Monocytohigh-density lipoprotein ratio has a high predictive value for the diagnosis of multiple system atrophy and the differentiation from Parkinson’s disease

Abstract

Background and purposeInflammation 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, and RPR) and MSA, and the difference between MSA and Parkinson’s disease (PD) was further compared by these inflammatory markers.Materials and methodsThis 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 analyzed to obtain MHR, NLR, and RPR values.ResultsCompared 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). Multivariate logistic regression analysis showed that MHR*10 (corrected OR = 1.312, 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. The receiver operating characteristic (ROC) curve indicated that the areas under the curve (AUCs) of the MHR, NLR, and RPR 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), and 0.612 (95% CI 0.516–0.708; P < 0.05), 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 and 77%, respectively. Spearman correlation analysis showed that the MHR was significantly and positively correlated with the course of MSA cerebellar type (MSA-C) patients.ConclusionThere 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.

The Peripheral Immune Traits Changed in Patients with Multiple System Atrophy

“…The NLR, an inflammatory marker, can predict the severity and prognosis of neurodegenerative diseases such as PD [56], progressive supranuclear palsy [57] and amyotrophic lateral sclerosis [58]. Three studies have reported higher NLR in MSA patients being associated with a poor outcome [17,18,24]. However, our current study did not find a significant difference in NLR between MSA and controls.…”

Platelet Dynamics in Neurodegenerative Disorders: Investigating the Role of Platelets in Neurological Pathology

“…The enrichment of neurotrophins in this lysate raises the prospect of leveraging PLTs functions to address PD symptoms. However, the experimental nature of this strategy necessitates further research to fully comprehend the underlying mechanisms and evaluate its clinical effectiveness [108].…”

Inflammation in multiple system atrophy

“…Higher serum monocyte to high-density lipoprotein ratio (MHR), neutrophil-to-lymphocyte ratio (NLR), and red cell distribution width to platelet ratio (RPR) was reported (49). An increase in CD3+ and CD4+ T-lymphocyte, the CD4+/CD8+ ratio, and a decrease in Ig concentration were found, especially in female patients (22).…”

“…MHR serum level was higher in MSA than in PD (49). The diagnostic value of serum miR-30c-5p in discriminating between MSA and PD was reported with a sensitivity of 82% and a specificity of 54% (55).…”