Assessment of Monocyte/HDL Ratio in Patients with Acute Appendicitis

Abstract

Aim:In patients with acute appendicitis (AA), the number of monocytes increase and the level of high-density lipoprotein cholesterol (HDL-C) decrease. The monocyte/HDL-C ratio (MHR) has recently been used as a diagnostic and prognostic marker for acute inflammation. As far as we research in the literatures, there is no information about the use or alteration of MHR in patients with AA. The aim of this study was to investigate the MHR change in patients with AA and its utility for this disease.Methods:This cross-sectional study includes 206 patients with AA and 57 healthy controls that are similar in age and sex. Serum lipid panel was measured in all patients in addition to routine history, physical examination and laboratory evaluations. Patients were divided into two groups with and without AA and all data were compared.Results:MHR was significantly higher in patients with AA (17.5±9.9 vs 8.5±1.6 and p<0.001). Perforation was detected in 32 (15.5%) patients with AA. MHR was significantly higher in patients with perforation than non-perforated patients (16.1±8.46 vs 23.5±9.34 and p<0.001). Laboratory data showed that white blood cell count, monocyte, lymphocyte, neutrophil, triglyceride and neutrophil/lymphocyte ratio (NLR) levels were higher in patients with AA; serum HDL cholesterol levels were lower (p<0.05 for each-one). In logistic regression analysis, it was determined that MHR and NLR values independently determined AA patients. The area under the curve was most for MHR and the area under the curve was 0.865 and 0.780 for MHR and NLR, respectively. In this analysis, when the cut-off value for MHR was taken as 10, it was found that it detected the patients with AA with a sensitivity of 80.4% and a specificity of 81.8%.Conclusion:In our study, it was found for the first time that MHR value was significantly increased in patients with AA. In addition to the classical diagnostic examinations in patients presenting to the emergency department with the diagnosis of AA; MHR can also be used in diagnostic approach as a simple, easily accessible, inexpensive and objective parameter.

Keywords

• acute appendicitis
• monocyte/hdl ratio
• emergency department