Monocyte-HDL Ratio: Can It Be Included in the Follow-Up of Diabetes Mellitus and Diagnosis of Diabetic Nephropathy?
Öz
Background and Aim: Diabetic nephropathy is the most common cause of end-stage renal disease and albuminuria is the earliest manifestation of diabetic nephropathy.Oxidative stress and inflammation caused by advanced glyco-oxidation end products contribute to micro and macrovascular complications of diabetes. Monocyte to high-density lipoprotein (HDL) cholesterol ratio (MHR) is an essential indicator of inflammation and oxidative stress. In this study, we aimed to reveal the relationship between diabetes regulation and complications and MHR.
Material and Method: A total of 182 subjects, including 152 patients with diabetes mellitus (DM) and 30 healthy controls, were included in this study. All data of the subjects were scanned retrospectively. The DM group was divided into two groups nephropathy (n=68) and non-nephropathy (n=84), with a limit of 30 mg/day for albuminuria. MHR was calculated by dividing the monocyte count by the HDL cholesterol count.
Results: When patients with DM were divided into nephropathy and non-nephropathy, patients with nephropathy had higher MHR levels than the other group. We showed that MHR correlated with albuminuria, creatinine, and HbA1c in patients with diabetic nephropathy. In addition, in the regression analysis, albuminuria and MHR were predictors of DN, while MHR, age, and creatinine were found to be independent predictors of albuminuria.
Conclusion: MHR, which is an easily calculated marker with simple laboratory tests, which is frequently requested in routine practice in the follow-up of diabetes patients, can help predict the regulation of diabetes and its kidney complications.
Anahtar Kelimeler
Albuminuria diabetic nephropathy inflammation monocyte-hdl cholesterol ratio Albüminüri diyabetik nefropati inflamasyon monosit-HDL kolesterol oranı
Kaynakça
- Unwin N, Shaw J, Zimmet P, Alberti KG. Impaired glucose tolerance and impaired fasting glycaemia: The current status on definition and intervention. Diabet Med 2002; 19(9): 708-23.
- Wild S, Roglic G, Green A, Sicree R, King H. Global Prevalence of Diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care 2004; 27(5): 1047-53.
- Ninomiya T, Perkovic V, De Galan BE, Zoungas S, Pillai A, Jardine M et al. Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes. J Am Soc Nephrol 2009; 20(8): 1813-21.
- Fox CS, Coady S, Sorlie PD, D’Agostino RB, Pencina MJ, Vasan RS et al. Increasing cardiovascular disease burden due to diabetes mellitus: The Framingham Heart Study. Circulation 2007; 115(12): 1544-50.
- Müller-Wieland PD med D, Nauck M, Petersmann A, Müller-Wieland D, Schleicher E, Müller UA et al. Definition, Classification and Diagnosis of Diabetes Mellitus. Diabetologe 2019; 15(2): 128–34.
- Van Dijk C, Beri T. Pathogenesis of diabetic nephropathy. Rev Endocr Metab Disord 2004;5:237-48.
- Barter PJ, Nicholls S, Rye KA, et al. Antiinflammatory properties of HDL. Circ Res. 2004;95:764–772.
- Assmann G, Gotto AM. HDL cholesterol and protective factors in atherosclerosis. Circulation. 2004; 109(23)1: 308-14.
- Kanbay M, Solak Y, Unal HU, Kurt YG, Gok M, Cetinkaya H et al. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol 2014; 46(8): 1619-25.
- Shi C, Pamer EG. Monocyte recruitment during infection and inflammation. Nat Rev Immunol 2011; 11(11): 762-74.
- Yang J, Zhang L, Yu C, Yang XF, Wang H. Monocyte and macrophage differentiation: Circulation inflammatory monocyte as biomarker for inflammatory diseases. Biomark Res 2014; 2(1): 1.
- Mestas J, Ley K. Monocyte-Endothelial Cell Interactions in the Development of Atherosclerosis. Trends Cardiovasc Med 2008; 18(6): 228-32.
- Efe FK. The association between monocyte HDL ratio and albuminuria in diabetic nephropathy. Pak J Med Sci. 2021 Jul-Aug;37(4):1128-1132.
- Onalan E. The relationship between monocyte to high-density lipoprotein cholesterol ratio and diabetic nephropathy. Pak J Med Sci. 2019 Jul-Aug;35(4):1081-1086.
- 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 Sep;12(9):953-959.
- Kausik Umanath, Julia B Lewis. Update on Diabetic Nephropathy: Core Curriculum 2018. Am J Kidney Dis. 2018 Jun;71(6):884-895.
- Ganjali S, Gotto AM Jr, Ruscica M, Atkin SL, Butler AE, Banach M, Sahebkar A.Monocyte-to-HDL-cholesterol ratio as a prognostic marker in cardiovascular diseases. J Cell Physiol. 2018 Dec;233(12):9237-9246
- 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 Sep;41(6):523-9.
- Xu H, Pang Y, Li X, Zha B, He T. Monocyte to high-density lipoprotein cholesterol ratio as an independent risk factor for papillary thyroid carcinoma. Ding H.J Clin Lab Anal. 2021 Nov;35(11):e24014.
- Vural G, Gumusyayla S. 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 Oct;97(42):e12857
- Tang X, Tan Y, Yang Y, Li M, He X, Lu Y et al. Association of the Monocyte-to-High-Density Lipoprotein Cholesterol Ratio With Diabetic Retinopathy. Front Cardiovasc Med. 2021 Sep 21;8:707008.
- Mayasari DS, Taufiq N, Hariawan H. Association of monocyte-to-high density lipoprotein ratio with arterial stiffness in patients with diabetes. BMC Cardiovasc Disord. 2021 Jul 30;21(1):362.
- Demirbaş A, Elmas ÖF, Atasoy M, Türsen Ü, Lotti T. Can monocyte to HDL cholesterol ratio and monocyte to lymphocyte ratio be markers for inflammation and oxidative stress in patients with vitiligo? A preliminary study. Arch Dermatol Res. 2021 Aug;313(6):491-498
- Turkmen D, Altunisik N, Sener S. Investigation of monocyte HDL ratio as an indicator of inflammation and complete blood count parameters in patients with acne vulgaris. Int J Clin Pract. 2020 Dec;74(12):e13639
- Anjali Ganda, Martin Magnusson, Laurent Yvan-Charvet, Bo Hedblad, Gunnar Engström, Ding Ai et al. Mild Renal Dysfunction and Metabolites Tied to Low HDL Cholesterol Are Associated With Monocytosis and Atherosclerosis. Tall. Circulation. 2013 Mar 5;127(9):988-96
- 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 Sep;12(9):953-959
- Kahraman C, Kahraman NK, Coşgun S. Prognostic value of the monocyte/high density lipoprotein cholesterol ratio in diabetic nephropathy patients. Acta Medica Mediterranea. 2016;32:981.
- Woollard KJ, Geissmann F. Monocytes in atherosclerosis:subsets and functions. Nat Rev Cardiol. 2010;7(2):77–86. doi:10.1038/nrcardio.2009.228
- Cooper ME. Interaction of metabolic and haemodynamic factors in mediating experimental diabetic nephropathy. Diabetologia. 2001;44:1957–1972.
Monosit-HDL Oranı: Diyabetik Hastaların Takibinde ve Diyabetik Nefropatinin Tanısında Kullanılabilir mi ?
Öz
Giriş ve Amaç: Diyabetik nefropati, son dönem böbrek hastalığının en yaygın nedenidir ve albüminüri, diyabetik nefropatinin en erken belirtisidir. İleri gliko-oksidasyon son ürünlerinin neden olduğu oksidatif stres ve inflamasyon, diyabetin mikro ve makrovasküler komplikasyonlarına katkıda bulunur. Monosit sayısının, yüksek yoğunluklu lipoprotein (HDL) kolesterol seviyesine oranı (MHR), inflamasyon ve oksidatif stresin önemli bir göstergesidir. Çalışmada, diyabet regülasyonu ve komplikasyonlarıyla MHR arasındaki ilişkinin ortaya çıkarılması amaçlanmıştır.
Gereç ve Yöntem: Çalışmaya 152’si diabetes mellitus (DM) hastası ve 30’u sağlıklı kontrol olmak üzere toplam 182 kişi dahil edildi. Olguların tüm verileri retrospektif olarak tarandı. DM grubu albüminüri sınırı 30 mg/gün olmak üzere, nefropatisi olan (n=68) ve non-nefropatili (n=84) olmak üzere iki gruba ayrıldı. MHR, monosit sayısının HDL kolesterol sayısına bölünmesiyle hesaplandı.
Bulgular: DM'li hastalar nefropatik ve non-nefropatik olarak ayrıldığında, nefropatili hastaların MHR düzeyleri diğer gruba göre daha yüksekti. Diyabetik nefropatili hastalarda MHR'nin albüminüri, kreatinin ve HbA1c ile korele olduğunu gösterdik. Ayrıca regresyon analizinde albüminüri ve MHR DN'yi öngördürürken, MHR, yaş ve kreatinin düzeyi albüminürinin bağımsız ön görüdürücüleriydi.
Sonuç: Diyabet hastalarının takibinde rutin pratikte sıklıkla istenen ve basit laboratuvar testleri ile kolayca hesaplanabilen bir belirteç olan MHR, diyabetin hem regülasyonunda hem de böbrek komplikasyonlarını öngörmede faydalı bir belirteç olabilir.
Anahtar Kelimeler
Albüminüri diyabetik nefropati inflamasyon monosit-HDL kolesterol oranı
Kaynakça
- Unwin N, Shaw J, Zimmet P, Alberti KG. Impaired glucose tolerance and impaired fasting glycaemia: The current status on definition and intervention. Diabet Med 2002; 19(9): 708-23.
- Wild S, Roglic G, Green A, Sicree R, King H. Global Prevalence of Diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care 2004; 27(5): 1047-53.
- Ninomiya T, Perkovic V, De Galan BE, Zoungas S, Pillai A, Jardine M et al. Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes. J Am Soc Nephrol 2009; 20(8): 1813-21.
- Fox CS, Coady S, Sorlie PD, D’Agostino RB, Pencina MJ, Vasan RS et al. Increasing cardiovascular disease burden due to diabetes mellitus: The Framingham Heart Study. Circulation 2007; 115(12): 1544-50.
- Müller-Wieland PD med D, Nauck M, Petersmann A, Müller-Wieland D, Schleicher E, Müller UA et al. Definition, Classification and Diagnosis of Diabetes Mellitus. Diabetologe 2019; 15(2): 128–34.
- Van Dijk C, Beri T. Pathogenesis of diabetic nephropathy. Rev Endocr Metab Disord 2004;5:237-48.
- Barter PJ, Nicholls S, Rye KA, et al. Antiinflammatory properties of HDL. Circ Res. 2004;95:764–772.
- Assmann G, Gotto AM. HDL cholesterol and protective factors in atherosclerosis. Circulation. 2004; 109(23)1: 308-14.
- Kanbay M, Solak Y, Unal HU, Kurt YG, Gok M, Cetinkaya H et al. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol 2014; 46(8): 1619-25.
- Shi C, Pamer EG. Monocyte recruitment during infection and inflammation. Nat Rev Immunol 2011; 11(11): 762-74.
- Yang J, Zhang L, Yu C, Yang XF, Wang H. Monocyte and macrophage differentiation: Circulation inflammatory monocyte as biomarker for inflammatory diseases. Biomark Res 2014; 2(1): 1.
- Mestas J, Ley K. Monocyte-Endothelial Cell Interactions in the Development of Atherosclerosis. Trends Cardiovasc Med 2008; 18(6): 228-32.
- Efe FK. The association between monocyte HDL ratio and albuminuria in diabetic nephropathy. Pak J Med Sci. 2021 Jul-Aug;37(4):1128-1132.
- Onalan E. The relationship between monocyte to high-density lipoprotein cholesterol ratio and diabetic nephropathy. Pak J Med Sci. 2019 Jul-Aug;35(4):1081-1086.
- 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 Sep;12(9):953-959.
- Kausik Umanath, Julia B Lewis. Update on Diabetic Nephropathy: Core Curriculum 2018. Am J Kidney Dis. 2018 Jun;71(6):884-895.
- Ganjali S, Gotto AM Jr, Ruscica M, Atkin SL, Butler AE, Banach M, Sahebkar A.Monocyte-to-HDL-cholesterol ratio as a prognostic marker in cardiovascular diseases. J Cell Physiol. 2018 Dec;233(12):9237-9246
- 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 Sep;41(6):523-9.
- Xu H, Pang Y, Li X, Zha B, He T. Monocyte to high-density lipoprotein cholesterol ratio as an independent risk factor for papillary thyroid carcinoma. Ding H.J Clin Lab Anal. 2021 Nov;35(11):e24014.
- Vural G, Gumusyayla S. 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 Oct;97(42):e12857
- Tang X, Tan Y, Yang Y, Li M, He X, Lu Y et al. Association of the Monocyte-to-High-Density Lipoprotein Cholesterol Ratio With Diabetic Retinopathy. Front Cardiovasc Med. 2021 Sep 21;8:707008.
- Mayasari DS, Taufiq N, Hariawan H. Association of monocyte-to-high density lipoprotein ratio with arterial stiffness in patients with diabetes. BMC Cardiovasc Disord. 2021 Jul 30;21(1):362.
- Demirbaş A, Elmas ÖF, Atasoy M, Türsen Ü, Lotti T. Can monocyte to HDL cholesterol ratio and monocyte to lymphocyte ratio be markers for inflammation and oxidative stress in patients with vitiligo? A preliminary study. Arch Dermatol Res. 2021 Aug;313(6):491-498
- Turkmen D, Altunisik N, Sener S. Investigation of monocyte HDL ratio as an indicator of inflammation and complete blood count parameters in patients with acne vulgaris. Int J Clin Pract. 2020 Dec;74(12):e13639
- Anjali Ganda, Martin Magnusson, Laurent Yvan-Charvet, Bo Hedblad, Gunnar Engström, Ding Ai et al. Mild Renal Dysfunction and Metabolites Tied to Low HDL Cholesterol Are Associated With Monocytosis and Atherosclerosis. Tall. Circulation. 2013 Mar 5;127(9):988-96
- 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 Sep;12(9):953-959
- Kahraman C, Kahraman NK, Coşgun S. Prognostic value of the monocyte/high density lipoprotein cholesterol ratio in diabetic nephropathy patients. Acta Medica Mediterranea. 2016;32:981.
- Woollard KJ, Geissmann F. Monocytes in atherosclerosis:subsets and functions. Nat Rev Cardiol. 2010;7(2):77–86. doi:10.1038/nrcardio.2009.228
- Cooper ME. Interaction of metabolic and haemodynamic factors in mediating experimental diabetic nephropathy. Diabetologia. 2001;44:1957–1972.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Original Article |
| Yazarlar | |
| Erken Görünüm Tarihi | 29 Ağustos 2023 |
| Yayımlanma Tarihi | 31 Ağustos 2023 |
| Gönderilme Tarihi | 23 Kasım 2022 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 33 Sayı: 4 |
Genel Tıp Dergisi Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı (CC BY NC) ile lisanslanmıştır.