin A1c (HbA1c), total kolesterol, düşük yoğunluklu lipoprotein LDL
kolesterol (LDL-K), yüksek yoğunluklu lipoprotein HDL kolesterol (HDL-K),
trigliserid (TG) ve mikroalbuminüri, MHR, Framingham Kardiyovasküler Risk
Skorlamasına (FCR) göre olan kardiyovasküler risk oranı incelendi. DN ile DN-olmayan diyabetikler arasında
DM süresi açısından fark olduğu görüldü (p<0.05). DN grubun total kolesterol
düzeyleri DN-olmayan gruptan (p<0.05) ve kontrol grubundan (p<0.01) yüksek
bulundu. Yine DN grubun HbA1c düzeyleri de daha yüksek bulundu (p<0.001). Kontrol
grubunun FCR skorları DN ve DN olmayan gruptan anlamlı şekilde düşüktü (p<0001).
Grupların MHR’si arasında fark bulunmadı. Tüm hastalarda MHR ile HbA1c, FCR skorları
arasında korelasyon bulundu (Spearman’s rho p <0.05). Bu çalışmada diyabetik
nöropatisi olan hastalarda MHR’nin kardiyovasküler risk belirteci olabileceği
sonucuna ulaşılamamıştır. Ancak tüm hastalarda MHR ile kardiyovasküler risk
arasında bir korelasyon görülmüştür. Bu konuda daha geniş serilerde çalışma
yapılmasına ihtiyaç vardır.
Anahtar Kelimeler
Kaynakça
- 1. Dokken BB. The Pathophysiology of Cardiovascular Disease and Diabetes: Beyond Blood Pressure and Lipids. Diabetes Spectrum. 2008;21(3):160-165. doi: 10.2337/diaspect.21.3.160.
- 2. Oto A. Diabet ve Koroner Arter Hastalığı: Gelişen Dünyanın Korkunç İkilisi. Türkiye Kardiovasküler Tıp Elektronik Dergisi. 2007 Nov. Avaible from: http://www. Turkkardiyovaskulertipe-dergisi.com Last Access: 16th May 2011.
- 3. Bansal V, Kalita J, Misra UK. Diabetic neuropathy. Postgrad Med J. 2006;82:95–100.
- 4. Barter PJ, Nicholls S, Rye KA, et al. Antiinflammatory properties of HDL. Circ Res. 2004;95:764–772.
- 5. Negi G, Kumar A, Joshi RP, et al. Oxidative stress and Nrf2 in the pathophysiology of diabetic neuropathy: old perspective with a new angle. Biochem and Biophys Res Commun. 2011;408:1–5.
- 6. 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):30-35.
- 7. Charnogursky GA, Emanuele NV, Emanuele MA. Neurological complications of diabetes. Curr Neurol Neurosci Rep. 2014;14:457:1-16. 8. Johnstone MT, Nesto R. Diabetes mellitus and heart disease. In: Pickup JC, Williams G, editors. Joslin's Diabetes Mellitus. 14th ed. Philadelphia: Lippincott Williams and Wilkins; 2005:975- 998.
- 9. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001; 285: 2486-2497.
- 10. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulfonylureas or insulin compared with conventional treatment and risk of comlications in patients with type 2 diabetes. Lancet 1998;352:854-65.
- 11. Katulanda P, Ranasinghe P, Jayawardena R, et al. The prevalence, patterns and predictors of diabetic peripheral neuropathy in a developing country. Diabetol Metab Syndr. 2012;4:21:1–8. doi: 10.1186/1758-5996-4-21.
- 12. Perez-Matos MC, Morales-Alvarez MC, Mendivil CO. Lipids: a suitable therapeutic target in diabetic neuropathy. J Diabetes Res. 2017:6943851:1–9. doi: 10.1155/2017/6943851.
- 13. Krauss RM. Lipids and lipoproteins in patients with type 2 diabetes. Diabetes Care. 2004;27:1496–1504.
- 14. Çomoğlu S, Yardımcı S, Okçu Z. The alterations in plasma lipid profile of diabetic polyneuropathic patients. T Klin J Med Sci. 2001;21:345–348.
- 15. Isomaa B, Henricsson M, Almgren P, et al. The metabolic syndrome influences the risk of chronic complications in patients with Type II diabetes. Diabetologia. 2001;44:1148–1154.
- 16. Obrosova IG, Ilnytska O, Lyzogubov VV, et al. High-fat diet induced neuropathy of pre-diabetes and obesity: effects of “healthy” diet and aldose reductase inhibition. Diabetes. 2007;56:2598–2608.
- 17. Murphy AJ, Woollard KJ, Hoang A, et al. High density lipoprotein reduces the human monocyte inflammatory response. Arterioscler Thromb Vasc Biol. 2008;28:2071–2077.
- 18. Garcia C, Feve B, Ferré P, et al. Diabetes and inflammation: fundamental aspects and clinical implications. Diabetes Metab. 2010;36:327–338.
- 19. Skundric DS, Lisak RP. Role of neuropoietic cytokines in development and progression of diabetic polyneuropathy: from glucose metabolism to neurodegeneration. Exp Diabesity Res. 2003;4:303–312.
- 20. Lim AK, Tesch GH. Inflammation in diabetic nephropathy. Mediators Inflamm. 2012:146154:1-12.
- 21. Blüher M, Unger R, Rassoul F, et al. Relation between glycaemic control, hyperinsulinaemia and plasma concentrations of soluble adhesion molecules in patients with impaired glucose tolerance or Type II diabetes. Diabetologia. 2002;45:210–216.
- 22. Hilgendorf I, Swirski FK, Robbins CS. Monocyte fate in atherosclerosis. Arterioscler Thromb Vasc Biol. 2015;35:272–279.
- 23. Nandy D, Janardhanan R, Mukhopadhyay D, et al. Effect of hyperglycemia on human monocyte activation. J Investig Med. 2011;59:661–667.
- 24. Negi G, Kumar A, Joshi RP, et al. Oxidative stress and Nrf2 in the pathophysiology of diabetic neuropathy: old perspective with a new angle. Biochem and Biophys Res Commun. 2011;408:1–5.
- 25. Canpolat U, Çetin EH, Cetin S, et al. Association of monocyte-to-HDL cholesterol ratio with slow coronary flow is linked to systemic inflammation. Clin Appl Thromb Hemost. 2016;22:476–482.
- 26. Kundi H, Kiziltunc E, Cetin M, et al. Association of monocyte/HDL-C ratio with SYNTAX scores in patients with stable coronary artery disease. Herz. 2016;41:523–529.
- 27. Karatas A, Turkmen E, Erdem E, Dugeroglu H, Kaya Y.Monocyte to high-density lipoprotein cholesterol ratio in patients with diabetes mellitus and diabetic nephropathy. Biomark Med. 2018;12(9):953-959.
- 28. Aydin E, Ates I, Arikan MF, Yilmaz N, Dede F.The ratio of monocyte frequency to HDL cholesterol level as a predictor of asymptomatic organ damage in patients with primary hypertension. Hypertens Research. 2017;40(8):758-764.
- 29. Cetin MS, 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. Heart Lung Circ. 2016;25(11):1077-1086.
- 30. Vural G.,Gümüşyayla Ş., Monocyte-to-high density lipoprotein ratio is associated with a decreased compound muscle action potential amplitude in patients with diabetic axonal polyneuropathy. Medicine (Baltimore). 2018;97(42).
The Relationship Between Monocyte / HDL-Cholesterol Ratio and Cardiovascular Risk in Diabetic Neuropathia
Öz
The aim of this study was to investigate
whether monocyte/HDL cholesterol ratio (MHR) could be a marker of
cardiovascular risk in patients with diabetic neuropathy which is one of the
microvascular complication of diabetes. 30
patients with diabetic neuropathy (DN), 30 patients with non-DN- diabetes
mellitus (DM), 30 healthy individuals with non-DM same age and sex in our
internal medicine clinic between January 2018- September 2018 were
retrospectively studied. Age, gender, body mass index (BMI), smoking, hypertension,
the number of monocytes, HbA1c, total cholesterol, low density lipoprotein
LDL-cholesterol (LDL-C), high density lipoprotein HDL-cholesterol (HDL-C),
triglyceride, microalbuminuria, MHR, Framingham Cardiovascular Risk Scoring
(FCR) were investigated. There was
a significant difference in the duration of DM between non-DN and diabetic
patients (p <0.05). Total cholesterol levels of DN group were higher than
non-DN group (p <0.05) and control group (p <0.01). The FCR scores of the
control group were significantly lower than the DN and non-DN groups (p
<0001).There was no difference between MHR and HbA1c and FCR scores in all
patients (Spearman’s rho p <0.05). In
this study, we could not conclude that MHR can be a predictor of cardiovascular
risk in patients with diabetic neuropathy. However, there was a correlation between cardiovascular risk and MHR in
all patients. There is a need for further studies on this subject.
Anahtar Kelimeler
Kaynakça
- 1. Dokken BB. The Pathophysiology of Cardiovascular Disease and Diabetes: Beyond Blood Pressure and Lipids. Diabetes Spectrum. 2008;21(3):160-165. doi: 10.2337/diaspect.21.3.160.
- 2. Oto A. Diabet ve Koroner Arter Hastalığı: Gelişen Dünyanın Korkunç İkilisi. Türkiye Kardiovasküler Tıp Elektronik Dergisi. 2007 Nov. Avaible from: http://www. Turkkardiyovaskulertipe-dergisi.com Last Access: 16th May 2011.
- 3. Bansal V, Kalita J, Misra UK. Diabetic neuropathy. Postgrad Med J. 2006;82:95–100.
- 4. Barter PJ, Nicholls S, Rye KA, et al. Antiinflammatory properties of HDL. Circ Res. 2004;95:764–772.
- 5. Negi G, Kumar A, Joshi RP, et al. Oxidative stress and Nrf2 in the pathophysiology of diabetic neuropathy: old perspective with a new angle. Biochem and Biophys Res Commun. 2011;408:1–5.
- 6. 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):30-35.
- 7. Charnogursky GA, Emanuele NV, Emanuele MA. Neurological complications of diabetes. Curr Neurol Neurosci Rep. 2014;14:457:1-16. 8. Johnstone MT, Nesto R. Diabetes mellitus and heart disease. In: Pickup JC, Williams G, editors. Joslin's Diabetes Mellitus. 14th ed. Philadelphia: Lippincott Williams and Wilkins; 2005:975- 998.
- 9. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001; 285: 2486-2497.
- 10. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulfonylureas or insulin compared with conventional treatment and risk of comlications in patients with type 2 diabetes. Lancet 1998;352:854-65.
- 11. Katulanda P, Ranasinghe P, Jayawardena R, et al. The prevalence, patterns and predictors of diabetic peripheral neuropathy in a developing country. Diabetol Metab Syndr. 2012;4:21:1–8. doi: 10.1186/1758-5996-4-21.
- 12. Perez-Matos MC, Morales-Alvarez MC, Mendivil CO. Lipids: a suitable therapeutic target in diabetic neuropathy. J Diabetes Res. 2017:6943851:1–9. doi: 10.1155/2017/6943851.
- 13. Krauss RM. Lipids and lipoproteins in patients with type 2 diabetes. Diabetes Care. 2004;27:1496–1504.
- 14. Çomoğlu S, Yardımcı S, Okçu Z. The alterations in plasma lipid profile of diabetic polyneuropathic patients. T Klin J Med Sci. 2001;21:345–348.
- 15. Isomaa B, Henricsson M, Almgren P, et al. The metabolic syndrome influences the risk of chronic complications in patients with Type II diabetes. Diabetologia. 2001;44:1148–1154.
- 16. Obrosova IG, Ilnytska O, Lyzogubov VV, et al. High-fat diet induced neuropathy of pre-diabetes and obesity: effects of “healthy” diet and aldose reductase inhibition. Diabetes. 2007;56:2598–2608.
- 17. Murphy AJ, Woollard KJ, Hoang A, et al. High density lipoprotein reduces the human monocyte inflammatory response. Arterioscler Thromb Vasc Biol. 2008;28:2071–2077.
- 18. Garcia C, Feve B, Ferré P, et al. Diabetes and inflammation: fundamental aspects and clinical implications. Diabetes Metab. 2010;36:327–338.
- 19. Skundric DS, Lisak RP. Role of neuropoietic cytokines in development and progression of diabetic polyneuropathy: from glucose metabolism to neurodegeneration. Exp Diabesity Res. 2003;4:303–312.
- 20. Lim AK, Tesch GH. Inflammation in diabetic nephropathy. Mediators Inflamm. 2012:146154:1-12.
- 21. Blüher M, Unger R, Rassoul F, et al. Relation between glycaemic control, hyperinsulinaemia and plasma concentrations of soluble adhesion molecules in patients with impaired glucose tolerance or Type II diabetes. Diabetologia. 2002;45:210–216.
- 22. Hilgendorf I, Swirski FK, Robbins CS. Monocyte fate in atherosclerosis. Arterioscler Thromb Vasc Biol. 2015;35:272–279.
- 23. Nandy D, Janardhanan R, Mukhopadhyay D, et al. Effect of hyperglycemia on human monocyte activation. J Investig Med. 2011;59:661–667.
- 24. Negi G, Kumar A, Joshi RP, et al. Oxidative stress and Nrf2 in the pathophysiology of diabetic neuropathy: old perspective with a new angle. Biochem and Biophys Res Commun. 2011;408:1–5.
- 25. Canpolat U, Çetin EH, Cetin S, et al. Association of monocyte-to-HDL cholesterol ratio with slow coronary flow is linked to systemic inflammation. Clin Appl Thromb Hemost. 2016;22:476–482.
- 26. Kundi H, Kiziltunc E, Cetin M, et al. Association of monocyte/HDL-C ratio with SYNTAX scores in patients with stable coronary artery disease. Herz. 2016;41:523–529.
- 27. Karatas A, Turkmen E, Erdem E, Dugeroglu H, Kaya Y.Monocyte to high-density lipoprotein cholesterol ratio in patients with diabetes mellitus and diabetic nephropathy. Biomark Med. 2018;12(9):953-959.
- 28. Aydin E, Ates I, Arikan MF, Yilmaz N, Dede F.The ratio of monocyte frequency to HDL cholesterol level as a predictor of asymptomatic organ damage in patients with primary hypertension. Hypertens Research. 2017;40(8):758-764.
- 29. Cetin MS, 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. Heart Lung Circ. 2016;25(11):1077-1086.
- 30. Vural G.,Gümüşyayla Ş., Monocyte-to-high density lipoprotein ratio is associated with a decreased compound muscle action potential amplitude in patients with diabetic axonal polyneuropathy. Medicine (Baltimore). 2018;97(42).
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Aralık 2019 |
| Gönderilme Tarihi | 16 Eylül 2019 |
| Kabul Tarihi | 25 Eylül 2019 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 4 Sayı: 4 |
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