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严重症状性主动脉瓣狭窄患者的单核细胞与淋巴细胞比值与甲状旁腺激素浓度相关。

Monocyte-to-lymphocyte ratio correlates with parathyroid hormone concentration in patients with severe symptomatic aortic stenosis.

作者信息

Olasińska-Wiśniewska Anna, Urbanowicz Tomasz, Grodecki Kajetan, Kübler Piotr, Perek Bartłomiej, Grygier Marek, Misterski Marcin, Walczak Maciej, Szot Mateusz, Jemielity Marek

机构信息

Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland.

Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland.

出版信息

Adv Med Sci. 2023 Sep;68(2):396-401. doi: 10.1016/j.advms.2023.09.011. Epub 2023 Oct 12.

Abstract

PURPOSE

The normal healthy valve is devoid of inflammatory cells, however background of aortic stenosis (AS) may include inflammatory processes. Moreover, the link between hyperparathyroidism and heart failure is postulated. Simple whole blood analysis with indices is a beneficial tool in cardiovascular diseases' assessment. The purpose of the study was to evaluate correlation between parathyroid hormone (PTH) and simple blood parameters in severe AS.

MATERIAL AND METHODS

The study included 62 patients with severe AS. Patients with inflammatory or autoimmune co-morbidities were excluded. Blood samples were collected, and clinical and demographic data were analyzed.

RESULTS

The final study group comprised 55 patients (31 females, 56.4%; mean age 77.13 (SD 6.76)). In 23 patients (41.8%), PTH concentration was markedly increased. The study group was divided into two subgroups according to the PTH concentration. Patients from both groups did not differ significantly in terms of age and co-morbidities. PTH concentration correlated positively with monocyte-lymphocyte ratio (MLR) (p ​= ​0.008, Spearman rho 0.356) and platelet-lymphocyte ratio (PLR) (p ​= ​0.047, Spearman rho 0.269), creatinine level (p ​= ​0.001, Spearman rho 0.425) and glomerular filtration rate (GFR-MDRD) (p ​= ​0.009, Spearman rho -0.349). The multivariable logistic regression with backward analysis revealed MLR (p ​= ​0.029) and GFR (p ​= ​0.028) as independent significant predictors of abnormal PTH values. The receiver operator characteristics (ROC) curve was performed for the model of MLR and GFR-MDRD (AUC ​= ​0.777), yielding the sensitivity of 60.9% and specificity of 90.6%.

CONCLUSIONS

PTH concentration correlates with monocyte-to-lymphocyte and platelet-to-lymphocyte ratios in calcified AS.

摘要

目的

正常健康瓣膜无炎症细胞,但主动脉瓣狭窄(AS)的背景可能包括炎症过程。此外,甲状旁腺功能亢进与心力衰竭之间的联系也被提出。简单的全血分析及相关指标是评估心血管疾病的有益工具。本研究的目的是评估严重AS患者甲状旁腺激素(PTH)与简单血液参数之间的相关性。

材料与方法

本研究纳入62例严重AS患者。排除患有炎症或自身免疫性合并症的患者。采集血样,并分析临床和人口统计学数据。

结果

最终研究组包括55例患者(31例女性,占56.4%;平均年龄77.13岁(标准差6.76))。23例患者(41.8%)的PTH浓度显著升高。根据PTH浓度将研究组分为两个亚组。两组患者在年龄和合并症方面无显著差异。PTH浓度与单核细胞-淋巴细胞比率(MLR)呈正相关(p = 0.008,Spearman秩相关系数0.356)、与血小板-淋巴细胞比率(PLR)呈正相关(p = 0.047,Spearman秩相关系数0.269)、与肌酐水平呈正相关(p = 0.001,Spearman秩相关系数0.425)以及与肾小球滤过率(GFR-MDRD)呈负相关(p = 0.009,Spearman秩相关系数 -0.349)。采用向后分析的多变量逻辑回归显示MLR(p = 0.029)和GFR(p = 0.028)是PTH值异常的独立显著预测因素。对MLR和GFR-MDRD模型绘制了受试者工作特征(ROC)曲线(AUC = 0.777),灵敏度为60.9%,特异度为90.6%。

结论

在钙化性AS中,PTH浓度与单核细胞与淋巴细胞比率以及血小板与淋巴细胞比率相关。

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