Can lymphocyte to monocyte ratio be used as a predictor of atherosclerotic carotid plaques in elderly adults?
Öz
Introduction: The lymphocyte/
monocyte ratio(LMR), a novel marker of inflammation, has been accepted as a
predictor for atherosclerosis. However, the relationship between LMR and
carotid atherosclerotic stenosis in older healthy adults remains undefined.
Aim: The aim of our study was to determine
retrospectively the association of LMR with carotid stenosis, evaluated by
carotid artery doppler ultrasonography.
Materials and Methods: Our study included 102 patients, aged ≥ 65 years,hospitalized in our clinic from January 2011 to December 2017. Blood samples were taken from all of the patients to determine the levels of white blood cell subtypes. LMR was calculated as the ratio of lymphocyte count to monocyte count. Patients also underwent carotid artery doppler ultrasonography to define the presence of carotid stenosis.
Results:After dividing the patient group
into two subgroups according to carotid stenosis, the patients with severe
stenosis(carotid stenosis> 50% )(n=42) had lower
lymphocyte count and LMR value but higher monocyte count. Then the patient
group with carotid stenosis> 50% were divided into two subgroups again. While
a statistically significant difference was found between the LMR values of
these 3 groups, this difference was in favor of the first group(carotis
stenosis ˂50%). The optimum cut-off LMR values was determined as 2.49
with a sensitivity of 72.6% and a specificity of 80.7%.
Conclusion: Lower levels of LMR can be used as a strong predictor of the presence
of severe carotid stenosis in elderly adults.
Anahtar Kelimeler
white blood cell subtypes lymphocyte/ monocyte ratio inflammation atherosclerosis
Kaynakça
- 1. Balkan S. editör. 3 rd ed.Serebrovasküler hastalıklar. vols 46-61. 3 rd ed. Ankara; 2002.p236-255.
- 2. Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J,Love BB, Gordon DL, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 1993;24:35-41.
- 3. Pagram H, Bivard A, Lincz LF, Levi C. Peripheral immune cell counts and advanced imaging as biomarkers of stroke outcome. Cerebrovasc Dis Extra, 2016; 6: 120–128.
- 4. Ross R. Atherosclerosis –an inflmamatory disease. N engl J Med 1999;340:115-126.
- 5. Tuttolomondo A,Di Raimondo D, Pecoraro R,Serio A, Aguanno G, Pinto A,et al. Immune-inflmammatory markers and arterial stiffness indexes in subjects with acute ischemic stroke. Atherosclerosis 2012;213(1):311-318.
- 6. Kim J, Song TJ, Park JH, Lee HS. Different prognostic value of white blood cell subtypes in patients with acute cerebral infarction. Atherosclerosis, 2012; 222: 464–467.
- 7. Bolayir A, Cigdem B, Gokce SF,Bolayir HA, Kayim Yildiz O,Bolayir E,et al. The Effect of Eosinopenia on Mortality in Patients with Intracerebral Hemorrhage. Journal of Stroke and Cerebrovascular Disease 2017;10(26):2248- 2255.
- 8. Rodrigues SF, Granger DN. Leukocyte-mediated tissue injury in ischemic stroke. Curr Med Chem, 2014; 21: 2130–2137.
- 9. Ren H, Liu X, Wang L,Gao Y. Lymphocyte-to-monocyte ratio: a novel predictor of the prognosis of acute ischemic stroke. Journal of Stroke And Cerebrovascular Diseases 2017; 26(11): 2595–2602.
- 10. Liberale L, Montecucco F, Bonaventura A, Casetta I,Seraceni S, Trentini A, et al. Monocyte count at onset predicts post-stroke outcomes during a 90-day follow up. Eur J Clin Invest 2017; 47(10): 702–710.
- 11. Bolayir A,Gokce SF, Cigdem B, Bolayir HA, Kayim Yildiz O,Bolayir E,et al. Monocytes/high-density lipoprotein ratio predicts the mortality in ischemic stroke. NeurologiaiNeurochirurgiaPolska 2017.Article in Press
- 12. Ancuta P, Wang J, Gabuzda D. CD 16 monocytes produce IL-6,CCL2 and matrix metalloproteinase -9 upon interaction with CX3 CL1- expressing endoteial cells. J Leukoc Biol 2006;80:1156-1164.
- 13. Ji H, Li Y, Fan Z, Zuo B, Jian X, Li L, et al. Monocyte/lymphocyte ratio predicts the severity of coronary artery disease: a syntax score assessment. BMC Cardiovasc Disord 2017;17:903.
- 14. Balta S, Celik T,Mikhailidis DP. The relation between atherosclerosis and the neutrophil-lymphocyte ratio. Clin Appl Thromb hemost 2016;22(5):405-411.
- 15. Horne BD, Anderson JL, John JM, Weasver A, Bair TL, Jensen Kr ,et al. Which white blood cell subtypes predict increased cardiovascular risk? J Am coll cardiol 2005;45:1638-1643.
- 16. Kadoya M, Koyama H, Kurajoh M,Kanzaki A, Kakutani Hatayama M,Okazaki H, et al. Sleep, cardiac autonomic function, and atherosclerosis in patients with cardiovascular risks: HSCAA study. Atherosclerosis 2015;238:409-414.
- 17. Tracey KJ. Reflex control of immunity. Nat Rev Immunuol 2009;9(6):418-428.
- 18. Bolayir A, Gokce SF. The role of mean platelet volume, platelet distrubition width and platelet/lymphocyte ration in development of cerebral venous thrombosis. Cumhuriyet Medical Journal 2017;39:683-691.
- 19. Urra X, Villamor N, Amaro S, Gomez-Choco M, Obach V,Oleaga L,et al. Monocyte subtypes predict clinical course and prognosis in human stroke. J Cereb Blood Flow Metab 2009;29:994-1002.
Lenfosit/monosit oranı yaşlı erişkinlerde aterosklerotik karotis plaklarınının bir göstergesi olarak kullanılabilir mi?
Öz
Amaç: Bu
çalışmadaki amacımız geriye dönük olarak LMO’nun karotis arter doppler
ultrasonografi ile saptanmış karotis stenozu ile ilişkisini saptamaktır.
Yöntem: Çalışmamız 65 yaş ve üzerinde, Ocak 2011- Aralık 2017 tarihleri arasında kliniğimizde takip edilen 102 hastayı içermektedir. Tüm hastalardan beyaz küre alt tiplerinin ölçümü için kan örneği alındı. LMO değeri lenfosit sayısının monosit sayısına oranı olarak hesaplandı. Hastalara ayrıca karotis stenozunu saptamak için karotis arter doppler ultrasonografisi de uygulandı.
Bulgular:
Hasta grubu karotis stenozu ciddiyetine göre iki alt gruba
ayrıldıktan sonra, ciddi darlığı olan hastaların(karotis stenozu> %50)(n=42)
daha düşük lenfosit sayısı ve LMO değerine ancak daha yüksek monosit sayısına
sahip olduğu saptandı. Daha sonra karotis stenozu %50’nin üzerinde olan
hastalar tekrar iki alt gruba ayrıldı. Her üç grup arasında LMO değeri
açısından istatistiksel olarak anlamlı fark saptanırken; bu fark birinci grup
lehineydi.(karotis stenozu ˂%50). LMO değeri için en iyi kesim noktası %72.6 duyarlılık ve %80.7
seçicilikle 2.49 olarak saptandı.
Sonuç: Düşük
LMO seviyeleri yaşlı erişkinlerde ciddi karotis stenozunun varlığı için güçlü
bir gösterge olarak kullanılabilir.
Anahtar Kelimeler
Beyaz küre alt tipleri lenfosit/monosit oranı inflamasyon ateroskleroz karotis arter stenozu;
Kaynakça
- 1. Balkan S. editör. 3 rd ed.Serebrovasküler hastalıklar. vols 46-61. 3 rd ed. Ankara; 2002.p236-255.
- 2. Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J,Love BB, Gordon DL, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 1993;24:35-41.
- 3. Pagram H, Bivard A, Lincz LF, Levi C. Peripheral immune cell counts and advanced imaging as biomarkers of stroke outcome. Cerebrovasc Dis Extra, 2016; 6: 120–128.
- 4. Ross R. Atherosclerosis –an inflmamatory disease. N engl J Med 1999;340:115-126.
- 5. Tuttolomondo A,Di Raimondo D, Pecoraro R,Serio A, Aguanno G, Pinto A,et al. Immune-inflmammatory markers and arterial stiffness indexes in subjects with acute ischemic stroke. Atherosclerosis 2012;213(1):311-318.
- 6. Kim J, Song TJ, Park JH, Lee HS. Different prognostic value of white blood cell subtypes in patients with acute cerebral infarction. Atherosclerosis, 2012; 222: 464–467.
- 7. Bolayir A, Cigdem B, Gokce SF,Bolayir HA, Kayim Yildiz O,Bolayir E,et al. The Effect of Eosinopenia on Mortality in Patients with Intracerebral Hemorrhage. Journal of Stroke and Cerebrovascular Disease 2017;10(26):2248- 2255.
- 8. Rodrigues SF, Granger DN. Leukocyte-mediated tissue injury in ischemic stroke. Curr Med Chem, 2014; 21: 2130–2137.
- 9. Ren H, Liu X, Wang L,Gao Y. Lymphocyte-to-monocyte ratio: a novel predictor of the prognosis of acute ischemic stroke. Journal of Stroke And Cerebrovascular Diseases 2017; 26(11): 2595–2602.
- 10. Liberale L, Montecucco F, Bonaventura A, Casetta I,Seraceni S, Trentini A, et al. Monocyte count at onset predicts post-stroke outcomes during a 90-day follow up. Eur J Clin Invest 2017; 47(10): 702–710.
- 11. Bolayir A,Gokce SF, Cigdem B, Bolayir HA, Kayim Yildiz O,Bolayir E,et al. Monocytes/high-density lipoprotein ratio predicts the mortality in ischemic stroke. NeurologiaiNeurochirurgiaPolska 2017.Article in Press
- 12. Ancuta P, Wang J, Gabuzda D. CD 16 monocytes produce IL-6,CCL2 and matrix metalloproteinase -9 upon interaction with CX3 CL1- expressing endoteial cells. J Leukoc Biol 2006;80:1156-1164.
- 13. Ji H, Li Y, Fan Z, Zuo B, Jian X, Li L, et al. Monocyte/lymphocyte ratio predicts the severity of coronary artery disease: a syntax score assessment. BMC Cardiovasc Disord 2017;17:903.
- 14. Balta S, Celik T,Mikhailidis DP. The relation between atherosclerosis and the neutrophil-lymphocyte ratio. Clin Appl Thromb hemost 2016;22(5):405-411.
- 15. Horne BD, Anderson JL, John JM, Weasver A, Bair TL, Jensen Kr ,et al. Which white blood cell subtypes predict increased cardiovascular risk? J Am coll cardiol 2005;45:1638-1643.
- 16. Kadoya M, Koyama H, Kurajoh M,Kanzaki A, Kakutani Hatayama M,Okazaki H, et al. Sleep, cardiac autonomic function, and atherosclerosis in patients with cardiovascular risks: HSCAA study. Atherosclerosis 2015;238:409-414.
- 17. Tracey KJ. Reflex control of immunity. Nat Rev Immunuol 2009;9(6):418-428.
- 18. Bolayir A, Gokce SF. The role of mean platelet volume, platelet distrubition width and platelet/lymphocyte ration in development of cerebral venous thrombosis. Cumhuriyet Medical Journal 2017;39:683-691.
- 19. Urra X, Villamor N, Amaro S, Gomez-Choco M, Obach V,Oleaga L,et al. Monocyte subtypes predict clinical course and prognosis in human stroke. J Cereb Blood Flow Metab 2009;29:994-1002.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Dahili Tıp Bilimleri Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 5 Haziran 2018 |
| Kabul Tarihi | 15 Mayıs 2018 |
| Yayımlandığı Sayı | Yıl 2018Cilt: 40 Sayı: 2 |