Evaluation of inflammatory markers in patients with migraine

Aim: The aim of this study was to evaluate erythrocyte sedimentation rate (ESR), high sensitivity C-reactive protein (hsCRP), neutrophil-to-lymphocyte ratio (NLR), monocyte to HDL-C ratio (MHR), and bilirubin levels in patients with migraine and compare with levels measured in healthy subjects. Methods: This retrospective case-control study included 136 migraine patients and 80 healthy controls who were admitted to our neurology outpatient clinic or emergency between June 2017 and June 2018. Laboratory examinations, disease characteristics, presence of aura, and the presence of white matter hyperintensities (WMHs) were recorded and demographic features and laboratory data were compared between two groups. Results: The mean age of the case group was 36.9 ± 10.6 years and the control group was 37 ± 12 years. In the patient group, total bilirubin, direct bilirubin, indirect bilirubin, and lymphocyte values were significantly lower than the control group. NLR, hsCRP, and ESR levels were significantly higher in the patient group than the control group. The patient and control groups did not show a significant difference according to the presence of WMHs. In the group with aura, monocyte and MHR values were higher than those without aura. The hsCRP values in the group with aura were significantly lower than the group without aura. Conclusion: This study showed that low bilirubin and high NLR, MHR, hsCRP, and ESR values might be potential inflammatory markers in migraine patients. These markers may contribute to our understanding of the pathophysiology of migraine. Since the cost of these tests is cheap and they are widely used, it is possible to believe that they may be useful for protecting migraine patients against long-term comorbidities.

Migren hastalarında enflamatuvar belirteçlerin değerlendirilmesi

Amaç: Bu çalışmanın amacı migren hastalarında eritrosit sedimentasyon hızı (ESR), yüksek duyarlılıklı C-reaktif protein (hsCRP), nötrofil-lenfosit oranı (NLO), monosit-HDL-C oranı (MHO) ve bilirubin düzeylerinin değerlendirilmesi ve sağlıklı bireylerde ölçülen seviyelerle karşılaştırılmasıdır. Yöntemler: Bu retrospektif vaka-kontrol çalışmasına Haziran 2017-Haziran 2018 tarihleri arasında hastanemiz nöroloji polikliniğine veya acil servisine başvuran 136 migren hastası ve 80 sağlıklı kontrol dahil edildi. Tüm katılımcıların laboratuvar tetkikleri, hastalık özellikleri, aura varlığı ve beyaz cevher lezyonlarının varlığı kaydedildi ve demografik özellikler ve laboratuvar verileri iki grup arasında karşılaştırıldı. Bulgular: Vaka grubunun yaş ortalaması 36.9 ±10.6 yıl ve kontrol grubunun 37±12 yıl idi. Hasta ve kontrol grupları arasında yaş ve cinsiyet açısından anlamlı fark saptanmadı. Vaka grubunda total bilirubin, direkt bilirubin, indirekt bilirubin, lenfosit değerleri kontrol grubuna göre anlamlı derecede düşüktü. Hasta grubunda NLO, hsCRP, ESR düzeyleri kontrol grubuna göre anlamlı yüksekti. Vaka ve kontrol grupları beyaz cevher lezyonları varlığı açısından anlamlı farklılık göstermedi. Aurası olan ve olmayan migren hastalarında yaş, cinsiyet, total bilirubin, direkt bilirubin ve indirekt bilirubin değerleri, NLO, ürik asit, lenfosit ve ESR düzeyleri açısından anlamlı fark saptanmadı. Auralı grupta monosit ve MHO değerleri aurasız gruba göre yüksekti. Auralı grupta hsCRP değeri aurasız gruba göre istatistiksel olarak anlamlı düşüktü. Sonuç: Bu çalışma, migren hastalarında düşük bilirubin ve yüksek NLO, CRP ve ESR değerlerinin potansiyel enflamatuvar marker olabileceğini göstermiştir. Bu markerlar hastalığın patofizyolojisini anlamamıza katkıda bulunabilir. Ayrıca söz konusu testlerin maliyeti ucuz ve yaygın kullanılan tetkikler olduğundan özellikle migren hastalarını olası uzun dönem komorbiditelerden korumak açısından faydalı olabileceği görüşündeyiz.

Kaynakça

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