Predictive Value Of Novel Inflammatory Markers For Multiple System Atrophy

Background and Objective:Inflammation is closely related to the pathogenesis of multiple system atrophy(MSA).As markers of inflammation,the monocyte to high-density lipoprotein ratio(MHR),neutrophil to lymphocyte ratio(NLR)and red cell distribution width to platelet ratio(RPR)have been proven to be associated with a large variety of diseases.The aim of this study was to explore the association between inflammatory markers(MHR,NLR,RPR)and MSA,and the difference between MSA and PD was further compared by these inflammatory markers.Methods:This study was divided into three groups: 47 patients with MSA,125 patients with PD and 124 healthy controls.The corresponding laboratory indicators of subjects were collected and analysed to obtain MHR,NLR and RPR values.Results:1.There were 47 cases in MSA group,including 30 males(63.8%),aged 61(55-66)years.In the PD group of 125 patients,72(57.6%)were males,aged 63(56-68)years;In the healthy control group,there were 124 cases,including 60 males(48.4%),aged 58(52-67.75)years.There were no significant differences in age and gender among the three groups(P > 0.05).Compared with healthy controls,the MHR,NLR and RPR were higher in the MSA group(P<0.05),and the MHR was higher in the MSA group than in the PD group(P < 0.001).2.Multivariate logistic regression analysis showed that MHR*10(corrected OR=1.313,95% CI 1.093-1.575)and RPR*100(corrected OR=1.262,95% CI 1.055-1.509)were positively correlated with the risk of MSA.3.The receiver operating characteristic(ROC)curve indicated that the areas under the curve(AUCs)of the MHR,NLR,RPR and their combined indexes for predicting MSA were 0.651(95% CI 0.562-0.74;P < 0.05),0.6(95% CI 0.501-0.699;P <0.05),0.612(95% CI 0.516-0.708;P < 0.05),and 0.688(95%CI 0.604-0.771;P <0.001),respectively.The AUC of MSA and PD predicted by the MHR was 0.727(P <0.001).When the cut-off value was 0.38,the sensitivity and specificity were 60% and77%,respectively.4.Spearman correlation analysis showed that the MHR was significantly and positively correlated with the course of MSA cerebellar type(MSA-C)patients.Conclusions:There may be peripheral inflammation in patients with MSA.Compared with NLR and RPR,MHR has higher predictive value for the diagnosis and differential diagnosis of MSA.