The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang Province, China.
The First Affiliated Hospital of Zhejiang, Chinese Medical University, Hangzhou, 310053, Zhejiang Province, China.
Eur Arch Otorhinolaryngol. 2024 May;281(5):2293-2301. doi: 10.1007/s00405-023-08340-y. Epub 2023 Nov 28.
In several disorders, the monocyte to high-density lipoprotein ratio (MHR) has been considered a biomarker of systemic inflammation and oxidative stress. However, its role in Bell's palsy (BP) remains unclear. This study investigates the relationship between elevated MHR and poor recovery in BP patients.
The clinical data of 729 BP patients were analyzed retrospectively. The House-Brackmann Facial Nerve Grading System (H-B) was utilized to assess the severity of facial motor dysfunction during admission and the follow-up period after discharge. According to the 6 months follow-up data, H-B grades 1-2 were classified as recovered (n = 557), and H-B grades 3-6 as unrecovered (n = 172). The patients were split into MHR ≤ 0.26 (n = 361) and MHR > 0.26 (n = 368) groups based on the median MHR to further analyze the connection between different MHRs and prognosis.
The level of MHR was substantially greater in the unrecovered group of BP patients than in the restored group (medians[interquartile range], 0.32[0.20, 0.49] vs 0.24[0.11, 0.39], P < 0.001). MHR was an independent risk factor for BP prognosis as indicated by the multivariate logistic regression analysis (OR = 4.467, 95% CI = 1.875-10.646, P = 0.001). The area under the curve (AUC) was 0.615 (95% CI = 0.566-0.664, P < 0.001). The initial H-B score did not differ significantly between MHR ≤ 0.26 (n = 361) and MHR > 0.26 (n = 368) groups. However, after 6 months of follow-up, the high-MHR group's H-B score was considerably greater than the low-MHR group's.
MHR is expected to be an accessible and effective biomarker of BP. In BP patients, elevated MHR is related to an increased chance of poor recovery.
在几种疾病中,单核细胞与高密度脂蛋白比值(MHR)已被认为是全身炎症和氧化应激的生物标志物。然而,其在贝尔麻痹(BP)中的作用尚不清楚。本研究旨在探讨 MHR 升高与 BP 患者预后不良之间的关系。
回顾性分析了 729 例 BP 患者的临床资料。采用 House-Brackmann 面神经功能分级系统(H-B)评估入院时和出院后随访期间面部运动功能障碍的严重程度。根据 6 个月的随访数据,H-B 分级 1-2 为恢复(n=557),H-B 分级 3-6 为未恢复(n=172)。根据中位数 MHR 将患者分为 MHR≤0.26(n=361)和 MHR>0.26(n=368)两组,进一步分析不同 MHR 与预后的关系。
BP 患者未恢复组的 MHR 水平明显高于恢复组(中位数[四分位间距],0.32[0.20,0.49]比 0.24[0.11,0.39],P<0.001)。多因素 logistic 回归分析显示,MHR 是 BP 预后的独立危险因素(OR=4.467,95%CI=1.875-10.646,P=0.001)。曲线下面积(AUC)为 0.615(95%CI=0.566-0.664,P<0.001)。MHR≤0.26(n=361)和 MHR>0.26(n=368)两组之间,初始 H-B 评分无显著差异。然而,6 个月随访后,高 MHR 组的 H-B 评分明显高于低 MHR 组。
MHR 有望成为 BP 的一种易于获取且有效的生物标志物。在 BP 患者中,MHR 升高与预后不良的风险增加有关。