Skip to main content
SpringerLink
Log in

Investigation of MHR-nephropathy relationship and the effect of SGLT2is on MHR in patients with type 2 diabetes

  • Original Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Objective

The aim of this study was to evaluate the relationship between monocyte/high-density lipoprotein (HDL) ratio (MHR), an inflammatory marker, and diabetic nephropathy (DN), a microvascular complication of diabetes in diabetic patients and to investigate the effect of sodium-glucose co-transporter 2 inhibitors (SGLT2i) on MHR.

Material and methods

The study included 119 diabetic patients. Hemogram, glucose, HbA1c, urea, creatinine, albumin, HDL cholesterol, LDL cholesterol, triglycerides, total cholesterol, MHR, NLR (neutrophil-lymphocyte ratio), and CRP parameters were evaluated in blood parameters taken after 8–10 h of fasting before and 6 months after SGLT2 inhibitor use, and albumin, creatinine, and albumin/creatinine parameters were evaluated in urine samples. Parameters were compared according to nephropathy status and SGLT2i type used.

Results

The MHR in diabetic nephropathy (DN (+)) patients was significantly higher than in DN (−) patients (p = 0.005). There was no significant difference in NLR value in both groups. The MHR value decreased significantly after the use of SGLT2i in all patients participating in the study (p = 0.01). NLR value decreased in DN (−) patients after SGLT2i use. No difference was observed in DN (+) patients.

Conclusion

In this study, results supporting the relationship between DN and MHR and the effect of SGLT2i drugs on MHR were found. The use of MHR value as a marker in clinical course monitoring and shaping the treatment according to these markers may be useful in terms of prediction and treatment of complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Turkısh Diabetes Mellitus Study and Education Group (2022) TEMD diabetes mellitus and complications diagnosis, treatment and follow-up guideline. [cited 2022 Oct 9]. p 15–186. Available from: https://file.temd.org.tr/Uploads/publications/guides/documents/diabetes-mellitus_2022.pdf

  2. Bennett K, Aditya BS (2015) An overview of diabetic nephropathy: epidemiology, pathophysiology and treatment. J Diabetes Nurs 19(2):61–7

    Google Scholar 

  3. Warren AM, Knudsen ST, Cooper ME (2019) Diabetic nephropathy: an insight into molecular mechanisms and emerging therapies. Expert Opin Ther Targets. 23(7):579–591. https://doi.org/10.1080/14728222.2019.1624721

    Article  PubMed  Google Scholar 

  4. (2023) Kidney Int 103(2):282-296. https://doi.org/10.1016/j.kint.2022.10.030. Epub 2022 Dec 5.PMID:36470394Review

  5. (2019) Am J Cardiol 124(Suppl 1): S28–S35. https://doi.org/10.1016/j.amjcard.2019.10.027

  6. Rudiger A, Burckhardt OA, Harpes P et al (2006) The relative lymphocyte count on hospital admission is a risk factor for long-term mortality in patients with acute heart failure. Am J Emerg Med 24(4):451–454

    Article  PubMed  Google Scholar 

  7. Zahorec R (2001) Ratio of neutrophil to lymphocyte counts–rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 102(1):5–14

    CAS  PubMed  Google Scholar 

  8. (2023) BMC Cardiovasc Disord 23(1):451. https://doi.org/10.1186/s12872-023-03461-y

  9. Balta S, Celik T, Mikhailidis DP et al (2016) The relation between atherosclerosis and the neutrophil–lymphocyte ratio. Clin Appl Thromb/Hem 22(5):405–411

    Article  CAS  Google Scholar 

  10. Forget P, Khalifa C, Defour J-P et al (2017) What is the normal value of the neutrophil-to-lymphocyte ratio? BMC Res Notes 10(1):1–4

    Article  Google Scholar 

  11. Ancuta P, Wang J, Gabuzda D (2006) CD16+monocytes produce IL-6, CCL2, and matrix metalloproteinase-9 upon interaction with CX3CL1-expressing endothelial cells. J Leukoc Biol. 80:1156–1164. https://doi.org/10.1189/jlb.0206125

    Article  CAS  PubMed  Google Scholar 

  12. Parthasarathy S, Barnett J, Fong LG (1990) High-density lipoprotein inhibits the oxidative modification of low-density lipoprotein. Biochim Biophys Acta. 1044:275–283. https://doi.org/10.1016/0005-2760(90)90314-N

    Article  CAS  PubMed  Google Scholar 

  13. Ya G, Qiu Z, Tianrong P (2018) Relation of monocyte/high-density lipoprotein cholesterol ratio with coronary artery disease in type 2 diabetes mellitus. Clin Lab. 64(6):901–906. https://doi.org/10.7754/Clin.Lab.2018.171022

    Article  CAS  PubMed  Google Scholar 

  14. Onalan E (2019) The relationship between monocyte to high-density lipoprotein cholesterol ratio and diabetic nephropathy. Pak J Med Sci 35(4):1081–6

    PubMed  PubMed Central  Google Scholar 

  15. Vural G, Gumusyayla S (2018) Monocyte-to-high density lipoprotein ratio is associated with a decreased compound muscle action potential amplitude in patients with diabetic axonal polyneuropathy. Medicine (Baltimore) 97(42). https://doi.org/10.1097/MD.0000000000012857

    Article  CAS  PubMed  Google Scholar 

  16. Zinman B, Wanner C, Lachin JM et al (2015) Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes (EMPA-REG). N Eng J Med 373:2117–2128

    Article  CAS  Google Scholar 

  17. Zelniker TA, Wiviott SD, Raz I et al (2019) SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet 10166(Vol 393):31–39

  18. Hayden MR, Grant DG, Aroor AR, Demarco VG (2019) Empagliflozin ameliorates type 2 diabetes-induced ultrastructural remodeling of the neurovascular unit and neuroglia in the female db/db mouse. Brain Sci. 9:57. https://doi.org/10.3390/brainsci9030057

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Lee N, Heo YJ, Choi SE et al (2021) Anti-inflammatory effects of empagliflozin and gemigliptin on LPS-stimulated macrophage via the IKK/NF- κ B, MKK7/JNK, and JAK2/STAT1 signalling pathways. J Immunol Res. https://doi.org/10.1155/2021/9944880

  20. Yaribeygi H, Atkin SL, Butler AE (2019) Sodium—glucose cotransporter inhibitors and oxidative stress: an update. J Cell Physiol 234:3231–3237. https://doi.org/10.1002/jcp.26760

    Article  CAS  PubMed  Google Scholar 

  21. Iannantuoni F, De Marañon AM, Diaz-morales N et al (2019) The SGLT2 inhibitor empagliflozin ameliorates the inflammatory profile in type 2 diabetic patients and promotes an antioxidant response in leukocytes. J Clin Med 8:1814. https://doi.org/10.3390/jcm8111814

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Sa-nguanmoo P, Tanajak P, Kerdphoo S et al (2017) SGLT2-inhibitor and DPP-4 inhibitor improve brain function via attenuating mitochondrial dysfunction, insulin resistance, inflammation, and apoptosis in HFD-induced obese rats. Toxicol Appl Pharmacol 333:43–50. https://doi.org/10.1016/j.taap.2017.08.005

    Article  CAS  PubMed  Google Scholar 

  23. La Grotta R, de Candia P, Olivieri F et al (2022) Anti-inflammatory effect of SGLT-2 inhibitors via uric acid and insulin. Cell Mol Life Sci 79(5):273. https://doi.org/10.1007/s00018-022-04289-z.PMID:35503137;PMCID:PMC9064844

    Article  PubMed  PubMed Central  Google Scholar 

  24. Sivgin H, Çetin S (2023) Effect of empagliflozin use on monocyte high-density lipoprotein ratio and plasma atherogenic index in obese and non-obese type 2 diabetic patients. Eur Rev Med Pharmacol Sci. 27(17):8090–8100. https://doi.org/10.26355/eurrev_202309_33569

    Article  CAS  PubMed  Google Scholar 

  25. Sen Uzeli Ü, Doğan M (2023) The effects of dapagliflozin on monocyte-HDL ratio and neutrophil- lymphocyte ratio among patients with type-2 diabetes mellitus. Eur Rev Med Pharmacol Sci. 27(21):10577–10582. https://doi.org/10.26355/eurrev_202311_34337

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

  1. 25-Aralık State Hospital, Gaziantep, Turkey

    Bedriye Gizem Tekin & Erengül Pektaş

Authors
  1. Bedriye Gizem Tekin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Erengül Pektaş
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bedriye Gizem Tekin.

Ethics declarations

Ethics approval

The study has been approved by the local ethics committee.

Competing interests

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tekin, B.G., Pektaş, E. Investigation of MHR-nephropathy relationship and the effect of SGLT2is on MHR in patients with type 2 diabetes. Ir J Med Sci (2024). https://doi.org/10.1007/s11845-024-03638-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11845-024-03638-0

Keywords

Search

Navigation