Research Article
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Migren hastalarında enflamatuvar belirteçlerin değerlendirilmesi

Year 2019, Volume: 4 Issue: 1, 37 - 40, 15.03.2019
https://doi.org/10.25000/acem.494415

Abstract



Amaç: Bu
çalışmanın amacı migren hastalarında eritrosit sedimentasyon hızı (ESR), yüksek
duyarlılıklı C-reaktif protein (hsCRP), nötrofil-lenfosit oranı (NLO),
monosit-HDL-C oranı (MHO) ve bilirubin düzeylerinin değerlendirilmesi ve
sağlıklı bireylerde ölçülen seviyelerle karşılaştırılmasıdır.

Yöntemler:
Bu retrospektif vaka-kontrol çalışmasına Haziran 2017-Haziran 2018 tarihleri
arasında hastanemiz nöroloji polikliniğine veya acil servisine başvuran 136
migren hastası ve 80 sağlıklı kontrol dahil edildi. Tüm katılımcıların
laboratuvar tetkikleri, hastalık özellikleri, aura varlığı ve beyaz cevher
lezyonlarının varlığı kaydedildi ve demografik özellikler ve laboratuvar
verileri iki grup arasında karşılaştırıldı.

Bulgular:
Vaka grubunun yaş ortalaması 36.9 ±10.6 yıl ve kontrol grubunun 37±12 yıl idi.
Hasta ve kontrol grupları arasında yaş ve cinsiyet açısından anlamlı fark
saptanmadı. Vaka grubunda total bilirubin, direkt bilirubin, indirekt
bilirubin, lenfosit değerleri kontrol grubuna göre anlamlı derecede düşüktü.
Hasta grubunda NLO, hsCRP, ESR düzeyleri kontrol grubuna göre anlamlı yüksekti.
Vaka ve kontrol grupları beyaz cevher lezyonları varlığı açısından anlamlı
farklılık göstermedi. Aurası olan ve olmayan migren hastalarında yaş, cinsiyet,
total bilirubin, direkt bilirubin ve indirekt bilirubin değerleri, NLO, ürik
asit, lenfosit ve ESR düzeyleri açısından anlamlı fark saptanmadı. Auralı
grupta monosit ve MHO değerleri aurasız gruba göre yüksekti. Auralı grupta
hsCRP değeri aurasız gruba göre istatistiksel olarak anlamlı düşüktü.







Sonuç: Bu
çalışma, migren hastalarında düşük bilirubin ve yüksek NLO, CRP ve ESR
değerlerinin potansiyel enflamatuvar marker olabileceğini göstermiştir. Bu
markerlar hastalığın patofizyolojisini anlamamıza katkıda bulunabilir. Ayrıca
söz konusu testlerin maliyeti ucuz ve yaygın kullanılan tetkikler olduğundan
özellikle migren hastalarını olası uzun dönem komorbiditelerden korumak
açısından faydalı olabileceği görüşündeyiz. 

References

  • 1. Burstein R, Noseda R, Borsook D. Migraine: multiple processes, complex pathophysiology. J Neurosci. 2015;35:6619-29.
  • 2. Lipton RB, Bigal ME. Migraine: epidemiology, impact, and risk factors for progression. Headache. 2005;45:3-13.
  • 3. Sinclair AJ, Matharu M. Migraine, cerebrovascular disease and the metabolic syndrome. Ann Indian Acad Neurol. 2012;15:72-7.
  • 4. Nagai M, Terao S, Yilmaz G, Yilmaz CE, Esmon CT, Watanabe E, et al. Roles of inflammation and the activated protein C pathway in the brain edema associated with cerebral venous sinus thrombosis. Stroke. 2010;41:147-52.
  • 5. Ammirati E, Moroni F, Norata GD, Magnoni M, Camici PG. Markers of inflammation associated with plaque progression and instability in patients with carotid atherosclerosis. Mediators Inflamm. 2015;2015:718329.
  • 6. Ozdemir HH. Analysis of the albumin level, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio in Guillain-Barré syndrome. Arq Neuropsiquiatr. 2016;74:718-22.
  • 7. Artoni A, Abbattista M, Bucciarelli P, Gianniello F, Scalambrino E, Pappalardo E, et al. Platelet to Lymphocyte Ratio and Neutrophil to Lymphocyte Ratio as Risk Factors for Venous Thrombosis. Clin Appl Thromb Hemost. 2018;24:808-14.
  • 8. Çiçek G, Kundi H, Bozbay M, Yayla C, Uyarel H. The relationship between admission monocyte HDL-C ratio with short-term and long-term mortality among STEMI patients treated with successful primary PCI. Coron Artery Dis. 2016;27:176-84.
  • 9. Kanbay M, Solak Y, Unal HU, Kurt YG, Gok M, Cetinkaya H, et al. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol. 2014;46:1619-25.
  • 10. Kapitulnik J. Bilirubin: An endogenous product of heme degradation with both cytotoxic and cytoprotective properties. Mol Pharmacol. 2004;66:773–9.
  • 11. Headache Classification Subcommittee of the International Headache Society. The international classification of headache disorders: 3rd edition (beta version). Cephalalgia. 2013;33:629-808.
  • 12. Spierings EL. Pathogenesis of the migraine attack. Clin J Pain 2003;19:255-62.
  • 13. Yetkin E, Ozisik H, Ozcan C, Aksoy Y, Turhan H. Decreased endothelium-dependent vasodilatation in patients with migraine: A new aspect to vascular pathophysiology of migraine. Coron Artery Dis 2006;17:29-33.
  • 14. Avci AY, Lakadamyali H, Arikan S, Benli US, Kilinc M. High sensitivity C-reactive protein and cerebral white matter hyperintensities on magnetic resonance imaging in migraine patients. J Headache Pain. 2015;16:9.
  • 15. Wang F, He Q, Ren Z, Li F, Chen W, Lin X, et al.Association of serum levels of intercellular adhesion molecule-1 and interleukin-6 with migraine. Neurol Sci. 2015;36:535-40.
  • 16. Liu R, Ma M, Cui M, Dong Z, Wang X, Zhang W, et al. Effects of tumor necrosis factor-β (TNF-β) 252A>G polymorphism on the development of migraine: a meta-analysis. PLoS One. 2014;9:e100189.
  • 17. Lippi G, Mattiuzzi C, Cervellin G. C- reactive protein and migraine. Facts or speculations? Clin Chem Lab Med. 2014;52:1265-72.
  • 18. Peng YF, Xie LQ, Xiang Y, Xu GD. Serum Bilirubin and Their Association With C-Reactive Protein in Patients With Migraine. J Clin Lab Anal. 2016;30:982-5.
  • 19. Stocker R, Yamamoto Y, McDonagh AF, Glazer AN, Ames BN. Bilirubin is an antioxidant of possible physiological importance. Science. 1987;235:1043-6.
  • 20. Nunez J, Nunez E, Bodi V, Sanchis J, Miñana G, Mainar L, et al. Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction. Am J Cardiol. 2008;101:747–52.
  • 21. Yuksel M, Yildiz A, Oylumlu M, Akyüz A, Aydın M, Kaya H, et al. The association between platelet/lymphocyte ratio and coronary artery disease severity. Anatol J Cardiol. 2015;15:640-7.
  • 22. Rezende SM, Lijfering WM, Rosendaal FR, Cannegieter SC. Hematologic variables and venous thrombosis: red cell distribution width and blood monocyte count are associated with an increased risk. Haematologica. 2014;99:194-200.
  • 23. Efe TH, Arslan ED, Ertem AG, Yayla Ç, Felekoğlu MA, İnci S, et al. The prognostic value of the monocyte/hdl ratio in predicting short-term mortality in patients with acute pulmonary embolism. Koşuyolu Heart Journal. 2016;19:149-53.
  • 24. Pisanu C, Preisig M, Castelao E, Glaus J, Cunningham JL, Del Zompo M, et al. High leptin levels are associated with migraine with aura. Cephalalgia. 2017;37:435-41.
  • 25. Yılmaz N, Yılmaz M, Sirin B, Yılmaztekin S, Kutlu G. The relationship between levels of plasma-soluble urokinase plasminogen activator receptor (suPAR) and presence of migraine attack and aura. J Recept Signal Transduct Res. 2017;37:447-52.
  • 26. Yuasa N, Nagata E, Fujii N, Ito M, Tsukamoto H, Takizawa S. Serum apolipoprotein E may be a novel biomarker of migraine. PLoS One. 2018;13:e0190620.
  • 27. Lippi G, Mattiuzzi C, Cervellin G. C-reactive protein and migraine. Facts or speculations? Clin Chem Lab Med. 2014;52:1265-72.
  • 28. Tunç A, Tekeşin AK, Güngen BD, Arda E. Cognitive performance in young and middle-aged adults with migraine: Investigating the correlation with white matter hyperintensities and psychological symptoms. Neurol Neurochir Pol. 2018;52:470-6.
  • 29. Bashir A, Lipton RB, Ashina S, Ashina M. Migraine and structural changes in the brain: a systematic review and meta-analysis. Neurology. 2013;81:1260-8.

Evaluation of inflammatory markers in patients with migraine

Year 2019, Volume: 4 Issue: 1, 37 - 40, 15.03.2019
https://doi.org/10.25000/acem.494415

Abstract



Aim: The aim of this
study was to evaluate erythrocyte sedimentation rate (ESR), high sensitivity
C-reactive protein (hsCRP), neutrophil-to-lymphocyte ratio (NLR), monocyte to
HDL-C ratio (MHR), and bilirubin levels in patients with migraine and compare
with levels measured in healthy subjects.

Methods: This
retrospective case-control study included 136 migraine patients and 80 healthy
controls who were admitted to our neurology outpatient clinic or emergency
between June 2017 and June 2018. Laboratory examinations, disease
characteristics, presence of aura, and the presence of white matter
hyperintensities (WMHs) were recorded and demographic features and laboratory
data were compared between two groups.

Results: The mean age
of the case group was 36.9 ± 10.6 years and the control group was 37 ± 12
years. In the patient group, total bilirubin, direct bilirubin, indirect
bilirubin, and lymphocyte values were significantly lower than the control
group. NLR, hsCRP, and ESR levels were significantly higher in the patient
group than the control group. The patient and control groups did not show a
significant difference according to the presence of WMHs. In the group with
aura, monocyte and MHR values were higher than those without aura. The hsCRP
values in the group with aura were significantly lower than the group without
aura.







Conclusion: This study
showed that low bilirubin and high NLR, MHR, hsCRP, and ESR values might be
potential inflammatory markers in migraine patients. These markers may
contribute to our understanding of the pathophysiology of migraine. Since the
cost of these tests is cheap and they are widely used, it is possible to
believe that they may be useful for protecting migraine patients against
long-term comorbidities.

References

  • 1. Burstein R, Noseda R, Borsook D. Migraine: multiple processes, complex pathophysiology. J Neurosci. 2015;35:6619-29.
  • 2. Lipton RB, Bigal ME. Migraine: epidemiology, impact, and risk factors for progression. Headache. 2005;45:3-13.
  • 3. Sinclair AJ, Matharu M. Migraine, cerebrovascular disease and the metabolic syndrome. Ann Indian Acad Neurol. 2012;15:72-7.
  • 4. Nagai M, Terao S, Yilmaz G, Yilmaz CE, Esmon CT, Watanabe E, et al. Roles of inflammation and the activated protein C pathway in the brain edema associated with cerebral venous sinus thrombosis. Stroke. 2010;41:147-52.
  • 5. Ammirati E, Moroni F, Norata GD, Magnoni M, Camici PG. Markers of inflammation associated with plaque progression and instability in patients with carotid atherosclerosis. Mediators Inflamm. 2015;2015:718329.
  • 6. Ozdemir HH. Analysis of the albumin level, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio in Guillain-Barré syndrome. Arq Neuropsiquiatr. 2016;74:718-22.
  • 7. Artoni A, Abbattista M, Bucciarelli P, Gianniello F, Scalambrino E, Pappalardo E, et al. Platelet to Lymphocyte Ratio and Neutrophil to Lymphocyte Ratio as Risk Factors for Venous Thrombosis. Clin Appl Thromb Hemost. 2018;24:808-14.
  • 8. Çiçek G, Kundi H, Bozbay M, Yayla C, Uyarel H. The relationship between admission monocyte HDL-C ratio with short-term and long-term mortality among STEMI patients treated with successful primary PCI. Coron Artery Dis. 2016;27:176-84.
  • 9. Kanbay M, Solak Y, Unal HU, Kurt YG, Gok M, Cetinkaya H, et al. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol. 2014;46:1619-25.
  • 10. Kapitulnik J. Bilirubin: An endogenous product of heme degradation with both cytotoxic and cytoprotective properties. Mol Pharmacol. 2004;66:773–9.
  • 11. Headache Classification Subcommittee of the International Headache Society. The international classification of headache disorders: 3rd edition (beta version). Cephalalgia. 2013;33:629-808.
  • 12. Spierings EL. Pathogenesis of the migraine attack. Clin J Pain 2003;19:255-62.
  • 13. Yetkin E, Ozisik H, Ozcan C, Aksoy Y, Turhan H. Decreased endothelium-dependent vasodilatation in patients with migraine: A new aspect to vascular pathophysiology of migraine. Coron Artery Dis 2006;17:29-33.
  • 14. Avci AY, Lakadamyali H, Arikan S, Benli US, Kilinc M. High sensitivity C-reactive protein and cerebral white matter hyperintensities on magnetic resonance imaging in migraine patients. J Headache Pain. 2015;16:9.
  • 15. Wang F, He Q, Ren Z, Li F, Chen W, Lin X, et al.Association of serum levels of intercellular adhesion molecule-1 and interleukin-6 with migraine. Neurol Sci. 2015;36:535-40.
  • 16. Liu R, Ma M, Cui M, Dong Z, Wang X, Zhang W, et al. Effects of tumor necrosis factor-β (TNF-β) 252A>G polymorphism on the development of migraine: a meta-analysis. PLoS One. 2014;9:e100189.
  • 17. Lippi G, Mattiuzzi C, Cervellin G. C- reactive protein and migraine. Facts or speculations? Clin Chem Lab Med. 2014;52:1265-72.
  • 18. Peng YF, Xie LQ, Xiang Y, Xu GD. Serum Bilirubin and Their Association With C-Reactive Protein in Patients With Migraine. J Clin Lab Anal. 2016;30:982-5.
  • 19. Stocker R, Yamamoto Y, McDonagh AF, Glazer AN, Ames BN. Bilirubin is an antioxidant of possible physiological importance. Science. 1987;235:1043-6.
  • 20. Nunez J, Nunez E, Bodi V, Sanchis J, Miñana G, Mainar L, et al. Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction. Am J Cardiol. 2008;101:747–52.
  • 21. Yuksel M, Yildiz A, Oylumlu M, Akyüz A, Aydın M, Kaya H, et al. The association between platelet/lymphocyte ratio and coronary artery disease severity. Anatol J Cardiol. 2015;15:640-7.
  • 22. Rezende SM, Lijfering WM, Rosendaal FR, Cannegieter SC. Hematologic variables and venous thrombosis: red cell distribution width and blood monocyte count are associated with an increased risk. Haematologica. 2014;99:194-200.
  • 23. Efe TH, Arslan ED, Ertem AG, Yayla Ç, Felekoğlu MA, İnci S, et al. The prognostic value of the monocyte/hdl ratio in predicting short-term mortality in patients with acute pulmonary embolism. Koşuyolu Heart Journal. 2016;19:149-53.
  • 24. Pisanu C, Preisig M, Castelao E, Glaus J, Cunningham JL, Del Zompo M, et al. High leptin levels are associated with migraine with aura. Cephalalgia. 2017;37:435-41.
  • 25. Yılmaz N, Yılmaz M, Sirin B, Yılmaztekin S, Kutlu G. The relationship between levels of plasma-soluble urokinase plasminogen activator receptor (suPAR) and presence of migraine attack and aura. J Recept Signal Transduct Res. 2017;37:447-52.
  • 26. Yuasa N, Nagata E, Fujii N, Ito M, Tsukamoto H, Takizawa S. Serum apolipoprotein E may be a novel biomarker of migraine. PLoS One. 2018;13:e0190620.
  • 27. Lippi G, Mattiuzzi C, Cervellin G. C-reactive protein and migraine. Facts or speculations? Clin Chem Lab Med. 2014;52:1265-72.
  • 28. Tunç A, Tekeşin AK, Güngen BD, Arda E. Cognitive performance in young and middle-aged adults with migraine: Investigating the correlation with white matter hyperintensities and psychological symptoms. Neurol Neurochir Pol. 2018;52:470-6.
  • 29. Bashir A, Lipton RB, Ashina S, Ashina M. Migraine and structural changes in the brain: a systematic review and meta-analysis. Neurology. 2013;81:1260-8.
There are 29 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Original Research
Authors

Aysel Tekeşin 0000-0002-0856-9387

Abdülkadir Tunç 0000-0002-9747-5285

Publication Date March 15, 2019
Published in Issue Year 2019 Volume: 4 Issue: 1

Cite

Vancouver Tekeşin A, Tunç A. Evaluation of inflammatory markers in patients with migraine. Arch Clin Exp Med. 2019;4(1):37-40.