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Monocyte-to-high-density lipoprotein ratio and systemic immune-inflammation index: Potential parameters for the evaluation of disease activity and severity in Graves’ ophthalmopathy?

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Abstract

Purpose

To assess changes in monocyte-to-high-density lipoprotein (HDL) ratio (MHR), neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) with Graves’ ophthalmopathy (GO) and their possible relation with GO disease activity and severity.

Methods

A total of 20 patients with GO and 24 healthy controls were involved in the study. The thyroid status, MHR (monocyte count/HDL cholesterol level), NLR (neutrophil count/lymphocyte count) and SII [(neutrophil count × platelet count)/lymphocyte count] were compared between the groups. The relation of systemic inflammation parameters with disease activity and severity was evaluated.

Results

The mean Clinical Activity Score (CAS) was 0.75 ± 0.78 in the GO group. None of the patients were active. The severity was mild for 14 (70.0%) patients and moderate-to-severe for 6 (30.0%) patients. MHR (17.28 ± 5.56 vs. 13.28 ± 5.08), NLR (2.51 ± 1.09 vs. 1.69 ± 0.53) and SII [600.42 (391.79–837.16) vs. 413.69 (344.26–603.82)] values were significantly increased in GO patients than in the controls (p = 0.017, p = 0.005 and p = 0.036, respectively). CAS was significantly correlated with MHR (r = 0.815, p < 0.001), NLR (r = 0.768, p = 0.017) and SII (r = 0.837, p < 0.001). The severity of GO was associated with increased MHR, NLR and SII (p = 0.019, p = 0.036 and p = 0.008, respectively). ROC analysis demonstrated that MHR, NLR and SII have a good ability to differentiate GO patients from healthy individuals.

Conclusion

GO patients have higher MHR and SII levels than healthy controls. Higher MHR, NLR and SII values were associated with increasing disease severity and activity, supporting the efficacy of these non-invasive, low-cost markers in determining the course of GO. Future prospective controlled trials are needed to elucidate the relation between inflammatory markers and GO.

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Data availability

The data that support the findings of this study are available from the corresponding author, [BYT], upon reasonable request.

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Acknowledgements

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Funding

No specific funding was received from any funding bodies in the public, commercial or not for-profit sectors to carry out the work described in this manuscript.

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Authors and Affiliations

  1. Department of Ophthalmology, Kocaeli University, Kocaeli, Turkey

    Büşra Yılmaz Tuğan & Abdullah Ergen

  2. Department of Ophthalmology, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey

    Berna Özkan

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  1. Büşra Yılmaz Tuğan
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  2. Abdullah Ergen
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Contributions

Conceptualization: BYT; Methodology: BYT; Formal analysis and investigation: BYT; Writing—original draft preparation: BYT; Writing—review and editing: BYT, AE, BÖ. Funding acquisition: none, Resources: none; Supervision: BYT and BÖ. All authors read and approved the final manuscript.

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Correspondence to Büşra Yılmaz Tuğan.

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Ethical approval

The study was reviewed and approved by the local ethics committee of Kocaeli University (Approval number: GOKAEK-2022/11.01).

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This study was presented in Turkish Ophthalmological Association 45. Spring Symposium in Istanbul/Turkey as an oral presentation. This article is an expanded and detailed version of the oral presentation.

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Yılmaz Tuğan, B., Ergen, A. & Özkan, B. Monocyte-to-high-density lipoprotein ratio and systemic immune-inflammation index: Potential parameters for the evaluation of disease activity and severity in Graves’ ophthalmopathy?. Int Ophthalmol 44, 154 (2024). https://doi.org/10.1007/s10792-024-03077-x

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