The monocyte to high-density lipoprotein cholesterol ratio and outcomes in type 2 diabetes mellitus patients with non-ST-segment elevation acute coronary syndrome

Li, Chen; Fan, Haoyu; Liu, Yuanhui; Zeng, Li-Huan; Chen, Pengyuan; Duan, Chongyang; Liang, Huasheng; He, Pengcheng

doi:10.21037/atm-21-4876

Cited by 13 publications

(19 citation statements)

References 31 publications

(17 reference statements)

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“…Analysis showed that the risk of long-term MACEs in high MHR group was significantly higher than patients with low MHR in population of Turkey (HR = 1.90, 95% CI 1.27-2.85, P = .002) [13,14] and age > 60 years (HR = 2.02, 95% CI 1.38-2.96, P < .001). [18,20] Subgroup analysis according to sample size, and follow-up showed pooled HR estimates with similar results to that of the original analysis. Interestingly, STEMI patients (HR = 2.66, 95% CI 1.62-4.35, P < .001) [14,19] with high MHR tend to have a higher risk of developing long-term MACEs than ACS patients (HR = 1.41, 95% CI 1.15-1.73, P = .001).…”

Section: Subgroup Analysesmentioning

confidence: 58%

“…[ 13 , 14 , 16 , 21 ] One study included CAD patients, [ 15 ] 3 studies included ST-segment elevation myocardial infarction (STEMI) patients, [ 14 , 16 , 19 ] and 5 studies ACS patients. [ 13 , 17 , 18 , 20 , 21 ]…”

Section: Resultsmentioning

confidence: 99%

“…Zhang Y 2016 [17] China 24.6 3630 57.9 70.4 ACS Long term MACEs 7 Chen L 2021 [18] China [20] China 12.0 435 63.0 67.4 ACS Long term MACEs 7 Oylumlu M 2020 [21] Turkey 39.0 825 62.4 71.3 ACS Long-term mortality 7…”

Section: Discussionmentioning

confidence: 99%

“…[11,12] Previous researches assessed the value of a novel biomarker, named as monocyte to HDL-C ratio (MHR), in predicting mortality and MACEs in patients with CHD. [13][14][15][16][17][18][19][20][21] MHR has showed to be an inexpensive and convenient method for predicting the prognosis of CHD, but the outcomes were diverse. Therefore, we carried out a meta-analysis to evaluate the relationship between MHR and the risk of mortality and MACEs in CHD patients.…”

Section: Introductionmentioning

confidence: 99%

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Monocyte to high-density lipoprotein ratio predict long-term clinical outcomes in patients with coronary heart disease: A meta-analysis of 9 studies

et al. 2022

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Background: A novel inflammation-related biomarker, the monocyte to high-density lipoprotein cholesterol ratio (MHR), had a great relation to the development and prognosis of coronary atherosclerotic heart disease. Current study was to investigate whether the MHR was a potential tool in predicting the mortality and major adverse cardiac events (MACEs) in patients suffering coronary heart disease (CHD) by meta-analysis.Methods: The Cochrane Library, PubMed, MEDLINE, Scopus, EMBASE, and Web of science were searched for relevant cohort studies published prior to February 10, 2022. The association between MHR and mortality/MACEs was analyzed in patients with CHD. Hazard ratios (HR) with 95% confidence interval (CI) were calculated to estimate the strength of association.Results: In the meta-analysis, a total of 9 studies of 11,345 patients with CHD were included. Compared with the low level of MHR group, the high MHR value was associated with higher long-term MACEs (HR = 1.72 95% CI 1.36-2.18, P < .001), long-term mortality (HR = 1.71, 95% CI 1.10-2.66, P = .017), and in-hospital mortality/MACEs (HR = 2.82, 95% CI = 1.07-7.41, P = .036).Conclusions: This study suggested that increased MHR value might be associated with higher long-term mortality and longterm MACEs in CHD patients. MHR might serve as a potential prognostic indicator for risk stratification in patients with CHD.Abbreviations: CAD = coronary artery disease, CHD = coronary heart disease, CI = confidence interval, HDL = High-density lipoprotein, HDL-C = HDL-cholesterol, HR = Hazard ratios, MACEs = major adverse cardiac events, MHR = monocyte to highdensity lipoprotein cholesterol ratio, NOS = New Castle-Ottawa scale, PRISMA = preferred reporting items for systematic reviews and meta-analyses, STEMI = ST-segment elevation myocardial infarction.

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Section: Subgroup Analysesmentioning

confidence: 58%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Monocyte to high-density lipoprotein ratio predict long-term clinical outcomes in patients with coronary heart disease: A meta-analysis of 9 studies

et al. 2022

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“…The monocyte-to-HDL-C ratio (MHR) may be a novel marker of inflammation and oxidative stress. Elevated MHR is associated with the occurrence and development of extracranial and intracranial atherosclerotic stenosis ( 21 ), non-ST-segment elevation acute coronary syndrome ( 22 ), and neuromyelitis optica spectrum disorders ( 23 ). However, the relationship between MHR and NAFLD risk has not been fully addressed, especially in the general American population.…”

Section: Introductionmentioning

confidence: 99%

Association Between Monocyte to High-Density Lipoprotein Cholesterol Ratio and Risk of Non-alcoholic Fatty Liver Disease: A Cross-Sectional Study

Wang

Dong

et al. 2022

Front. Med.

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Background:Non-alcoholic fatty liver disease (NAFLD) is a global health problem affecting more than a quarter of the entire adult population. Both monocytes and high-density lipoprotein cholesterol (HDL-C) were found to participate in the progression of hepatic inflammation and oxidative stress. We speculated that the monocyte-to-HDL-C ratio (MHR) may be associated with the risk of NAFLD.MethodsWe conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 2017–2018. NAFLD was identified using a controlled attenuation parameter (CAP) of ≥274 dB/m. Degree of liver fibrosis were assessed by liver stiffness measurement (LSM) and LSM values≥8.0, ≥ 9.7, and ≥13.7 kPa were defined as significant fibrosis (≥F2), advanced fibrosis (≥F3) and cirrhosis (F4), respectively. The association between MHR and the risk of NAFLD and liver fibrosis was estimated using weighted multivariable logistic regression. The non-linear relationship between MHR and the risk of NAFLD was further described using smooth curve fittings and threshold effect analysis.ResultsOf 4,319 participants, a total of 1,703 (39.4%) participants were diagnosed with NAFLD. After complete adjustment for potential confounders, MHR was positively associated with the risk of NAFLD (OR = 2.87, 95% CI: 1.95–4.22). The risk of NAFLD increased progressively as the MHR quarter increased (P for trend < 0.001). In subgroup analysis stratified by sex, a positive association existed in both sexes; Women displayed higher risk (men: OR = 2.12, 95% CI: 1.33–3.39; women: OR = 2.64, 95%CI: 1.40–4.97). MHR was positively associated with the risk of significant liver fibrosis (OR = 1.60, 95% CI: 1.08–2.37) and cirrhosis (OR = 1.83, 95% CI: 1.08–3.13), but not with advanced liver fibrosis (OR = 1.53, 95% CI: 0.98–2.39) after full adjustment for potential confounders. In the subgroup analysis by sex, the association between MHR and different degrees of liver fibrosis was significantly positive in women. When analyzing the relationship between MHR and NAFLD risk, a reverse U-shaped curve with an inflection point of 0.36 for MHR was found in women.ConclusionHigher MHR was associated with increased odds of NAFLD among Americans of both sexes. However, an association between MHR and liver fibrosis was found mainly among women.

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Neutrophil to high-density lipoprotein cholesterol ratio as the risk mark in patients with type 2 diabetes combined with acute coronary syndrome: a cross-sectional study

Ren

Zhu

Zhao

et al. 2023

Sci Rep

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Chronic inflammation and dyslipidemia are important risk factors in developing atherosclerotic cardiovascular disease, such as coronary heart disease. Acute coronary syndrome (ACS) is one of the most dangerous syndromes in coronary heart disease. Type 2 diabetes mellitus (T2DM) is considered equal to coronary heart disease owing to the high cardiac risk induced by chronic inflammation and dyslipidemia. The neutrophil to high-density lipoprotein cholesterol ratio (NHR) is a novel and straightforward marker that reflects inflammation and lipid metabolic disorder. However, few studies have been on the role of NHR in assessing the risk of ACS in T2DM patients. Here we analyzed NHR level in ACS patients with T2DM, exploring its predictive and diagnostic values. 211 hospitalized ACS patients with T2DM were recruited as the case group, and 168 hospitalized T2DM patients as the control group (all patients collected from 6/2020 to 12/2021 in Xiangya Hospital). Biochemical test results and echocardiograms, as well as demographic information such as age, BMI, diabetes mellitus, smoking, drinking, and history of hypertension, were recorded. Frequencies, percentages, means, and standard deviations were used to describe the data. The shapiro–Wilk test was used to assess the normality of the data. Normally distributed data were compared using the independent sample T-test, and non-normally distributed data were compared using Mann–Whitney U test. Correlation analysis was performed using the Spearman rank correlation test, and receiver operating characteristic (ROC) curve analysis and multivariable logistic regression analysis were performed by SPSS version 24.0 (SPSS Inc) and GraphPad Prism 9.0 (GraphPad Software Inc). p < 0.05 was considered significant. In the study population, NHR was higher in patients with T2DM combined with ACS than in T2DM patients without ACS (p < 0.001). After adjusting for BMI, alcohol consumption, and history of hypertension, multifactorial logistic regression analysis revealed that NHR is a risk factor for T2DM patients combined with ACS (OR 1.221, p = 0.0126). Correlation analysis on all ACS patients with T2DM showed that NHR level was positively correlated with cTnI (r = 0.437, p < 0.001), CK (r = 0.258, p = 0.001), CK-Mb (r = 0.447, p < 0.001), LDH (r = 384, p < 0.001), Mb (r = 0.320, p < 0.001), LA (r = 0.168, p = 0.042) and LV levels (r = 0.283, p = 0.001). And meanwhile, NHR level was negatively correlated with EF (r = − 0.327, p < 0.001) and FS levels (r = − 0.347, p < 0.001). ROC curve analysis showed that NHR ≧ 4.32 had a sensitivity of 65.45% and a specificity of 66.19% for predicting ACS in T2DM patients [area under the curve (AUC) = 0.722, p < 0.001]. Furthermore, in all ACS patients with T2DM, the diagnostic power of NHR was stronger in ST-segment elevated ACS patients (STE-ACS) than that in non-ST-segment elevated ACS patients (NSTE-ACS) (p < 0.001). With its convenience and effective character, NHR could be a potential and new marker for predicting the presence, progression, and severity of ACS in T2DM population.

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The monocyte to high-density lipoprotein cholesterol ratio and outcomes in type 2 diabetes mellitus patients with non-ST-segment elevation acute coronary syndrome

Cited by 13 publications

References 31 publications

Monocyte to high-density lipoprotein ratio predict long-term clinical outcomes in patients with coronary heart disease: A meta-analysis of 9 studies

Monocyte to high-density lipoprotein ratio predict long-term clinical outcomes in patients with coronary heart disease: A meta-analysis of 9 studies

Association Between Monocyte to High-Density Lipoprotein Cholesterol Ratio and Risk of Non-alcoholic Fatty Liver Disease: A Cross-Sectional Study

Neutrophil to high-density lipoprotein cholesterol ratio as the risk mark in patients with type 2 diabetes combined with acute coronary syndrome: a cross-sectional study

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