Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease

Int Urol Nephrol. 2014 Aug;46(8):1619-25. doi: 10.1007/s11255-014-0730-1. Epub 2014 May 23.

Abstract

Background and aim: 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.

Materials and 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.

Conclusion: 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.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / mortality*
  • Cholesterol, HDL / blood*
  • Cross-Sectional Studies
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic / blood*
  • Kidney Failure, Chronic / complications
  • Leukocyte Count
  • Male
  • Middle Aged
  • Monocytes*
  • Myocardial Infarction / blood
  • Myocardial Infarction / epidemiology
  • Prospective Studies
  • Stroke / blood
  • Stroke / epidemiology

Substances

  • Cholesterol, HDL