Mehmet Alican SAPMAZ, İlknur SAYAR, Ece YİĞİT, Tuncay KÜÇÜKÖZKAN

Postmenapozal Hastalarda Trombosit Hacmi, Trombosit/Lenfosit ve Nötrofil/Lenfosit Oranlarının Vücut Kitle İndeksine Göre Karşılaştırılması ve Bu Sonuçların Kardiyovasküler Risk ve Sıcak Basması Üzerine Etkileri

Amaç: Postmenopozal dönemindeki kadınlarda nötrofil/lenfosit oranı, trombosit/lenfosit oranı ve ortalama trombosit hacminin kardiyovasküler riski öngören birer belirteç olup olmadıklarının tespit edilmesi hedeflenmiştir. Gereç ve Yöntem: Kardiyovasküler hastalığı olmayan, postmenapozal dönemindeki hastalar çalışmamıza dahil edilmiştir. Boy ve kilo ölçümleri yapılarak vücut kitle indeksleri hesaplanmış, hemogram ve lipid profili analizleri yapılmış ve karotis intima kalınlıkları ölçülmüştür. Bu değerlere göre kardiyovasküler riski yüksek olan grup ve düşük olan grup arasında nötrofil/lenfosit oranı, trombosit/lenfosit oranı ve ortalama trombosit hacmi değerleri açısından anlamlı farklılık olup olmadığı analiz edilmiştir. Bulgular: Çalışmamıza 158 kadın hasta dahil edilmiştir. Vücut kitle indexi ≥30 olan grubun total kolesterol, trigliserid, düşük yoğunluklu lipoprotein ve lenfosit düzeyi ve ayrıca bilateral karotis intima kalınlıkları anlamlı olarak daha yüksek bulunmuştur. İki grup arasında nötrofil sayısı, trombosit sayısı, ortalama trombosit hacmi, nötrofil/lenfosit oranı ve yüksek dansiteli lipoprotein düzeyleri açısından anlamlı farklılık tespit edilemezken, trombosit/lenfosit oranı VKİ ≥30 olan grupta daha düşük bulunmuştur. Sonuç: Çalışmamızda kardiyovasküler hastalığı olmayan postmenopozal dönemdeki hastalar kardiyovasküler hastalık gelişimi açısından yüksek ve düşük riskli olarak ikiye ayrılarak kıyaslanmıştır. Çalışmanın sonucu bu inflamatuar belirteçlerin henüz hastalık tablosu ortaya çıkmamış hastalarda risk öngörmede anlamlı belirteçler olmadığını göstermiştir.

Anahtar Kelimeler:

Menopoz, inflamasyon, kardiyovasküler hastalıklar

Comparison of Thrombocyte Volume, Thrombocyte/Lymphocyte and Neutrophil/Lymphocyte Ratios According to Body Mass Index in Postmenopausal Patients and The Effect of These Results On Cardiovascular Risk and Hot Flashes

Aim: It was aimed to determine whether neutrophil/lymphocyte ratio, platelet/lymphocyte ratio and mean platelet volume are predictors of cardiovaskular risk in postmenopausal women. Material and Method: Postmenopausal patients without cardiovascular disease were included in our study. Body mass indexes were calculated by measuring height and weight, hemogram and lipid profile analyzes were made and carotid intima thickness was measured. According to these values, it was analyzed whether there was a significant difference between the group with high cardiovascular risk and the group with low risk in terms of neutrophil/lymphocyte ratio, platelet/lymphocyte ratio and mean platelet volume values. Results: 158 female patients were included in our study. Total cholesterol, triglyceride, low density lipoprotein and lymphocyte levels as well as bilateral carotid intima thicknesses were found to be significantly higher in the group with a body mass index of ≥30. While there was no significant difference between the two groups in terms of neutrophil count, platelet count, mean platelet volume, neutrophil/lymphocyte ratio and high-density lipoprotein levels, the platelet/lymphocyte ratio was found to be lower in the group with BMI ≥30. Conclusion: In our study postmenopausal patients without cardiovascular disease were divided into two groups as high and low risk for the development of cardiovascular disease and compared. The result of the study showed that these inflammatory markers are not significant markers in predicting risk in patients who have not yet manifested the disease.

Keywords:

Menapause, inflammation, cardiovascular diseases,

PDF

___

1- Gezer A. Menopoz ve Osteoporoz, Kadın Hastalıkları ve Doğum Bilgisi Kitabı 1. bs, Güneş Kitabevi, Ofset Matbaacılık, Ankara ; 2004 .s. 1163-1165
2- Nathorst-Boos J, Schoultz B , Psychological Reactions and Sexual Life After Hysterectomy with and without Oophorectomy , Gynecol Obstet Invest . 1992; 34(2) : 97-101.
3- Steams V, Ullmer L, Lopez JF, Smith Y, Isaacs C, Hayes DF . Hot Flushes , Lancet 2002 ; 360: 1851-1861
4- Reddy Kilim S., RaoChandala S. A Comparativestudy of Lipid Profile Andoestradiol in pre- and post-Menopausal women. Journal of Clinicaland Diagnostic Research. 2013 ; 7(8):1596–1598
5- Varu D. M. S., Vegad D. A. M., Jani D. H. A., Savalia D. C. V., Joshi D. V. S. A Comparativestudy of Serum Lipid Profile Between Premenopausal and Postmenopausal Women. National Journal of Integrated Research in Medicine. 2012 ; 3(1):43–45
6- Deepthi S., Naidu J., Narayan A. R. Relationship Between Estrogen and Lipid Profile Status in Postmenopausal Women. International Journal of Applied Biology and Pharmaceutical Technology. 2012; 3(3 ): 230–234
7- Kumar S., Shah C. , Oommen ER. Study of Cardiovascular Risk Factors in Pre and Postmenopausal Women. International Journal of Pharma Sciences and Research. 2012;3(12):560–570
8- Manson JE. , Hsia J. , Johnson KC. et al. Estrogen Plus Progestin and The Risk of Coronary Heart Disease . The New England Journal of Medicine 2003 ; 349:523-534
9- Geroulakos G. , O’Gornam DJ. , Kalodiki E. et al. The Carotid Intima-Media Thickness as a Marker of the Presence of Severe Symptomatic Coronary Artery Disease. Eur Heart J 1994 ;15(6):781-5
10- Demircan S. , Tekin A. , Topcu S. ve ark. Comparison of Carotid Intima Media Thickness in Patients with Stabile Angina Pectoris Versus Patients with Acute Coronary Sendrome. Am J Cardiol 2005 ; 96(5):643-4
11- Gibson PH. , Cuthbertson BH. , Croal BL. et al. Usefulness of Neutrophil/Lymphocyte Ratio as Predictor of New-Onset Atrial Fibrillation After Coronary Artery Bypass Grafting. Am J Cardiol 2010 ; 105: 186-91
12- Li N. ; Platelet–Lymphocyte Cross-Talk. Journal of Leukocyte Biology, 2008 ; 83(5): 1069- 1078.
13- Murray CJL. , Lopez AD. Alternative Projections of Mortality and Disability by Cause 1990-2020: Global Burden of Disease Study Lancet 1997 ; 349: 1498-1504.
14- 4. World HealthOrganization. Reducing Risks, Promoting Healthy Life. The World Health Report 2002
15- Colina I. , Sunsundegui P ., Camarero B. , Núñez-Córdoba JM. , Beloqui Ó. Comparison of Correlations of Equation-Derived Body Fat Percentage and Body Mass Index with Carotid Intima-Media Thickness 2018 Acta Diabeto Lógica Landecho MF,
16- Zahorec R. Ratio of Neutrophil to Lymphocyte Counts—Rapid and Simple Parameter of Systemic Inflammation and Stress in Critically Ill. Bratisl LekListy 2001; 102:5-14
17- Y. Furuncuoğlu, S. Tulgar , A.N. Doğan , S. Çakar , Y.K. Tulgar , B. Çakıroğlu How Obesity Affects the Neutrophil/Lymphocyte and Platelet/Lymphocyte Ratio, Systemic Immune-Inflammatory Index and Platelet Indices Eur Rev Med Pharmacol Sci 2016 ; 20(7):1300-6
18- E. Erdal , M. İnanır Platelet to Lymphocyte Ratio (PLR) and Platelet Crit (PCT) in Young Patients with Morbid Obesit ; Rev Assoc Med Bras 1992 ; 65(9):1182-1187
19- Sharma K. , Patel A. , Shah K. , Konat A. Is Neutrophil-to-Lymphocyte Ratio a Predictor of Coronary Artery Disease in Western Indians? International Journal of Inflammation 2017 ; 2017(4) :1-8
20- Durmus E. , Kivrak T. , Gerin F. , Sunbul M. , Sari I., Erdogan O. Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio are Predictors of Heart Failure , Arq Bras Cardiol 2015; 105(6): 606–613
21- Seropian I. , Romeo F. , Pizarro R. et al. Neutrophil‐to‐Lymphocyte Ratio and Platelet‐to‐Lymphocyte Ratio as Predictors of Survival After Heart Transplantation , ESC Heart Fail 2018 ; 5(1):149-156
22- Koo S. , Ahn Y. , Lim J. et al. Obesity Associates with Vasomotor Symptoms in Postmenopause but with Physical Symptoms in Perimenopause , BMC Womens Health 2017 ; 17(1):126