Monocyte-HDL Ratio: Can It Be Included in the Follow-Up of Diabetes Mellitus and Diagnosis of Diabetic Nephropathy?

Background and Aim: Diabetic nephropathy is the most common cause of end-stage renal disease and albuminuria is the earliest manifestation of diabetic nephropathy.Oxidative stress and inflammation caused by advanced glyco-oxidation end products contribute to micro and macrovascular complications of diabetes. Monocyte to high-density lipoprotein (HDL) cholesterol ratio (MHR) is an essential indicator of inflammation and oxidative stress. In this study, we aimed to reveal the relationship between diabetes regulation and complications and MHR. Material and Method: A total of 182 subjects, including 152 patients with diabetes mellitus (DM) and 30 healthy controls, were included in this study. All data of the subjects were scanned retrospectively. The DM group was divided into two groups nephropathy (n=68) and non-nephropathy (n=84), with a limit of 30 mg/day for albuminuria. MHR was calculated by dividing the monocyte count by the HDL cholesterol count. Results: When patients with DM were divided into nephropathy and non-nephropathy, patients with nephropathy had higher MHR levels than the other group. We showed that MHR correlated with albuminuria, creatinine, and HbA1c in patients with diabetic nephropathy. In addition, in the regression analysis, albuminuria and MHR were predictors of DN, while MHR, age, and creatinine were found to be independent predictors of albuminuria. Conclusion: MHR, which is an easily calculated marker with simple laboratory tests, which is frequently requested in routine practice in the follow-up of diabetes patients, can help predict the regulation of diabetes and its kidney complications

Covid-19 hastalarında yoğun bakım yatışı ile ilişkili faktörler

Aim: In this study, it was aimed whether biochemical parameters, vital signs and neutrophil-lymphocyte ratio (NLR) values could be used in determining the indication for intensive care hospitalization in COVID-19 patients. Patients and Methods: This retrospective observational study was conducted in the emergency department of a university hospital. Patients with positive SARS-CoV-2 PCR test who applied to our hospital on 1-31 July 2020 were included in the study. Laboratory results, demographic findings and clinical results of the patients were collected electronically. The patients were divided into 3 groups as discharged, admitted to the service or intensive care unit. The incidence and severity of symptoms, comorbidities, laboratory values, and NLR values were compared between the groups. Results: A total of 489 patients were included in the study. The mean age of the included patients was 48.69 + 17.25 years, of which 260 (53.16%) were female. While 248 (50.9%) of these patients were discharged, 207 (42.3%) were taken to the service and 33 (6.7%) to the intensive care units. Age, heart rate, urea, creatinine, CRP, D-dimer and NLR values of the patients admitted to the intensive care unit were higher than the other groups, while oxygen saturation was statistically significantly lower in this group. Concomitant systemic diseases such as Diabetes Mellitus, Essential Hypertension, Chronic Obstructive Pulmonary Disease were more common in those hospitalized in the intensive care unit. In multivariable analysis, oxygen saturation (OR:0.803) and neutrophil-lymphocyte ratio (OR:1.09) were found to be independent predictors of the indication for hospitalization in the intensive care unit. Conclusion: As a result of our study, we think that especially low oxygen saturation and high neutrophillymphocyte ratio can be used in determining the indication for intensive care hospitalization in patients who apply to the emergency department due to COVID-19.Amaç: Bu çalışmada biyokimyasal parametreler, vital bulgular ve nötrofil-lenfosit oranı (NLR) değerlerinin COVID-19 hastalarında yoğun bakım yatış endikasyonunun belirlenmesinde kullanılabilir olup olmadığı amaçlandı. Hastalar ve Yöntem: Bu retrospektif gözlemsel çalışma, bir üniversite hastanesinin acil servisinde gerçekleştirildi. 1-31 Temmuz 2020 tarihinde hastanemize başvurmuş SARS-CoV-2 PCR testi pozitif olan hastalar çalışmaya dahil edildi. Elektronik ortamda hastaların laboratuvar sonuçları, demografik bulguları ve klinik sonuçları toplandı. Hastalar taburcu edilmiş, servise veya yoğun bakıma yatışı yapılmış olarak 3 gruba ayrıldı. Gruplar arasında semptomların görülme sıklığı, şiddeti, ek hastalıklar, laboratuvar değerleri, NLR değerleri kıyaslandı. Bulgular: Çalışmaya toplam 489 hasta dahil edildi. Dahil edilen hastaların ortalama yaşı 48.69 + 17.25 yıl iken bunların 260’ı (%53,16) kadındı. Bu hastaların 248’i (%50,9) taburcu edilirken, 207’si (%42,3) servislere, 33 (%6,7)’ü de yoğun bakım ünitelerine alındı. Yoğun bakıma yatış yapılan hastaların yaş, kalp hızı, üre, kreatinin, CRP, D-dimer ve NLR değerleri diğer gruplara kıyasla yüksekken, bu grupta oksijen saturasyonu ise istatiksel olarak anlamlı derecede düşüktü. Yoğun bakımı yatışı olanlarda Diabetes Mellitus, Esansiyel Hipertansiyon, Kronik Obstrüktif Akciğer hastalığı gibi eşlik eden sistemik rahatsızlıklar daha fazlaydı. Çok değişkenli analizde oksijen satürasyonu (OR:0.803) ve nötrofil-lenfosit oranı (OR:1.09) yoğun bakım ünitesinde yatış endikasyonunun bağımsız öngördürücüsü olarak b ulundu. Sonuç: Çalışmamızın sonucunda acil servise COVID-19 nedeni ile başvuran hastalarda özellikle düşük oksijen satürasyonu ve yüksek nötrofil-lenfosit oranının yoğun bakım yatış endikasyonun belirlenmesinde kullanılabileceklerini düşünüyoruz