Association of Monocyte Count and Monocyte/Lymphocyte Ratio with the Risk of Cardiovascular Outcomes in Patients with CKD

Abstract

BackgroundEmerging evidence suggests an association of higher monocyte count and monocyte/lymphocyte ratio (MLR) with the risk of cardiovascular disease (CVD) in individuals without chronic kidney disease (CKD); however, limited studies have examined if this association translates to the CKD population. This study examined whether monocyte count and MLR are associated with the risk of CVD, CVD death, and all-cause death in patients with nondialysis CKD who participated in the Chronic Renal Insufficiency Cohort observational study.MethodsBaseline monocyte count and MLR were categorized into tertiles and also modeled continuously. Cox proportional hazards models were used to examine the association between monocyte count (primary predictor) and MLR (secondary predictor) at baseline and time to a composite of CVD events, including heart failure, myocardial infarction, ischemic stroke, and peripheral artery disease (primary outcome). Secondary outcomes were time to CVD death and all-cause death.ResultsThe median follow-up time was 9 years for CVD events and 11.7 years for death. In the fully adjusted model, participants with a higher monocyte count and MLR had a greater risk of CVD events (hazard ratio [HR] per doubling of monocyte count=1.2 [95% CI, 1.1 to 1.31]; HR per doubling of MLR=1.26 [95% CI, 1.16 to 1.36]), CVD death (HR=1.18 [95% CI, 0.99 to 1.41]; HR=1.27 [95% CI, 1.1 to 1.48]), and all-cause death (HR=1.17 [95% CI, 1.06 to 1.3]; HR=1.18 [95% CI, 1.09 to 1.29]).ConclusionsThese results suggest that monocyte count and MLR may have the potential to be cost-effective, clinically available indicators of CVD risk in the CKD population.

Blood Monocyte Phenotype Is A Marker of Cardiovascular Risk in Type 2 Diabetes

“…Thus, even among people considered to have a normal monocyte count, those with T2D and a monocyte count >0.5×10 9 /L have a higher risk of cardiovascular events over the next decade compared with those with a count <0.5×10 9 /L. These data support findings previously published in populations of people with T2D, 29 or nondiabetic individuals but at high cardiovascular risk due to their age, 30 renal status, 31,32 or even their indication for scheduled coronary angiography. 33 It is noteworthy that this increased risk associated with monocyte counts >0.5×10 9 /L is independent of age, sex, and renal status.…”

The Absolute Monocyte Count at Diagnosis Affects Prognosis in Myelodysplastic Syndromes Independently of the IPSS-R Risk Score

“…Cells of the monocyte/macrophage system play a crucial role in atherosclerosis and heart failure [39,40]. A higher AMC is associated with an increased cardiovascular risk both in the general population [41,42] and several medical conditions, such as end stage kidney disease [43] and chronic HIV infection [44], as shown recently. Therefore, a higher monocyte count could be an indicator of an increased cardiovascular risk in MDSs.…”

Association between monocyte lymphocyte ratio and abdominal aortic calcification in US adults: A cross-sectional study

“… 13 In addition, Monocyte Lymphocyte Ratio (MLR), a robust inflammatory biomarker, could help predict the risk of cardiovascular disease and assess the severity of coronary artery disease. 14 , 15 , 16 The relationship between monocyte lymphocyte ratio and AAC has not been reported before. Therefore, using the 2013‒2014 National Health and Nutrition Examination Survey (NHANES) cohort, the authors assessed the association between MLR and AAC.…”