Monocyte to high-density lipoprotein cholesterol ratio reflects the peripheral inflammatory state in parkinsonian disorders

IF 3.1 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders Pub Date : 2024-10-03 DOI:10.1016/j.parkreldis.2024.107155

In Hee Kwak , Young Eun Kim , Yun Joong Kim , Hye-Mi Noh , Jeongjae Lee , Je Kook Yu , Hyeo-il Ma

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Abstract

Background

In Parkinson’s disease (PD) and Parkinson plus syndrome (PPS), inflammation is recognized as a relevant or contributing factor in the advancement of the diseases. For this reason, numerous biomarkers signaling immune alteration in both the central and peripheral nervous systems have been evaluated in PD and PPS. Nonetheless, the comprehensive inflammatory indices derived from readily available standard blood tests in PD, PPS, and healthy controls (HC) were rarely evaluated especially in the early stage of the diseases.

Objective

The aim of this study is to explore the serum level of peripheral inflammatory markers among the patients and investigate whether these markers contribute to symptoms.

Method

Clinical data and blood test results from drug naïve, early-stage 139 PD and 87 PPS patients, along with 139 age- and sex-matched healthy controls (HC) to PD were enrolled, with exclusion criteria applied to conditions potentially affecting inflammation. The study examined the disparities in peripheral inflammation among the groups, using total and subpopulation of white blood cells (WBCs), platelet count, red cell distribution width (RDW), high-density lipoprotein cholesterol (HDL-C), and other composite values reflecting inflammation including RDW to platelet ratio (RPR), neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), platelet to lymphocyte ratio (PLR), neutrophil to HDL-C ratio (NHR), monocyte to HDL-C ratio (MHR), lymphocyte to HDL-C ratio (LHR), platelet to HDL-C ratio (PHR), systemic inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI).

Result

The MHR values were significantly higher in both PD and PPS groups compared to HC (p < 0.001), and NHR was significantly higher in the PPS group only compared to the HC group (p < 0.001). However, no significant differences in all the inflammatory markers were observed between PPS and PD (p > 0.05). Subgroup analysis of progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) patients revealed significantly higher NHR and MHR levels compared to the HC group (p = 0.025, p = 0.050, respectively), with no significant difference among PSP, MSA, and PD groups. After adjustment for age, sex, and disease duration, MHR was positively associated with H&Y in the total population (β = 0.288, p < 0.001), negatively associated with MMSE in the PD group (β = −0.245, p = 0.017), and positively associated with both H&Y (β = 0.432, p < 0.001) and UPDRS part II (β = 0.295, p = 0.018) in PPS group.

Conclusion

NHR and MHR values are not effective as reliable diagnostic markers due to overlap among groups and their limited discriminative capacity in ROC analyses. However, MHR may potentially serve as an indicator reflecting peripheral inflammation in the early stage of PD and PPS compared to HC.

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单核细胞与高密度脂蛋白胆固醇的比率反映了帕金森氏症的外周炎症状态

背景在帕金森病（PD）和帕金森综合征（PPS）中，炎症被认为是疾病发展的相关因素或诱因。因此，已对帕金森病和帕金森综合征中中枢神经系统和外周神经系统免疫改变的许多生物标志物进行了评估。本研究旨在探讨患者血清中外周炎症标志物的水平，并研究这些标志物是否对症状有影响。方法纳入了139名PD早期患者、87名PPS患者以及139名与PD年龄和性别相匹配的健康对照者（HC）的临床数据和血液检测结果。研究使用白细胞（WBC）总数和亚群、血小板计数、红细胞分布宽度（RDW）、高密度脂蛋白胆固醇（HDL-C）和其他反映炎症的综合值（包括 RDW 与血小板比值（RPR）、中性粒细胞与淋巴细胞比值（NLR）），检查了各组间外周炎症的差异、单核细胞与淋巴细胞比值（MLR）、血小板与淋巴细胞比值（PLR）、中性粒细胞与高密度脂蛋白胆固醇比值（NHR）、单核细胞与高密度脂蛋白胆固醇比值（MHR）、淋巴细胞与高密度脂蛋白胆固醇比值（LHR）、血小板与高密度脂蛋白胆固醇比值（PHR）、全身炎症指数（SII）、全身炎症反应指数（SIRI）和全身炎症综合指数（AISI）。结果与 HC 组相比，PD 组和 PPS 组的 MHR 值均明显升高（p < 0.001），与 HC 组相比，仅 PPS 组的 NHR 值明显升高（p < 0.001）。然而，PPS 和 PD 之间的所有炎症指标均无明显差异（p > 0.05）。对进行性核上性麻痹（PSP）和多系统萎缩（MSA）患者进行的亚组分析显示，与 HC 组相比，NHR 和 MHR 水平明显更高（分别为 p = 0.025 和 p = 0.050），PSP、MSA 和 PD 组之间无明显差异。在对年龄、性别和病程进行调整后，总人群中 MHR 与 H&Y 呈正相关（β = 0.288，p < 0.001），PD 组中 MHR 与 MMSE 呈负相关（β = -0.245，p = 0.017），与 H&Y 均呈正相关（β = 0.结论NHR和MHR值作为可靠的诊断标志物并不有效，因为它们在组间存在重叠，而且在ROC分析中的鉴别能力有限。然而，与 HC 相比，MHR 有可能成为反映 PD 和 PPS 早期外周炎症的指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Parkinsonism & related disorders 医学-临床神经学

CiteScore

6.20

自引率

4.90%

发文量

292

审稿时长

39 days

期刊介绍： Parkinsonism & Related Disorders publishes the results of basic and clinical research contributing to the understanding, diagnosis and treatment of all neurodegenerative syndromes in which Parkinsonism, Essential Tremor or related movement disorders may be a feature. Regular features will include: Review Articles, Point of View articles, Full-length Articles, Short Communications, Case Reports and Letter to the Editor.