ÖZET
Amaç:
Bu çalışmanın amacı sağlıklı bireylerde monosit/yüksek yoğunluklu lipoprotein (HDL) oranının (MHO) yaş ve cinsiyet açısından değerlendirilmesidir.
Yöntem:
Tek merkezli retrospektif bu çalışmaya Kayseri Şehir Hastanesi İç hastalıkları Kliniği’ne 1 yıl içerisinde başvuran, herhangi bir kronik hastalığı bulunmayan, ilaç kullanımı olmayan ve C-reaktif protein değeri 5 mg/L’nin ve eritrosit sedimantasyon hızı 20 mm/h’nin altında olan 459 hasta dahil edildi. Hastalar 20-39 yaş (Grup 1), 40-59 yaş (Grup 2), 60-79 yaş (Grup 3) ve 80 yaş üzeri (Grup 4) olmak üzere dört gruba ayrıldı. Katılımcıların HDL seviyeleri, tam kan sayımları ve demografik verileri kaydedildi. MHO, monosit sayısının HDL düzeyine bölünmesiyle hesaplandı.
Bulgular:
HDL, monosit sayısı ve MHO düzeyi karşılaştırıldığında gruplar arasında anlamlı fark yoktu (sırasıyla, p=0,46, p=0,26, p=0,37). HDL (53,52±12,44 ile 43,25±10,96; p<0,001), monosit sayısı (0,53±0,16 ile 0,60±0,18; p<0,001) ve MHO (10,59±4,07 ile 15,03±6,62; p<0,001) düzeyi bakımından iki cinsiyet grubu arasında istatistiksel olarak 2 grup arasında anlamlı fark tespit edildi.
Sonuç:
MHO sistemik enflamasyonun bir biyobelirteci olup sağlıklı bireylerde yaş grupları arasında fark bulunmamıştır. Cinsiyet açısından ise HDL, monosit sayısı ve MHO düzeyleri farklılık göstermektedir. Bu durum kardiyovasküler hastalıkların kadın cinsiyette daha az görülmesi ile açıklanabilir.
References
1
Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: Part I: aging arteries: a “set up” for vascular disease. Circulation 2003;107(1):139-146.
2
Rohrer L, Hersberger M, von Eckardstein A. High density lipoproteins in the intersection of diabetes mellitus, inflammation and cardiovascular disease. Curr Opin Lipidol 2004;15(3):269-278.
3
Hansson GK, Libby P, Schönbeck U, Yan Z-Q. Innate and adaptive immunity in the pathogenesis of atherosclerosis. Circ Res 2002;91(4):281-291.
4
Hessler JR, Robertson ALJ, Chisolm GM. LDL-induced cytotoxicity and its inhibition by HDL in human vascular smooth muscle and endothelial cells in culture. Atherosclerosis 1979;32(3):213-229.
5
Zhao S, Yu S, Chi C, Fan X, Tang J, Ji H, et al. Association between macro- and microvascular damage and the triglyceride glucose index in community-dwelling elderly individuals: the Northern Shanghai Study. Cardiovasc Diabetol 2019;18(1):95.
6
Li XP, Zhao SP, Zhang XY, Liu L, Gao M, Zhou QC. Protective effect of high density lipoprotein on endothelium-dependent vasodilatation. Int J Cardiol 2000;73(3):231-236.
7
Parthasarathy S, Barnett J, Fong LG. High-density lipoprotein inhibits the oxidative modification of low-density lipoprotein. Biochim Biophys Acta 1990;1044(2):275-283.
8
Hilgendorf I, Swirski FK, Robbins CS. Monocyte fate in atherosclerosis. Arterioscler Thromb Vasc Biol 2015;35(2):272-279.
9
Weber C, Shantsila E, Hristov M, Caligiuri G, Guzik T, Heine GH, et al. Role and analysis of monocyte subsets in cardiovascular disease. Joint consensus document of the European Society of Cardiology (ESC) Working Groups “Atherosclerosis & Vascular Biology” and “Thrombosis”. Thromb Haemost 2016;116(4):626-637.
10
Kim E, Yang J, Beltran CD, Cho S. Role of spleen-derived monocytes/macrophages in acute ischemic brain injury. J Cereb blood flow 2014;34(8):1411-1419.
11
Gordon DJ, Probstfield JL, Garrison RJ, Neaton JD, Castelli WP, Knoke JD, et al. High-density lipoprotein cholesterol and cardiovascular disease. Four prospective American studies. Circulation 1989;79(1):8-15.
12
Berrougui H, Momo CN, Khalil A. Health benefits of high-density lipoproteins in preventing cardiovascular diseases. J Clin Lipidol 2012;6(6):524-533.
13
You S, Zhong C, Zheng D, Xu J, Zhang X, Liu H, et al. Monocyte to HDL cholesterol ratio is associated with discharge and 3-month outcome in patients with acute intracerebral hemorrhage. J Neurol Sci 2017;372:157-161.
14
Ganjali S, Gotto AMJ, Ruscica M, Atkin SL, Butler AE, Banach M, et al. Monocyte-to-HDL-cholesterol ratio as a prognostic marker in cardiovascular diseases. J Cell Physiol 2018;233(12):9237-9246.
15
Eagleton MJ, Henke PK, Luke CE, Hawley AE, Bedi A, Knipp BS, et al. Southern Association for Vascular Surgery William J. von Leibig Award. Inflammation and intimal hyperplasia associated with experimental pulmonary embolism. J Vasc Surg 2002;36(3):581-588.
16
Kayrak M, Erdoğan HI, Solak Y, Akilli H, Gül EE, Yildirim O, et al. Prognostic value of neutrophil to lymphocyte ratio in patients with acute pulmonary embolism: a restrospective study. Heart Lung Circ 2014;23(1):56-62.
17
Canpolat U, Çetin EH, Cetin S, Aydin S, Akboga MK, Yayla C, et al. Association of Monocyte-to-HDL Cholesterol Ratio with Slow Coronary Flow is Linked to Systemic Inflammation. Clin Appl Thromb Off J Int Acad Clin Appl Thromb 2016;22(5):476-482.
18
Pereira BI, Devine OP, Vukmanovic-Stejic M, Chambers ES, Subramanian P, Patel N, et al. Senescent cells evade immune clearance via HLA-E-mediated NK and CD8(+) T cell inhibition. Nat Commun 2019;10(1):2387.
19
Chen H, Ma F, Hu X, Jin T, Xiong C, Teng X. Elevated COX2 expression and PGE2 production by downregulation of RXRα in senescent macrophages. Biochem Biophys Res Commun 2013;440(1):157-162.
20
Di Mitri D, Azevedo RI, Henson SM, Libri V, Riddell NE, Macaulay R, et al. Reversible senescence in human CD4+CD45RA+CD27- memory T cells. J Immunol 2011;187(5):2093-2100.
21
Childs BG, Baker DJ, Kirkland JL, Campisi J, van Deursen JM. Senescence and apoptosis: dueling or complementary cell fates? EMBO Rep 2014;15(11):1139-1153.
22
Ossoli A, Remaley AT, Vaisman B, Calabresi L, Gomaraschi M. Plasma-derived and synthetic high-density lipoprotein inhibit tissue factor in endothelial cells and monocytes. Biochem J 2016;473(2):211-219.
23
Usta A, Avci E, Bulbul CB, Kadi H, Adali E. The monocyte counts to HDL cholesterol ratio in obese and lean patients with polycystic ovary syndrome. Reprod Biol Endocrinol 2018;16(1):34.
24
Negi G, Kumar A, Joshi RP, Sharma SS. Oxidative stress and Nrf2 in the pathophysiology of diabetic neuropathy: old perspective with a new angle. Biochem Biophys Res Commun 2011;408(1):1-5.
25
Kreisberg RA, Kasim S. Cholesterol metabolism and aging. Am J Med 1987;82(1B):54-60.
26
Wilson PW, Anderson KM, Harris T, Kannel WB, Castelli WP. Determinants of change in total cholesterol and HDL-C with age: the Framingham Study. J Gerontol 1994;49(6):M252-M257.
27
Ferrara A, Barrett-Connor E, Shan J. Total, LDL, and HDL cholesterol decrease with age in older men and women. The Rancho Bernardo Study 1984-1994. Circulation 1997;96(1):37-43.
28
Ridefelt P, Hagström E, Svensson MK, Åkerfeldt T, Larsson A. Age- and sex-specific reference values for non-HDL cholesterol and remnant cholesterol derived from the Nordic Reference Interval Project (NORIP). Scand J Clin Lab Invest 2019;79:39-42.
29
Gordon S, Martinez FO. Alternative activation of macrophages: mechanism and functions. Immunity 2010;32(5):593-604.
30
De Maeyer RPH, van de Merwe RC, Louie R, Bracken O V, Devine OP, Goldstein DR, et al. Blocking elevated p38 MAPK restores efferocytosis and inflammatory resolution in the elderly. Nat Immunol 2020;21(6):615-625.
31
De Maeyer RPH, Chambers ES. The impact of ageing on monocytes and macrophages. Immunol Lett 2021;230:1-10.
32
Harris TB, Ferrucci L, Tracy RP, Corti MC, Wacholder S, Ettinger WHJ, et al. Associations of elevated interleukin-6 and C-reactive protein levels with mortality in the elderly. Am J Med 1999;106(5):506-512.
33
Furman D, Chang J, Lartigue L, Bolen CR, Haddad F, Gaudilliere B, et al. Expression of specific inflammasome gene modules stratifies older individuals into two extreme clinical and immunological states. Nat Med 2017;23(2):174-184.
34
Bruunsgaard H, Ladelund S, Pedersen AN, Schroll M, Jørgensen T, Pedersen BK. Predicting death from tumour necrosis factor-alpha and interleukin-6 in 80-year-old people. Clin Exp Immunol 2003;132(1):24-31.
35
Clee SM, Kastelein JJ, van Dam M, Marcil M, Roomp K, Zwarts KY, et al. Age and residual cholesterol efflux affect HDL cholesterol levels and coronary artery disease in ABCA1 heterozygotes. J Clin Invest 2000;106(10):1263-1270.
36
Nandy D, Janardhanan R, Mukhopadhyay D, Basu A. Effect of hyperglycemia on human monocyte activation. J Investig Med Off Publ Am Fed Clin Res 2011;59(4):661-667.
37
Liu Q, Xu A, Hang H, Chen X, Dai Y, Wang M, et al. Establishment of Reference Intervals for SII, NLR, PLR, and LMR in Healthy Adults in Jiangsu Region in Eastern China. Clin Lab 2023;69(5).
38
Man JJ, Beckman JA, Jaffe IZ. Sex as a Biological Variable in Atherosclerosis. Circ Res 2020;126(9):1297-1319.
39
Mathur P, Ostadal B, Romeo F, Mehta JL. Gender-Related Differences in Atherosclerosis. Cardiovasc Drugs Ther 2015;29(4):319-327.
