The ratio of monocyte frequency to HDL cholesterol level as a predictor of asymptomatic organ damage in patients with primary hypertension

Association of carotid atherosclerotic plaque and intima-media thickness with the monocyte to high-density lipoprotein cholesterol ratio among low-income residents of rural China: a population-based cross-sectional study

BACKGROUND

The monocytes to high-density lipoprotein cholesterol ratio (MHR) has been identified as a potential biomarker for cardiovascular and cerebrovascular diseases. In this population-based cross-sectional study, we explored the relationships among carotid artery disease (CAD), including the presence of carotid atherosclerotic plaque (CAP) and carotid artery intima-media thickness (CIMT), the MHR, and related parameter changes.

METHODS

This cross-sectional study, Conducted from April to June 2019 in a rural area of Tianjin, involved middle-aged and elderly participants. Based on carotid ultrasound examinations, participants were divided into CAP and non-CAP groups. Logistic regression and Receiver Operating Characteristic (ROC) curve analyses were utilized to assess MHR's predictive value for CAP. Gender-specific analyses were also performed to examine predictive variations. The relationship between CIMT and MHR was evaluated using linear regression.

RESULTS

Of the 2109 participants meeting the inclusion criteria, 51.6% were identified with CAP. Multivariate analysis revealed a significant association between MHR and CAP prevalence, (OR, 9.670; 95% CI, 2.359-39.631; P = 0.002), particularly in females (OR, 5.921; 95% CI, 1.823-19.231; P = 0.003), after adjusting for covariates. However, no significant correlation was found between CIMT and MHR when adjusted for other factors. The ROC analysis showed the area under the curve for MHR and CAP to be 0.569 (95% CI: 0.544-0.593; P < 0.001).

CONCLUSIONS

These findings suggested that it is crucial to enhance early screening and intervention for CAD, specifically focusing on the prevention and progression of CAP, to address the unique health challenges faced by low-income groups in rural settings. Emphasizing these preventive measures could significantly contribute to improving cardiovascular health outcomes in this vulnerable population.

Predictive value of monocyte to HDL-C ratio for coronary artery lesions and intravenous immunoglobulin resistance in Kawasaki disease

We aimed to investigate the predictive validity of monocyte to high-density lipoprotein cholesterol ratio (MHR) for coronary artery lesions (CALs) and intravenous immunoglobulin (IVIG) resistance in complete Kawasaki disease (KD). MHR values of a total of 207 complete KD patients were calculated and analyzed with regard to their clinical characteristics and outcomes. We compared the differences in clinical data and laboratory parameters between CAL+ group and CAL- group as well as between IVIG-resistant group and IVIG-responsive group. Spearman's correlation analysis was applied to evaluate the correlation between C-reactive protein (CRP) and MHR. Multivariate logistic regression was used to identify risk factors of CALs and IVIG resistance. Receiver operating characteristic (ROC) curve analysis was chosen to determine the optimal cut-off value of MHR and its validity in predicting CALs and IVIG resistance. The MHR level was significantly higher in the CAL+ group, with cut-off value of 1.30 g/L, yielding a sensitivity of 0.753 and specificity of 0.805, as well as in IVIG-resistant group, with cut-off value of 1.03 g/L, yielding a sensitivity of 0.97 and specificity of 0.485. Multivariate logistic regression showed that MHR was an independent risk factor for CALs but not for IVIG resistance. According to the Spearman's correlation analysis, CRP was positively correlated with the MHR.

CONCLUSIONS

As a practical, cost-effective inflammatory biomarker, MHR has a significantly predictive value in complete KD children complicated with CALs and IVIG-resistance. Paying more attention to the changes of MHR in KD children may contribute to better understanding of KD development and prognosis in clinical practice.

WHAT IS KNOWN

• CALs are the most prevalent serious sequela of KD, and approximately 10%~20% of patients do not respond to IVIG therapy. • MHR could be a convenient biomarker to predict the development and progression of CVDs. It has been reported that the MHR is a new prognostic biomarker in several CVDs.

WHAT IS NEW

• MHR has a significantly predictive value in KD children complicated with CALs and IVIG-resistance. • Compared with the molecular and immunological biomarkers that have been reported, MHR has the characteristics of practical, cost-effective, higher sensitivity and specificity, which can be used as a predictive indicator in complete KD patients.

The Predictive Role of Hematological Parameters in Hypertension

Hypertension (HT) is a common chronic disease that often causes target-organ damage and severe complications, contributing to cardiovascular morbidity and mortality worldwide. Accumulating evidence suggests that inflammation plays a prominent role in the initiation and progression of HT. Multiple inflammatory biomarkers have been proposed to predict HT. Several new hematological parameters can reflect the inflammatory response and platelet activation. The major advantage of hematological parameters over conventional inflammatory markers is that they are relatively inexpensive and easily obtained from routine blood tests. Numerous studies have investigated several hematological parameters for their utility as predictive biomarkers for the diagnosis and prognosis of HT. Among them, the neutrophil to lymphocyte ratio (NLR), monocyte to high density lipoprotein cholesterol ratio (MHR), red cell distribution width (RDW), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), platelet distribution width (PDW), and systemic immune-inflammation index (SII) have recently received attention. We searched PubMed and Embase databases (up to September 18, 2022) to assess the relationships between hematological parameters and HT. This review discusses the diagnostic and prognostic value of these hematological parameters in HT, providing an important basis for early screening, risk stratification, and optimal management of hypertensive patients.

Evaluation of the relationship between monocyte to high-density lipoprotein cholesterol ratio and thrombus burden in patients with deep vein thrombosis

OBJECTIVE

The purpose of this study was to evaluate monocyte count and high-density lipoprotein cholesterol levels and their ratio (monocyte/high-density lipoprotein ratio) in patients with deep venous thrombosis as well as to determine whether this ratio at the time of diagnosis can be an indicator of thrombus burden in terms of thrombus location in deep venous thrombosis.

METHODS

We retrospectively analyzed the patient's diagnosis of deep venous thrombosis confirmed with venous Doppler ultrasound, using a database query for outpatients between 2018 and 2022. Of 378 patients included, blood count results at the time of diagnosis were available for 356. We recruited 300 age- and sex-matched patients with appropriate blood counts, without a diagnosis of deep venous thrombosis, as the control group, by querying the outpatient clinic database. The monocyte/high-density lipoprotein ratio was computed from the ratio of monocyte count to high-density lipoprotein-C. Patients were categorized based on the level of thrombus and the number of vein segments involved as evidenced by Doppler ultrasound findings.

RESULTS

The serum level of monocyte/high-density lipoprotein ratio was significantly higher in the patient group compared to the control group (p<0.01). Patients with proximal deep venous thrombosis had a higher mean monocyte/high-density lipoprotein ratio (19.6±5.1 vs. 17.1±5.5; p<0.01) than patients with distal deep venous thrombosis. Monocyte/high-density lipoprotein ratio increased with the number of vein segments involved (p<0.01).

CONCLUSION

Monocyte/high-density lipoprotein ratio is significantly elevated in patients with deep venous thrombosis when compared to the control group. Monocyte/high-density lipoprotein ratio levels were correlated with disease burden reflected by thrombus location and the number of vein segments involved in deep venous thrombosis patients.

Monocyte to high density lipoprotein ratio in patients with acute kidney injury after cardiac surgery

BACKGROUND

The Monocyte to high density lipoprotein ratio (MHR) has been postulated as a novel parameter associated with adverse renal and cardiovascular outcomes. In this study we investigated the association of MHR with cardiac surgery-associated acute kidney injury (CSA-AKI).

METHODS

In this retrospective study, we analyzed the data pertaining to 1505 patients undergoing cardiopulmonary bypass (CPB) surgery. The CSA-AKI, which was defined using Kidney Disease Improving Global Outcomes criteria. Concurrently, a retrospective scan of patient files was conducted and information relevant to nephropathy such as the level of their serum creatinine (SCr), Blood urea nitrogen (BUN), uric acid (UA), serum cystatin C (Cys-C), total cholesterol (TC), triglycerides (TG), glucose and MHR, ejection fraction, CPB duration time, and other indicators.

RESULTS

About 1505 patients were studied of whom 195 developed AKI. MHR was significantly higher in the AKI patients (p = 0.001). In multivariate logistic regression analysis, MHR, UA, Cys-C, age, glucose, and history of chronic kidney disease or hypertension were independently correlated with CSA-AKI.

CONCLUSIONS

As a laboratory index, the elevated MHR is convenient, independent, and a useful predictor for CSA-AKI.

Continuous Positive Linear Association between the Monocyte to High-Density Lipoprotein Cholesterol Ratio and Hypertension: A Cross-Sectional Study

BACKGROUND

Hypertension poses a major threat to human health, and inflammation is associated with hypertension. The monocyte to high-density lipoprotein cholesterol ratio (MHR) represents a new inflammatory indicator. However, the relationship between the MHR and hypertension remains unclear. The present study investigated the association of MHR with hypertension.

METHOD

For this cross-sectional study, we continuously collected data from the Physical Examination Centre of the Second Hospital of Hebei Medical University (N = 6632). The data included patients' demographic information and clinical information including blood pressure, blood biochemical measurements, and MHR. The relationship between the MHR and hypertension was examined using different methods in univariate and multivariate logistic analysis, smooth function analysis, the threshold saturation effect analysis and subgroup analysis.

RESULTS

The results showed that MHR was positively associated with hypertension without adjustment (odds ratio [OR] = 1.10, 95% confidence interval [CI]: 1.08-1.12, P < 0.001). The positive association still existed in minimally and fully adjusted models (OR = 1.08, 95% CI: 1.06-1.10, P < 0.001; OR = 1.07, 95% CI: 1.05-1.10, P < 0.001). Smooth function analysis of a generalized additive model revealed a continuous positive linear association between the MHR and hypertension throughout all MHR data (OR = 1.07, 95% CI: 1.05-1.10, P < 0.001). Subgroups analysis showed the homogeneity of the positive association among different subgroups.

CONCLUSIONS

A continuous positive linear association was found between the MHR and hypertension in a health examination population.

Is there a relationship between heart rate recovery and blood pressure in white coat hypertension?

Aim    Increasing evidence suggests that autonomic dysfunction may be involved in the etiology of white coat hypertension (WCH). The aim of this study was to evaluate cardiac autonomic function by using heart rate recovery (HRR) indices in patients with WCH classified according to their circadian rhythm type of blood pressure (BP).Material and methods    This cross-sectional study included 120 participants over the age of 18 yrs, including 50 patients diagnosed with WCH and 70 healthy controls with normal in- and out-of-office BP and without any known disease. Circadian rhythm types, i.e., dippers and non-dippers, were identified using ambulatory BP monitoring. The HRR indices were calculated by subtracting the 1st-minute (HRR1), 2nd-minute (HRR2), and 3rd-minute (HRR3) heart rates from the maximal heart rate recorded during stress testing.Results    The lesser decline in nighttime BP (6.4±2.14 and 13.3±2.2 mmHg, respectively; p&lt;0.001) and the smaller mean HRR1 (25.5±3.0 and 30.3±3.1 beats / min, respectively; p&lt;0.001) were evident in WCH non-dippers compared to WCH dippers. Linear regression analysis showed that HRR1 (β±SE=0.43±0.11; p&lt;0.001) and diastolic BP at maximum exercise (β±SE=0.14±0.07; p=0.040) are independent risk factors for the blunted decline in nighttime BP.Conclusion    Delayed recovery of heart rate after an exercise stress test is associated with non-dipper type of circadian rhythm of BP. This was more pronounced in WCH patients, and these patients are at risk of autonomic dysfunction.

The Role of Monocyte to High-Density Lipoprotein Cholesterol Ratio in Predicting the Severity of Proteinuria and Renal Dysfunction in Primary Nephrotic Syndrome

Introduction: Monocyte to high-density lipoprotein (HDL) cholesterol ratio (MHR) has emerged as a novel marker of endothelial injury, inflammation, and oxidative stress. This study aimed to investigate the effect of MHR on primary nephrotic syndrome (NS) and its relationship with the severity of proteinuria.

Methods: This study enrolled 161 patients newly diagnosed with primary NS and 100 healthy individuals. Demographic characteristics of the patients, primary NS diagnosis, basal laboratory parameters, the amount of 24-hour urinary protein excretion, and MHR were recorded. The groups were compared regarding these parameters.

Results: MHR was significantly higher in patients with primary NS compared with the healthy group (12.89 ± 4.86 and 9.71 ± 2.30, respectively; p < 0.001). There was no difference between the groups in terms of age and sex. The amount of protein in the 24-hour urine in patients with a diagnosis of primary NS was 6.91 ± 3.73 g/day. The correlation analysis showed a positive correlation between MHR and the amount of proteinuria (r = 0.519, p < 0.001) and creatinine level (r = 0.167, p = 0.034). The multivariate regression analysis found that the severity of proteinuria was independently correlated to MHR (p < 0.001). According to the receiver operating characteristic curve analysis, the optimal cut-off level for MHR in NS was 10.08 (area under the curve of 0.704, sensitivity of 68%, and a specificity of 62%).

Conclusion: Our study is the first to compare the severity of proteinuria and renal functions with MHR in patients with primary NS. We believe that MHR can be used as a biomarker to determine inflammation, endothelial injury, and the level of oxidative stress, and may be useful to predict prognosis in patients with primary NS.

Relationships between monocyte count to high-density lipoprotein cholesterol ratio and cardiovascular outcomes in patients commencing dialysis

Objective

High monocyte to high-density lipoprotein cholesterol ratio (MHR) is known to be a risk factor for cardiovascular (CV) complications. We aimed to evaluate the relationship between MHR and CV outcomes in patients commencing dialysis.

Methods

The medical records of patients who started maintenance dialysis between January 2006 and July 2017 were reviewed. The primary outcomes were all-cause mortality and overall CV mortality and the secondary outcomes were CV event-free survival and the incidence of CV complications.

Results

Five hundred ninety-seven patients were enrolled and allocated to low- or high-MHR groups. All-cause mortality did not differ between the groups during a mean follow-up period of 3.9 years. In addition, overall CV mortality did not differ between the groups. However, CV event-free survival was significantly lower in the high-MHR group than in the low-MHR group (47.5% vs. 59.0%). Multivariate Cox regression analysis showed that high MHR was an independent predictor of CV events (HR 1.886, 95% CI 1.015–3.505).

Conclusion

High MHR at the time of initiation of dialysis may represent a useful predictor of CV complications.

New prognostic factor for hepatitis B virus-related decompensated cirrhosis: Ratio of monocytes to HDL-cholesterol

Aim

Hepatitis B virus‐related decompensated cirrhosis (HBV‐DeCi) has a high mortality rate, and it remains a challenge to predict its outcomes in clinical practice. We aimed to determine the association between monocyte‐to‐HDL‐cholesterol ratio (MHR) and short‐term prognosis in HBV‐DeCi patients.

Methods

A total of 145 HBV‐DeCi patients were enrolled. A multivariate analysis was performed to identify predictors of mortality. The findings were validated by a receiver operating characteristic analysis using the area under the curve (AUC).

Results

A total of 20 (13.8%) patients had died 30 days after admission. MHR was markedly increased in the non‐survivors compared with the survivors. In the multivariate analysis, MHR was identified as an independent risk factor for mortality, with a significant predictive value (AUC = 0.825; sensitivity, 90.0%; specificity, 62.4%).

Conclusions

Elevated MHR is associated with increased mortality rate in HBV‐DeCi patients.

A risk biomarker for obstructive sleep apnea in patients with coronary artery disease: monocyte to high-density lipoprotein ratio

PURPOSE

The monocyte to high-density lipoprotein ratio (MHR) has been postulated to be a novel indicator associated with adverse cardiovascular outcomes in patients with coronary artery disease (CAD). These patients often have obstructive sleep apnea (OSA) and whether or not MHR may provide prognostic value for this comorbidity remains unclear. Therefore, we sought to explore the clinical value of MHR in evaluating OSA in patients with CAD.

METHODS

Consecutive patients with CAD were prospectively recruited and were assigned into four groups based on the quartiles of MHR. Portable monitoring for detecting nocturnal respiratory events was utilized to provide the diagnosis of OSA. Patients were defined as having OSA when respiratory event index ≥ 15 events/h. Univariate and multivariate regression analyses were used to explore the independent association between the levels of MHR and OSA.

RESULTS

A total of 1243 patients with CAD was included with a prevalence of OSA reaching 40% (n = 497). Patients with higher levels of MHR experienced increasing severity of OSA. In univariate analysis, MHR was a risk factor for OSA (odds ratio [OR] 1.90, 95% confidence interval [CI] 1.33-2.71, p < 0.001). Multivariate analysis showed that MHR was independently associated with the presence of OSA (OR 1.63, 95% CI 1.06-2.52, p = 0.027) after adjusting for possible confounding factors.

CONCLUSIONS

Elevated levels of MHR were independently associated with a higher likelihood of OSA in patients with CAD. MHR could be a screening tool and a risk biomarker of OSA in such patients.

Monocyte to HDL cholesterol ratio as a marker of the presence and severity of obstructive sleep apnea in hypertensive patients

This study aimed to investigate the correlation between monocyte to high-density lipoprotein cholesterol ratio (MHR) and obstructive sleep apnea (OSA) in patients with hypertension. A total of 246 hypertensive patients (67 controls, 65 mild, 51 moderate, and 63 severe OSA) were included. The relationship between MHR and OSA was analyzed. MHR correlated positively with apnea–hypopnea index (AHI), while negatively with mean SpO₂ (P < 0.01). MHR was higher in OSA group than the control group (9.2 ± 2.6 vs. 10.8 ± 3.6, P < 0.001). Moreover, MHR in severe OSA group was the highest among all groups (9.2 ± 2.6, 10.2 ± 3.2, 10.4 ± 4.0, and 11.8 ± 3.4 in control, mild, moderate, and severe OSA group, respectively, P < 0.001). Logistic regression analysis demonstrated that MHR was an independent predictor of the presence of OSA (OR = 1.152, P < 0.01) and severe OSA (OR = 1.142, P < 0.01). Area under the curve of MHR was 0.634 (P < 0.05) and 0.660 (P < 0.05) for predicting OSA and severe OSA respectively in the ROC analysis. In conclusion, MHR increased with the severity of OSA. As a practical and cost-effective test, MHR was expected to be an available marker in evaluating OSA risk and severity in hypertensive patients.

The Monocyte to High-Density Lipoprotein Cholesterol Ratio Is Associated with Left Ventricular Diastolic Function in Patients with No Significant Perfusion Abnormality

The monocyte to high-density lipoprotein cholesterol (HDL-C) ratio has been considered to be a prognostic marker. Whether this ratio is associated with left ventricular (LV) diastolic function remains undetermined. We tested the hypothesis that the monocyte to HDL-C ratio is associated with LV diastolic parameters derived from gated myocardial perfusion single-photon emission computed tomography (SPECT) in patients with no significant perfusion abnormality.The study population included 196 patients with no significant perfusion abnormalities and preserved ejection fraction. The peak filling rate (PFR) and one-third mean filling rate (1/3 MFR) were obtained as LV diastolic parameters using gated SPECT. Monocyte counts and plasma HDL-C levels were also examined.Significant associations were observed between the monocyte to HDL-C ratio and PFR (r = -0.20; P = 0.005) and 1/3 MFR (r = -0.19; P = 0.009). Multivariate linear regression analysis was performed to determine factors associated with LV diastolic parameters. Age (β = -0.27; P < 0.001), LV end-diastolic volume (β = -0.19; P = 0.034), and monocyte to HDL-C ratio (β = -0.15; P = 0.027) were determined to be significantly associated with PFR. Moreover, age (β = -0.13; P = 0.007), LV mass index (β = -0.18; P = 0.037), and the monocyte to HDL-C ratio (β = -0.13; P = 0.045) were significantly associated with 1/3 MFR.These results demonstrated that the monocyte to HDL-C ratio is associated with LV diastolic function, as derived from gated SPECT in patients with no significant perfusion abnormality.

Monocyte to HDL ratio: a novel marker of resistant hypertension in CKD patients

BACKGROUND

Inflammation, oxidative stress (OS), atherosclerosis and resistant hypertension (RH) are common features of chronic kidney disease (CKD) leading to a higher risk of death from cardiovascular disease. These effects seem to be modulated by impaired anti-oxidant, anti-inflammatory and reverse cholesterol transport actions of high-density lipoprotein cholesterol (HDL). HDL prevents and reverses monocyte recruitment and activation into the arterial wall and impairs endothelial adhesion molecule expression. Recently, monocyte count to HDL-cholesterol ratio (MHR) has emerged as a potential marker of inflammation and OS, demonstrating to be relevant in CKD. Our research was aimed to assess, for the first time, its reliability in RH.

METHODS

We performed a retrospective study on 214 patients with CKD and arterial hypertension who were admitted between January and June 2019 to our Department, 72 of whom were diagnosed with RH.

RESULTS

MHR appeared inversely related to eGFR (ρ = - 0.163; P = 0.0172). MHR was significantly higher among RH patients compared to non-RH ones (12.39 [IQR 10.67-16.05] versus 7.30 [5.49-9.06]; P < 0.0001). Moreover, MHR was significantly different according to the number of anti-hypertensive drugs per patient in the whole study cohort (F = 46.723; P < 0.001) as well as in the non-RH group (F = 14.191; P < 0.001). Moreover, MHR positively correlates with diabetes mellitus (ρ = 0.253; P = 0.0002), white blood cells (ρ = 0.664; P < 0.0001) and C-reactive protein (ρ = 0.563; P < 0.0001).

CONCLUSIONS

MHR may be a reliable biomarker due to the connection between HDL and monocytes. Our study suggests that MHR is linked with the use of multiple anti-hypertensive therapy and resistant hypertension in CKD patients, and can be a useful ratio to implement appropriate treatment strategies.

The association between monocyte HDL ratio and albuminuria in diabetic nephropathy

Objectives:

We aimed to investigate whether Monocyte-to-HDL ratio (MHR) had an association with albuminuria in patients with diabetic nephropathy (DN).

Methods:

Diabetic patients, who had admitted to the outpatient clinic of general internal disease department between September 2017 - February 2018 and had their spot urinary albumin/creatinine ratio measured, were examined retrospectively. Patients were separated based on the presence of DN. Patients with DN were grouped as Stage-I, Stage-II and Stage-III chronic kidney disease (CKD). Groups were compared in terms of MHR. The presence of a correlation between MHR and albuminuria was investigated.

Results:

MHR was found to be higher in the DN (n=85) group compared to Non- DN group. (16.2±5.5 vs. 14.3±4, p=0.037) And there was no significant difference in Stage-I, Stage-II and Stage-III CKD groups in terms of MHR. (15.2± 3.4, 16.1±6.0, 17.1±6.0, p=0.485). No significant correlation was found between MHR and albuminuria in DN and non-DN groups (p=0.634, r=0.052; p=0.553, r=-0.059).

Conclusions:

DN group had higher MHR than non-nephropathy group, whereas, there was no correlation between albuminuria and MHR.

Correlation between Imaging Morphological Findings and Laboratory Biomarkers in Patients with Diabetic Macular Edema

PURPOSE

To investigate the potential association between peripheral blood biomarkers and morphological characteristics of retinal imaging in patients with diabetic macular edema (DME).

METHODS

Participants in this cross-sectional study were 36 consecutive patients (36 eyes) with treatment-naïve DME, who underwent spectral domain-optical coherence tomography (SD-OCT), fundus photography, and fundus fluorescein angiography (FFA). In addition, peripheral blood samples were taken to evaluate full blood count and biochemical parameters. Correlation between imaging characteristics and laboratory parameters was examined.

RESULTS

Eyes with central subfield thickness greater than 405 μm presented significantly higher neutrophils/lymphocytes (p = 0.043) and higher lipoprotein (a) compared to eyes with CST < 405 μm (p = 0.003). Presence of hyperreflective foci on SD-OCT was associated with significantly higher white blood cell count (p = 0.028). Ellipsoid zone disruption was associated with significantly lower hematocrit (p = 0.012), hemoglobin (p = 0.009), and red blood cell count (p = 0.026), as well as with higher lipoprotein (a) (p = 0.015). Macular ischemia on FFA was associated with significantly higher monocytes (p = 0.027) and monocytes/HDL (p = 0.019). No significant associations were found between laboratory parameters and subretinal fluid, intraretinal fluid, exudates, cysts, disorganization of inner retinal layers, epiretinal membrane, and external limiting membrane condition.

CONCLUSION

Specific imaging morphological characteristics were found to be associated with laboratory parameters in patients with DME. These findings may shed light on the pathophysiology of DME and its correlation with the development of specific clinical signs.

<p>The Predictive Value of Monocyte Count to High-Density Lipoprotein Cholesterol Ratio in Restenosis After Drug-Eluting Stent Implantation</p>

Background

The clinical value of monocyte count to high-density lipoprotein cholesterol ratio (MHR) in in-stent restenosis (ISR) of patients who have undergone bare metal stent implantation has been studied. However, the predictive value of MHR in ISR for patients who have undergone drug-eluting stent (DES) implantation has not been explored.

Methods

Non-ST segment elevation acute coronary syndrome (NSTE-ACS) patients who had undergone DES implantation and coronary angiography follow-up at the Beijing Shijitan Hospital, Capital Medical University, between January 1, 2008, and December 31, 2018, were retrospectively enrolled. Patients were divided into ISR and non-ISR groups depending on the follow-up coronary angiography results. Relative clinical information was recorded and analyzed. The receiver operating characteristic curve analysis was used to determine the optimum cut-off pre-procedural MHR to predict ISR.

Results

A total of 214 patients were enrolled in our study. The mean period between two coronary angiography procedures was 25.4±9.8 months. Percutaneous coronary intervention due to NSTE myocardial infarction, a bifurcation lesion, increased platelet count, and a high MHR were the independent risk factors in multivariate logistic regression analyses.

Conclusion

Our results indicated that elevated MHR is an independent and useful predictor of ISR in NSTE-ACS patients who have undergone DES implantation.

The new prognostic factor for pulmonary embolism: The ratio of monocyte count to HDL cholesterol

PURPOSE

Aim of this study is to investigate effectiveness of the monocyte to HDL cholesterol ratio in patients diagnosed with pulmonary embolism for predicting intra-hospital mortality.

METHOD

A total of 269 patients diagnosed with pulmonary embolism in the emergency clinic were included in the study. Study was conducted retrospectively. Pulmonary Embolism Severity Index (PESI), Monocyte count and high density lipoprotein cholesterol (HDL) values were determined. MHR values of the patients were calculated. SPSS 26 package program was used to investigate the effectiveness of MHR in predicting mortality.

FINDINGS

Mean age of the patients was 64.51 ± 12.4 years. PESI, Number of monocytes and MHR were significantly higher in the group with mortality than the group without mortality (p < .05). HDL values were significantly lower (p < .05) in mortality group. Sensitivity of MHR 19 cut off value was 89.3%, and its specificity was 82.0%.

CONCLUSION

Use of predictors for mortality estimation in patients diagnosed with acute pulmonary embolism is important for faster administration of treatment modalities. We think MHR values can be used as a strong predictor according to the hemogram parameters and biochemical results.

Effect of Central Obesity and Hyperandrogenism on Selected Inflammatory Markers in Patients with PCOS: A WHtR-Matched Case-Control Study

White blood cell counts (WBC), lymphocyte-to-monocyte ratio (LMR), and monocyte-to-high-density lipoprotein cholesterol ratio (MHR) are used as chronic inflammation markers. Polycystic ovary syndrome (PCOS) is a constellation of systemic inflammation linked to central obesity (CO), hyperandrogenism, insulin resistance, and metabolic syndrome. The waist-to-height ratio (WHtR) constitutes a highest-concordance anthropometric CO measure. This study aims to access WBC, LMR, and MHR in PCOS and healthy subjects, with or without CO. Establishing relationships between complete blood count parameters, high-sensitivity C-reactive protein (hsCRP), and hormonal, lipid and glucose metabolism in PCOS. To do this, WBC, LMR, MHR, hsCRP, anthropometric, metabolic, and hormonal data were analyzed from 395 women of reproductive age, with and without, PCOS. Correlations between MHR, and dysmetabolism, hyperandrogenism, and inflammation variables were examined. No differences were found in WBC, LMR, MHR, and hsCRP between PCOS and controls (p > 0.05). PCOS subjects with CO had higher hsCRP, MHR, and WBC, and lower LMR vs. those without CO (p < 0.05). WBC and MHR were also higher in controls with CO vs. without CO (p < 0.001). MHR correlated with anthropometric, metabolic, and endocrine parameters in PCOS. WHtR appeared to strongly predict MHR in PCOS. We conclude that PCOS does not independently influence WBC or MHR when matched for CO. CO and dysmetabolism may modify MHR in PCOS and control groups.

The Monocyte to High-Density Lipoprotein Cholesterol Ratio in the Prediction for Atherosclerosis: A Retrospective Study in Adult Chinese Participants

The ratio of monocyte to high-density lipoprotein cholesterol level (MHR) was a newly proposed inflammatory and oxidative stress marker. This study aimed to explore the association between MHR and Brachial-ankle pulse wave velocity (Ba-PWV) in adult Chinese participants. A total of 2029 participants were divided into two groups according to the Ba-PWV: a high Ba-PWV group (Ba-PWV ≥1400 cm/s) and a low Ba-PWV group (Ba-PWV < 1400 cm/s). According to the cut-off points of quartile of MHR, the participants were divided into four groups. The relationship between MHR and Ba-PWV was analyzed. After adjusting for potential confounders, a non-linear relationship between MHR and Ba-PWV was found in the participants, and the inflection point was 7.78 in the non-linear curve. On the left of the inflection point, MHR had a positive correlation with Ba-PWV (OR = 1.17, 95% confidence interval (CI): 1.08 to 1.28, p < 0.01). However, there was no obvious relationship between MHR and Ba-PWV on the right of the inflection point (OR = 0.96, 95% CI: 0.90 to 1.01, p = 0.117). Further demographic analysis demonstrated that the positive relationship between MHR and Ba-PWV was found in the female participants with hypertension family history, but without a current history of hypertension, smoking, or drinking (p < 0.05). An increased MHR is a risk factor of atherosclerosis, which may predict the potential development of atherosclerosis. When the MHR is close to 7.78, it has the highest predictive value for the risk of atherosclerosis occurrence.

Monocyte to high-density lipoprotein cholesterol ratio as long-term prognostic marker in patients with coronary artery disease undergoing percutaneous coronary intervention

Background

The relation between monocyte to high-density lipoprotein cholesterol ratio (MHR) and coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) remains controversial. The present study aims to assess the prognostic value of MHR in patients with CAD who underwent PCI.

Methods

A total of 673 CAD patients were retrospectively enrolled and divided into four groups according to MHR values. Multivariate Cox regression analysis was performed to study the effects of different variables to clinical outcomes reported as major adverse cardiac events (MACE) and all-cause mortality (ACM).

Results

In a multivariate Cox analysis, after adjustment of other confounders, MHR was found to be an independent predictor of ACM (HR: 3.655; 95% CI: 1.170–11.419, P = 0.026) and MACE (HR =2.390, 95% CI 1.379–4.143, p < 0.002). Having a MHR in the third and fourth quartile were associated with a 2.83-fold and 3.26 -flod increased risk of MACE.

Conclusions

MHR is an independent predictor of ACM and MACE in CAD patients undergoing PCI.

Comparison of monocyte with high density lipoprotein cholesterol ratio in dipper and nondipper hypertensive patients

Aim: We aimed to compare the monocyte to HDL-cholesterol ratio (MHR) of nondipper hypertension (NDHT) and dipper hypertension patients. Patients & methods: A total of 162 patients were included in the study. Patients were grouped as dipper and nondipper according to 24-h ambulatory blood pressure recordings. Results: The MHR was significantly higher in nondipper hypertension group compared with control (p < 0.001) and dipper hypertension groups (p = 0.03). MHR, hs-CRP and red-cell distribution width (RDW) were independent predictors of nondipper hypertension. Area under the curve was 0.62 (p = 0.034) for MHR and 0.61 (p = 0.012) for hs-CRP in the ROC analysis. Conclusion: MHR has elevated levels in NDHT patients. Increased levels of MHR may evaluate as increased risk of cardiovascular events in NDHT patients.

Monocyte-to-HDL-cholesterol ratio as a prognostic marker in cardiovascular diseases

Inflammation and lipid accumulation are two basic hallmarks of atherosclerosis as a chronic disease. Inflammation not only is a local response but can also be considered as a systemic process followed by an elevation of inflammatory mediators. Monocytes are a major source of proinflammatory species during atherogenesis. In atherosclerosis, modified low-density lipoproteins (LDLs) are removed by macrophages; these are recruited in the vessel wall, inducing the release of inflammatory cytokines in inflamed tissue. Hence, inflammatory cholesterol ester-loaded plaque is generated. High-density lipoprotein-cholesterol (HDL-C) exhibits antiatherosclerotic effects by neutralizing the proinflammatory and pro-oxidant effects of monocytes via inhibiting the migration of macrophages and LDL oxidation in addition to the efflux of cholesterol from these cells. Furthermore, HDL plays a role in suppressing the activation of monocytes and proliferation-differentiation of monocyte progenitor cells. Thus, accumulation of monocytes and reduction of HDL-C may participate in atherosclerosis and cardiovascular diseases (CVD). Given that the relationship between the high number of monocytes and low HDL-C levels has been reported in inflammatory disorders, this review focused on understanding whether the monocyte-to-HDL ratio could be a convenient marker to predict atherosclerosis development and progression, hallmarks of CV events, instead of the individual monocyte count or HDL-C level.

Monocyte to high-density lipoprotein cholesterol ratio in patients with diabetes mellitus and diabetic nephropathy

AIM

We investigated the relationship of monocyte to high-density lipoprotein cholesterol ratio (MHR) with diabetes mellitus and diabetic nephropathy.

METHODS & RESULTS

A total of 220 diabetes mellitus patients and 70 healthy controls were enrolled. There was no difference in an MHR between normoalbuminuric diabetic patients and the healthy controls. The MHR in patients with diabetic nephropathy was significantly higher than that of both the normoalbuminuric diabetic patients and the healthy controls. There was a significant positive correlation between urine albumin to creatinine ratio and the MHR. In multivariate linear regression analysis, the MHR was independently correlated with urine albumin to creatinine ratio.  Conclusion: An increased MHR may be a biomarker for diabetic nephropathy.

The monocyte counts to HDL cholesterol ratio in obese and lean patients with polycystic ovary syndrome

BACKGROUND

Women with polycystic ovary syndrome are more likely to suffer from obesity, insulin resistance, and chronic low-grade inflammation. In fact, the excessive activation of monocytes exacerbates oxidative stress and inflammation. However, high-density lipoprotein cholesterol neutralizes the pro-inflammatory and pro-oxidant effects of monocytes. The aim of this study is to investigate whether monocyte counts to high-density lipoprotein cholesterol ratio can predict the inflammatory condition in patients with polycystic ovary syndrome.

METHODS

In this cross-sectional study, a total of 124 women (61 of them with polycystic ovary syndrome and 63 age-matched healthy volunteers) were included in the study population. Obese polycystic ovary syndrome patients (n = 30) with a body mass index of ≥25 kg/m² and lean polycystic ovary syndrome patients (n = 31) with a body mass index of < 25 kg/m² were compared to age-and body mass index-matched healthy subjects (30 obese and 33 non-obese).

RESULTS

The monocyte counts to high density lipoprotein cholesterol values in women with polycystic ovary syndrome were significantly higher than in control subjects (p = 0.0018). Moreover, a regression analysis revealed that body mass index, the homeostasis model assessment of insulin resistance and the high sensitivity C-reactive protein levels were confounding factors that affected the monocyte counts to high density lipoprotein cholesterol values. Additionally, a univariate and multivariate logistic regression analysis demonstrated that the increased monocyte counts to high density lipoprotein cholesterol values were more sensitive than the other known risk factors (such as increased body mass index, homeostasis model assessment of insulin resistance and high sensitive C-reactive protein levels) in the prediction of the inflammation in patients with polycystic ovary syndrome.

CONCLUSION

The present study demonstrated that the monocyte count to high density lipoprotein cholesterol may be a novel and useful predictor of the presence of polycystic ovary syndrome.

Evaluation of Monocyte to High-Density Lipoprotein Cholesterol Ratio in the Presence and Severity of Metabolic Syndrome

Monocyte to high-density lipoprotein cholesterol ratio (MHR) is a systemic inflammatory marker, and recently, it has been used quite commonly for the assessment of inflammation in cardiovascular disorders. The aim of the present study is to investigate the relevance of MHR as a marker to assess metabolic syndrome (MetS) and MetS severity in clinical practice. A total of 147 patients with MetS who were diagnosed according to National Cholesterol Education Program Adult Treatment Panel III criteria and 134 healthy controls, matched for age and gender, were included in our retrospective study. MHR values were 13.15 ± 6.07 for patients with MetS and 9.74 ± 5.24 for the control group. MHR values of the patients were found to be statistically significantly higher than the control group ( P < .0001). MHR showed a significantly positive correlation with the severity of MetS ( r = .429; P < .0001). When patients with MetS were assessed with MHR in the study population, receiver-operating characteristic curve analysis yielded a cutoff value of 9.36 with a sensitivity of 72%, a specificity of 61%, and a P value <.0001. In logistic regression analyses of MetS with several variables, MHR remained as an independent predictor of MetS (95% CI: 0.721-0.945, P = .005). MHR might be an available and useful inflammatory marker to evaluate patients with MetS and disease severity.