title: The Monocyte-to-Lymphocyte Ratio Correlates with Psycho-Neuro-Inflammatory Factors in Patients with Stable Coronary Artery Disease.
abstract: Psychosocial stress and depression have been recognized as major risk factors of coronary artery disease (CAD). Although monocytes are known to be key players in atherosclerosis, monocyte-based associations with psychoneuroendocrino-immuno-inflammatory (PNI) markers have not been widely investigated in stable CAD.
  
  
  
  We examined associations between the monocyte-to-lymphocyte ratio (MLR) and key PNI markers in stable CAD.
  
  
  
  We studied 23 patients with stable CAD who completed the Beck Depression Inventory (BDI) and Rahe's Brief Stress and Coping Inventory. A white blood cell differential was performed, and levels of cortisol, chromogranin A (CgA), LL-37, interleukin-6 (IL-6) and C-reactive protein (CRP) were assayed in plasma.
  
  
  
  Monocyte fraction, MLR and plasma CgA levels exceeded reference values, the social support score was low, and 7 patients had elevated BDI scores. In the multivariate-adjusted analysis, a higher MLR was associated with greater depressive symptom severity (r = 0.624, p < 0.01) as well as with higher concentrations of CgA (r = 0.660, p < 0.01), LL-37 (r = 0.643, p < 0.01), IL-6 (r = 0.532, p < 0.05) and CRP (r = 0.470, p < 0.05). BDI scores associated with CgA concentration (r = 0.618, p < 0.01) and CgA level correlated negatively with the social support score (r = -0.511, p < 0.05).
  
  
  
  Our findings suggest that, in patients with stable CAD, elevated MLR may be associated with depressive symptoms, with increased neuroendocrine-sympathetic activity (marked by CgA) and inflammatory markers that are pertinent to atherosclerosis initiation and progression. The increased neuroendocrine-sympathetic activity correlated with low social support and depressive symptom severity. The MLR might serve as an easy-to-obtain and inexpensive proxy measure of an activated PNI network in stable CAD.
authors.affiliation: Department of Biochemistry, Medical Faculty, University of Szeged, Szeged, Hungary.
authors.forename: Gyöngyi
authors.initials: G
authors.lastname: Serfőző
authors.forename: Tamás
authors.initials: T
authors.lastname: Horváth
authors.forename: Imre
authors.initials: I
authors.lastname: Földesi
authors.forename: Beatrix
authors.initials: B
authors.lastname: Rafael
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
authors.forename: Margit
authors.initials: M
authors.lastname: Keresztes
mesh_terms: D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000097:blood* / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000097:blood* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000453:epidemiology / Q000523:psychology; D018836:Inflammation Mediators / Q000097:blood*; D008214:Lymphocytes / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism*; D011569:Psychiatric Status Rating Scales
chemical_list: D018836:Inflammation Mediators