The platelet to high density lipoprotein ‐cholesterol ratio is a valid biomarker of nascent metabolic syndrome

Abstract

Aims The metabolic syndrome (MetS) is a major global problem, and inflammation and insulin resistance appear to be key underpinnings in this cardio‐metabolic cluster. MetS predisposes to an increased risk of diabetes and atherosclerotic cardiovascular disease (ASCVD). It has a procoagulant diathesis which included increased platelet activity and impaired fibrinolysis. High density lipoprotein (HDL) appears to be anti‐thrombotic. Accordingly, we examined the ratios between platelets to HDL‐cholesterol(C) and adiponectin (Adipo) in patients with nascent MetS without the confounding of diabetes, ASCVD and smoking to determine their validity as biomarkers of MetS. Methods Patients with nascent MetS (n = 58) and matched controls (n = 44) were recruited. Fasting blood samples were obtained for complete blood counts, basic metabolic panel, lipids, insulin, and Adipo. Ratios of platelets to HDL‐C and Adipo were calculated. Results Following adjustment for adiposity, only the platelet: HDL ratio was significantly increased in MetS and increased with severity of MetS. Receiver operating characteristic curve analysis showed that the platelet: HDL‐C area under the curve (AUC) significantly added to both platelets and platelet lymphocyte ratio AUCs. Also the platelet: HDL‐C ratio correlated with all cardio‐metabolic features of MetS, high sensitivity C‐reactive protein, insulin resistance chemerin, and leptin. Conclusions The ratio of platelets: HDL‐C is significantly increased in patients with nascent MetS and appear to be a valid biomarker of MetS. It could also emerge as a biomarker for athero‐thrombotic risk. However, these preliminary findings need confirmation in large prospective studies.

Investigation of systemic immune-inflammation index, neutrophil/high-density lipoprotein ratio, lymphocyte/high-density lipoprotein ratio, and monocyte/high-density lipoprotein ratio as indicators of inflammation in patients with schizophrenia and bipolar disorder

“…New inflammatory markers with the characteristics of convenience, non-invasive nature, low price, and reproducibility have been a focus of researchers. The SII, SIRI, MHR, NHR, LHR, and PHR are considered cost-effective and simple laboratory parameters indicating systemic inflammation in many diseases ( 18 , 19 , 21 – 23 , 26 , 27 , 30 – 34 ). They can reveal the immune response balance, and in many inflammatory diseases, including cancers, coronary heart disease, and coronavirus disease 2019 (COVID-19), they are considered independent predictors ( 24 , 35 – 37 ).…”

“…Furthermore, studies have found that high-density lipoprotein (HDL) showed antithrombotic, anti-inflammatory, and antioxidant effects, and HDL can inhibit the oxidation of low-density lipoprotein (LDL) and prevent its negative effects on the endothelium (25). In view of the role of neutrophils, monocytes, lymphocytes, platelets, and HDL in inflammation, the neutrophil/HDL ratio (NHR), lymphocyte/HDL ratio (LHR), monocyte/HDL ratio (MHR), and platelet/HDL ratio (PHR) have been recently investigated as new markers for inflammation, and they were suggested as potential markers of systemic inflammation and oxidative stress in many inflammatory diseases (26)(27)(28)(29)(30). They were found to be closely associated with the presence and prognosis of some physical health disorders, including cardiovascular disease, cancer, Parkinson's disease, ischemic stroke, and erectile dysfunction (24,27,28,31,32).…”

Prognostic value of the PDW/HDL-C ratio in patients with chest pain symptoms and coronary artery calcification

“…Another study demonstrates that PHR is significantly increased in patients with nascent metabolic syndrome (MetS) and appears to be a valid biomarker of MetS. It could also emerge as a biomarker for athero-thrombotic risk ( 20 ). However, there is no consensus on whether the PDW/HDL-C ratio could predict cardiovascular risks or not.…”

Altered HDL composition is associated with risk for complications in type 2 diabetes mellitus in South Asian descendants: a cross-sectional, case-control study on lipoprotein subclass profiling

“…High-density lipoproteins are composed of various lipids and proteins including apolipoproteins, enzymes, and lipid transfer factors, and exhibit large heterogeneity in size, density, and composition. The various HDL fractions represent different functionalities that mediate cholesterol e ux, anti-oxidation, anti-in ammation, and anti-thrombotic processes [9,10]. Low plasma HDL cholesterol (HDL-C) levels, for instance, were found associated with an increased risk of T2DM and cardiovascular disease [11][12][13], while also the importance of HDL functionality to cardiovascular disease incidence and prognosis of heart failure was observed [14][15][16], one of the main complications among T2DM patients.…”