Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease.
OBJECTIVE
Previous studies showed that renal dysfunction was associated with both a reduction in serum high-density lipoprotein (HDL) cholesterol concentration and increased circulating monocyte count. We aimed to investigate the effect of circulating monocyte to serum HDL cholesterol ratio (M/H ratio) on fatal and composite cardiovascular events, in an observational cohort study of chronic kidney disease (CKD) patients.


METHODS
A total of 340 subjects with stage 1-5 CKD were followed for a mean follow-up period of 33 (range 2-44) months and assessed for fatal and nonfatal CV events. M/H ratio was calculated for all patients. All-cause mortality and CVE were also analyzed in relation to M/H ratio.


RESULTS
Monocyte/HDL cholesterol ratio was negatively correlated with estimated glomerular filtration rate (eGFR) (r = -0.43, P < 0.001). Notably, both fatal and combined fatal and nonfatal cardiovascular events were more common in patients having a M/H ratio in the third tertile was associated with a hazard ratio of 2.24 and 4.91, respectively, for fatal and composite cardiovascular events compared to being in the first tertile.


CONCLUSIONS
Monocyte/HDL cholesterol ratio was increased with decreasing eGFR in predialytic CKD patients. Most importantly, we report for the first time that an increased M/H ratio was cross-sectionally associated with a worse cardiovascular profile and arose as independent predictors of major cardiovascular events during follow-up.
Division of Nephrology, Department of Medicine, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey, drkanbay@yahoo.com.
Mehmet
M
Kanbay
Yalcin
Y
Solak
Hilmi Umut
HU
Unal
Yasemin Gulcan
YG
Kurt
Mahmut
M
Gok
Hakki
H
Cetinkaya
Murat
M
Karaman
Yusuf
Y
Oguz
Tayfun
T
Eyileten
Abdulgaffar
A
Vural
Adrian
A
Covic
David
D
Goldsmith
Osman
O
Turak
Mahmut Ilker
MI
Yilmaz
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood* / Q000401:mortality*; D008076:Cholesterol, HDL / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009000:Monocytes; D009203:Myocardial Infarction / Q000097:blood / Q000453:epidemiology; D011446:Prospective Studies; D020521:Stroke / Q000097:blood / Q000453:epidemiology
D008076:Cholesterol, HDL