Association between monocyte-high density lipoprotein ratio (MHR) and severity level of lower extremity artery disease (LEAD)
. Faizin(1*), Bambang Irawan(2), Hariadi Hariawan(3)
(1) Resident of Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
(2) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
(3) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
(*) Corresponding Author
Abstract
The incidence of lower extremity artery disease (LEAD) has increased worldwide in the last decade. Its severity has been associated with increased morbidity and mortality. Atherosclerosis is believed as the main cause of LEAD. Monocytes and low-density lipoprotein (LDL) are the hallmarks of atherosclerosis. High-density lipoprotein (HDL) plays a role in suppressing the activation of monocytes. The monocyte to HDL ratio (MHR) has been reported as a marker of coronary artery disease complexity. However, this marker has not been investigated to assessthe LEAD severity. The study aimed to investigate the association between MHR and LEAD severity. This was an analytic observational study using a cross-sectional design. Patients were selected from the Vascular Disease Registry in Dr.Sardjito General Hospital, Yogyakarta from January 2016 – January 2019. The blood sample was drawn at one day prior, on the day, or one day after duplex ultrasound performed. The duplex ultrasound was then interpreted based on the duplex ultrasound score. Patients were classified into two groups according to the score i.e. severe (score ≥ 8) and nonsevere (score< 8). Where as, the MHR was classified into two groups according to the cut-off point i.e. high (≥ 14.51) and low (< 14.51). The Chi-square test was used for statistical analysis and pvalue <0.05 was considered as statistically significant. A total of 50 patients were involved in this study. There were 21 (42%) patients in the severe group and 29 (58%) in the nonsevere group. The proportion of the high MHR group and the low MHR group with severe levels of LEAD were 12 (57.1%) and 9 (42.9%), respectively. However, it was not statistically significant [p = 0.145; CI95% PR 1.57 (0.81 – 3.03)]. In conclusion, there is no association between MHR and LEAD severity.
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- Aboyans V, Ricco J-B, Bartelink M-LEL, Björck M, Brodmann M, Cohnert T, et al. 2017 European Society Cardiology Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J 2017; 39(9):763-816. https://doi.org/10.1093/eurheartj/ehx095
- Aronow WS. Association of lower extremity peripheral arterial disease with atherosclerotic vascular disease, cardiovascular events and mortality. J Cardiovasc Dis Diagn 2014; 2:e105. https://doi.org/10.4172/2329-9517.100e105
- Creager MA, Beckman JA, Loscalzo J. Vascular medicine: a companion to Braunwald's heart disease. 2nd ed. Philadelphia: Saunders, Elsevier Inc.; 2013.
- Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med 2005; 352(16):1685-95. https://doi.org/10.1056/NEJMra043430
- Herrington W, Lacey B, Sherliker P, Armitage J, Lewington S. Epidemiology of atherosclerosis and the potential to reduce the global burden of atherothrombotic disease. Cir Res 2016; 118(4):535-46. https://doi.org/10.1161/CIRCRESAHA.115.307611
- Lilly LS. Pathophysiology of heart disease: a collaborative project of medical students and faculty. 6thed. Philadelphie, PA: Wolters Kluwer; 2016.
- Riccioni G, Sblendorio V. Atherosclerosis: from biology to pharmacological treatment. J Geriatr Cardiol 2012; 9(3):305-17. https://doi.org/10.3724/SP.J.1263.2012.02132
- Collins R, Burch J, Cranny G, Aguiar-Ibáñez R, Craig D, Wright K, et al. Duplex ultrasonography, magnetic resonance angiography, and computed tomography angiography for diagnosis and assessment of symptomatic, lower limb peripheral arterial disease: systematic review. BMJ 2007; 334(7606):1257. https://doi.org/10.1136/bmj.39217.473275.55
- Hiremath R, Gowda G, Ibrahim J, Reddy HT, Chodiboina H, Shah R. Comparison of the severity of lower extremity arterial disease in smokers and patients with diabetes using a novel duplex Doppler scoring system. Ultrasonography 2017; 36(3):270-7. https://doi.org/10.14366/usg.16049
- Akboga MK, Balci KG, Maden O, Ertem AG, Kirbas O, Yayla C, et al. Usefulness of monocyte to HDL-cholesterol ratio to predict high SYNTAX score in patients with stable coronary artery disease. Biomark Med 2016; 10(4):375-83. https://doi.org/10.2217/bmm-2015-0050
- Kundi H, Kiziltunc E, Cetin M, Cicekcioglu H, Cetin ZG, Cicek G, et al. Association of monocyte/HDL-C ratio with SYNTAX scores in patients with stable coronary artery disease. Herz 2016; 41(6):523-9. https://doi.org/10.1007/s00059-015-4393-1
- Myers K, Clough AM. Practical vascular ultrasound: an illustrated guide.1sted.Boca Raton, FL: CRC Press; 2014. https://doi.org/10.1201/b17052
- Verim S, Taþçý Ý. Doppler ultrasonography in lower extremity peripheral arterial disease. Turk KardiyolDern Ars, 2013; 41(3):248-55. https://doi.org/10.5543/tkda.2013.76429
- Hiremath R, Gowda G, Ibrahim J, Reddy HT, Chodiboina H, Shah R. Comparison of the severity of lower extremity arterial disease in smokers and patients with diabetes using a novel duplex Doppler scoring system. Ultrasonography 2017; 36(3):270-7. https://doi.org/10.14366/usg.16049
- Hoffbrand AV, Moss PAH, Pettit JE. Essential haematology,5thed.Oxforf: Blackwell Publishing Ltd.; 2006.
- Wildgruber M, Aschenbrenner T, Wendorff H, Czubba M, Glinzer A, Haller B, et al. The "intermediate" CD14(++) CD16(+) monocyte subset increases in severe peripheral artery disease in humans. Sci Rep 2016; 6:39483. https://doi.org/10.1038/srep39483
- Ziegler-Heitbrock L, Ancuta P, Crowe S, Dalod M, Grau V, Hart DN, et al. Nomenclature of monocytes and dendritic cells in blood. Blood 2010; 116(16):e74-80. https://doi.org/10.1182/blood-2010-02-258558
- Ghattas A, Griffiths HR, Devitt A, Lip GY, Shantsila E. Monocytes in coronary artery disease and atherosclerosis: where are we now? JAm Coll Cardiol 2013; 62(17):1541-51. https://doi.org/10.1016/j.jacc.2013.07.043
- Annema W, von Eckardstein A. High-density lipoproteins. Multifunctional but vulnerable protections from atherosclerosis. Circ J 2013; 77(10):2432-48. https://doi.org/10.1253/circj.CJ-13-1025
- von Eckardstein A, Kardassis D. High density lipoproteins: from biological understanding to clinical exploitation. Heidelberg: Springer Nature; 2015. https://doi.org/10.1007/978-3-319-09665-0
- Pirillo A, Norata GD, Catapano AL. High-density lipoprotein subfractions - what the clinicians need to know. Cardiology 2013; 124(2):116-25. https://doi.org/10.1159/000346463
- Kasko M, Gaspar L, Dukát A, Gavorník P, Oravec S. High-density lipoprotein profile in newly-diagnosed lower extremity artery disease in Slovak population without diabetes mellitus. Neuro Endocrinol Lett 2014; 35:531-5.
- Savji N, Rockman CB, Skolnick AH, Guo Y, Adelman MA, Riles T, et al.Association between advanced age and vascular disease in different arterial territories: a population database of over 3.6 million subjects. J Am Coll Cardiol 2013; 61(16):1736-43. https://doi.org/10.1016/j.jacc.2013.01.054
- Aydin E, Ates I, FettahArikan M, 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 Res 2017; 40(8):758-64. https://doi.org/10.1038/hr.2017.36
- Srivaratharajah K, Abramson BL. Women and peripheral arterial disease: a review of sex differences in epidemiology, clinical manifestations, and outcomes. Can J Cardiol 2018; 34(4):356-61. https://doi.org/10.1016/j.cjca.2018.01.009
DOI: https://doi.org/10.19106/JMedSci005204202004
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