Relationship Between MHR,PLR And Degree Of Arteriosclerosis In Patients With Metabolic Syndrome

ObjectiveThis study aimed to analyze the correlation between Monocyte to High-density Platelet to lymphocyte ratio(MHR),Platelet to lymphocyte ratio(PLR),and multiple sclerosis(MS)patients with atherosclerosis.Additionally,it aimed to determine the reference value of MHR and PLR levels in predicting the presence of arteriosclerosis in MS patients.MethodsThe study selected patients who met the diagnostic criteria for MS and visited the Department of Cardiology of the Second Affiliated Hospital of Shenyang Medical College between December 2020 and December 2022.Based on the Chinese expert consensus on limb blood pressure measurement in adults,the Brachial ankle pulse wave conduction velocity(Ba-PWV)was measured,considering whether unilateral or bilateral Ba-PWV ≥ 14 m/s.The MS+AS group was further categorized into mild,moderate,and severe AS groups based on the degree of sclerosis.A comparison was made between the MS-AS group and the MS+AS group in terms of MS components,blood routine,blood biochemistry,laboratory indicators,limb blood pressure,MHR,and PLR.Binary and multivariate logistic regression analyses were performed to determine whether MHR and PLR were risk factors for MS combined with AS.One-way ANOVA was used to analyze MHR and to identify significant differences between PLR and MS with AS in different degrees.The test level α was set at 0.05.Receiver Operator Characteristic(ROC)curves were plotted,and the area under the curve(AUC),sensitivity,and specificity of MHR,PLR,and their combined effect were described to evaluate the predictive value of these indicators in diagnosing MS with AS.Results1.Comparison of MS constituent factors between the two groups showed no statistically significant differences in hypertension,high fasting blood glucose,low high-density lipoprotein cholesterol(HDL-C),or abdominal obesity(P>0.05).However,triglyceride(TG)levels in the MS+AS group were higher than those in the MS-AS group,with a statistically significant difference.2.Comparison of laboratory indicators between the two groups revealed statistically significant differences in age,white blood cell count,monocyte count,platelet count,TG,low-density lipoprotein cholesterol(LDL-C),HDL-C,MHR,and PLR.The MS+AS group exhibited higher age,platelet count,TG,LDL-C,MHR,and PLR compared to the MS-AS group,whereas HDL-C was lower in the MS+AS group.However,no statistically significant differences were observed in height,weight,body mass index,lymphocyte count,neutrophil count,hematocrit,TG,LDL-C,albumin,fasting hemoglobin,glycosylated hemoglobin,or uric acid(P>0.05).The left ankle brachial index,right ankle brachial index,and right ankle diastolic blood pressure were lower in the MS+AS group than in the MS-AS group,with statistically significant differences.Heart rate,right arm systolic blood pressure,right arm diastolic blood pressure,right arm pulse pressure,right ankle systolic blood pressure,left arm systolic blood pressure,left arm diastolic blood pressure,left arm pulse pressure,left ankle systolic blood pressure,and left ankle diastolic blood pressure showed no statistically significant differences(P>0.05).3.The correlation analysis of MHR,PLR,and MS patients with different degrees of AS demonstrated a significant correlation between the two indexes and MS patients with varying degrees of AS.4.Binary logistic regression analysis was performed with MS combined with AS as dependent variable,age,white blood cell count,white blood cell count,TG,PLR,MHR,LDL-C as independent variables,and the results showed that: Age,white blood cell count,TG,LDL-C,MHR,and PLR were independent risk factors for MS with AS,and then multiple ordinal logistic regression analysis was performed with MS combined with different degrees of AS as the dependent variable,and age,white blood cell count,TG,LOL-C,PLR,and MHR as independent variables.The analysis showed that: In addition to white blood cell count,age,TG,PLR,and MHR are independent risk factors for the progression of AS in MS patients,and they are positively correlated with the progression of AS,while OL-C is negatively correlated with the progression of AS,and they all have certain effects on the progression of atherosclerosis.5.MHR,PLR,and a combination of both were utilized as variables for detecting AS,while the occurrence of AS in MS patients served as the state variable to establish the ROC curve.The results indicated that the AUC of PLR for predicting AS in MS patients was 0.739(95% CI: 0.654-0.824,P<0.001),with a best cut-off value of139.655.The sensitivity was 80.3%,the specificity was 61.2%,and the Youden index was 0.415.The AUC of MHR for predicting AS in MS patients was 0.743(95% CI:0.656-0.830,P<0.001).The best cut-off value was 5.225,with a sensitivity of 76.4%,a specificity of 65.3%,and a Youden index of 0.417.The AUC of the combined MHR and PLR for predicting AS in MS patients was 0.784(95% CI: 0.706-0.862,P<0.001).The best cut-off value was 0.678,with a sensitivity of 75.6%,a specificity of 75.5%,and a Youden index of 0.511.Conclusions1.In patients with Metabolic Syndrome(MS)comorbid with Atherosclerosis(AS),Monocyte to High-Density Lipoprotein Ratio(MHR)and Platelet to Lymphocyte Ratio(PLR)are significantly increased.Moreover,MHR increases significantly with the progression of atherosclerosis,and PLR increases significantly in severe atherosclerosis.2.MHR,PLR,age,white blood cell count,and levels of Triglycerides(TG)and Low-Density Lipoprotein Cholesterol(LOL-C)are all independent risk factors for MS comorbid with AS.Both MHR and PLR have a certain influence on the progression of AS.