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

• DOI: 10.1007/s11255-014-0730-1
• Publication Date: 2014-05-22T15:11:41Z
• Authors: Mehmet Kanbay; Yalcin Solak; Hilmi Umut Unal; Yasemin Gulcan Kurt; Mahmut Gok; Hakki Cetinkaya; Murat Karaman; Yusuf Oguz; Tayfun Eyileten; Abdulgaffar Vural; Adrian Covic; David Goldsmith; Osman Turak; Mahmut Ilker Yilmaz
• Keywords: High-density lipoprotein; Nephrology; Monocyte

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.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.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.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.