Özge TURGAY YILDIRIM, Ercan AKŞİT, Fatih AYDIN, Ayse HÜSEYİNOGLU AYDIN, Evrin DAĞTEKİN

Nötrofil/lenfosit oranı ve platelet/lenfosit oranı non-dipper kan basıncı için biyobelirteç olarak kullanılabilir mi?

Amaç: Hipertansiyon, kardiyovasküler hastalıklar için önemli bir risk faktörüdür ve non-dipper kan basıncı kardiyovasküler olaylar için artmış risk ile ilişkilidir. Nötrofil lenfosit oranı (NLR) ve platelet lenfosit oranı (PLR) inflamasyon ve kardiyovasküler risk ile ilişkilidir. Bu çalışmanın amacı, hipertansif ve normotansif hastalarda NLR, PLR ve non-dipper kan basıncı arasındaki ilişkiyi araştırmaktır.Yöntemler: Çalışmaya toplam 482 hasta alındı. Çalışma retrospektif kohort çalışma olarak planlandı. 24 saatlik ayaktan kan basıncı monitorizasyonu sonuçlarına göre dört grup oluşturuldu. Grup 1 hipertansif, non-dipper hastalar, Grup 2 hipertansif, dipper hastalar; Grup 3 normotansif, non-dipper hastalar ve Grup 4 normotansif, dipper hastalar olarak sınıflandırıldı.Bulgular: Çalışma popülasyonunun yaş ortalaması 50,1±15,5 yıl idi ve %38,1'i erkekti. Grup 1 (n = 165), Grup 2 (n=88), Grup 3 (n=123) ve Grup 4 (n=91) NLR açısından karşılaştırıldığında sonuç istatistiksel olarak anlamlı farklıydı (p<0,001). Grup 1'de; Grup 2'ye (p=0,001), Grup 3'e (p=0,002) ve Grup 4'e (p=0,023) göre NLR değeri istatistiksel anlamlı yüksekti. Hipertansif hasta grubunda, Grup 1'in PLR değerleri Grup 2'den anlamlı olarak yüksekti (p=0,002). Pearson korelasyon analizine göre NLR ve PLR, diurnal kan basıncı değişkenliği ile korelasyon gösterdi (NLR için r=-0,188, p<0,001 ve PLR için r =-0,182, p<0,001). Regresyon analizinde NLR (p=0,040), PLR (p=0,021), yaş (p=0,006) ve hipertansiyon (p<0,001), kan basıncı değişkenliğinin bağımsız belirleyicileri olarak saptandı.Sonuç: Bulgularımız, NLR ve PLR'nin hipertansif hastalarda non-dipper kan basıncı için ucuz ve kolay erişilebilir işaretleyiciler olarak kullanılabileceğini göstermektedir.

Anahtar Kelimeler:

Nötrofil lenfosit oranı, Platelet lenfosit oranı, Hipertansiyon, Ayaktan kan basıncı monitorizasyonu, Non-dipper kan basıncı

Can neutrophil to lymphocyte ratio and platelet to lymphocyte ratio be used as biomarkers for non-dipper blood pressure?

Aim: Hypertension is a major risk factor for cardiovascular diseases and non-dipper status is associated with increased risk for cardiovascular events. Neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) are related to inflammation and cardiovascular risk. The purpose of the study is to investigate the relationship between NLR and PLR with non-dipper status of hypertensive and normotensive patients. Methods: A total of 482 patients were enrolled for the study. The study was planned as retrospective cohort study. Four groups were formed according to 24-h ambulatory blood pressure monitoring results. Group 1 was defined as hypertensive, non-dipper patients; group 2 as hypertensive, dipper patients; group 3 as normotensive, non-dipper patients and group 4 as normotensive, dipper patients.Results: Mean age of the study population was 50.1±15.5 years, 38.1% were male. According to the statistical analysis of Group 1 (n=165), Group 2 (n=88), Group 3 (n=123) and Group 4 (n=91) NLR was statistically different among groups (p<0.001). Group 1 had significantly higher values compared to Group 2 (p=0.001), Group 3 (p=0.002) and Group 4 (p=0.023). In hypertensive patient group, PLR values of Group 1 was significantly higher than Group 2 (p=0.002). Pearson correlation analysis showed that NLR and PLR were correlated with BP variability (r=-0.188, p<0.001 for NLR and r=-0.182 and p<0.001 for PLR). Regression analysis showed NLR (p=0.040), PLR (p=0.021), age (p=0.006) and hypertension (p<0.001) were independent predictors of BP variability.Conclusion: Our findings suggest that NLR and PLR can be used as inexpensive and easily accessible markers to detect non-dipper status in hypertensive patients.

Keywords:

Neutrophil to lymphocyte ratio, Platelet to lymphocyte ratio, Hypertension, Ambulatory blood pressure monitoring, Non-dipper blood pressure,

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