Association of Three Novel Inflammatory Markers: Lymphocyte to HDL-C Ratio, High-Sensitivity C-Reactive Protein to HDL-C Ratio and High-Sensitivity C-Reactive Protein to Lymphocyte Ratio With Metabolic Syndrome.

OBJECTIVE: We aimed to compare the association of three novel inflammatory indicators with metabolic syndrome (MetS) among Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort participants. METHODS: According to the International Diabetes Federation (IDF) criteria, the cohort participants were divided into the MetS(+) and MetS(-) groups. The lymphocyte to high-density lipoprotein cholesterol (HDL-C) ratio (LHR), high-sensitivity C-reactive protein (hs-CRP) to HDL-C ratio (HCHR) and hs-CRP to lymphocyte ratio (HCLR) were calculated and were compared between the groups. Binary logistic regression (LR) analysis was performed to find the association of the indices with the presence of MetS among men and women. Receiver-operating characteristic (ROC) curve analysis was used to establish cut-off values in predicting MetS for men and women. p-Values <0.05 were considered as statistically significant. RESULTS: Among a total of 8890 participants (5500 MetS(-) and 3390 MetS(+)), LHR, HCHR and HCLR were significantly higher in the MetS(+) group than in MetS(-) group (p < 0.001). In LR analysis, after adjusting for multiple cofounders, LHR remained an independent factor for the presence of MetS among men (OR: 1.254; 95% CI: 1.202-1.308; p < 0.001) and women (OR: 1.393; 95% CI: 1.340-1.448; p < 0.001). HCHR also remained an independent factor for the presence of MetS only in women (OR: 1.058; 95% CI: 1.043-1.073; p < 0.001). ROC curve analysis showed that LHR had the higher AUC for predicting MetS in both men (AUC: 0.627; 95% CI: 0.611-0.643; p < 0.001) and women (AUC: 0.683; 95% CI: 0.670, 0.696; p < 0.001). CONCLUSION: This suggests that among both genders, the LHR as an inexpensive and easy-to-access marker has a better diagnostic performance and could be a promising alternative to the traditional expensive inflammatory markers such as hs-CRP for the evaluation of inflammation in patients with MetS.

Serum uric acid to high-density lipoprotein ratio as a novel indicator of inflammation is correlated with the presence and severity of metabolic syndrome: A large-scale study.

INTRODUCTION: We investigated the association of serum uric acid to high-density lipoprotein ratio (UHR) with the presence and severity of metabolic syndrome (MetS) among MASHAD cohort participants. METHODS: In this cross-sectional study, according to International Diabetes Federation criteria, the cohort participants were divided into MetS (+) and MetS (-) groups. MetS (+) were classified into Group 1 (those with 3 MetS criteria), Group 2 (those with 4 MetS criteria) and Group 3 (those with 5 MetS criteria). UHR was compared among the groups. RESULTS: Data related to 9637 subjects including 3824 MetS (+) and 5813 MetS (-) were analysed. The mean UHR was significantly higher (p < .001) in the MetS (+) group compared with the MetS (-) group. UHR increased as the MetS severity increased (p < .001). ROC analysis revealed that UHR greater than 9.5% has 89.07% sensitivity and 77.03% specificity in differentiating MetS (-) from MetS (+) subjects. CONCLUSION: Among MASHAD cohort study participants, a significant association between UHR and MetS was found. Furthermore, there is an increase in UHR as the severity of MetS increases. Registration number of MASHAD cohort study: 85134.

Prolonged Resuscitation with Multiple Defibrillations; a Case Report.

Although American Heart Association Guidelines (AHA) are practical and standardized in many aspects of cardiopulmonary resuscitation (CPR) performance, recommendations on when to terminate resuscitation are not fully understood and clear. There is not enough evidence about how long we can continue CPR in shockable rhythms and how many shocks can be delivered to patients, and if there is an end point for it or not. This issue is more challenging when we read papers published on survival rates and good functional and neurological outcomes after prolonged CPRs. Here, we demonstrate a case of cardiac arrest receiving CPR in the emergency room, for whom it was hard and challenging to make a decision on when to terminate the resuscitation attempts.