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

Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease
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DOI:
10.1007/s11255-014-0730-1
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发表时间:
2014-08-01
影响因子:
2
通讯作者:
Yilmaz, Mahmut Ilker
Yilmaz, Mahmut Ilker
中科院分区:
医学4区
文献类型:
--
作者:
Kanbay, Mehmet;Solak, Yalcin;Yilmaz, Mahmut Ilker

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先前的研究表明,肾功能不全与血清高密度脂蛋白(HDL)胆固醇浓度降低和循环单核细胞计数增加有关。本研究旨在探讨循环单核细胞与血清高密度脂蛋白胆固醇比值(M/H比值)对慢性肾脏病(CKD)患者致死性和复合心血管事件的影响,对340例1-5期CKD患者进行了平均33个月(范围2-44)的随访,并评估了致死性和非致死性CV事件。计算所有患者的M/H比值。单核细胞/高密度脂蛋白胆固醇比值与肾小球滤过率(eGFR)呈负相关(r =-0.43,P < 0.001)。值得注意的是,在M/H比值处于第三个三分位数的患者中,致死性和致死性与非致死性心血管事件的发生率更高,与处于第一个三分位数的患者相比,致死性和复合心血管事件的风险比分别为2.24和4.91。最重要的是,我们首次报道了M/H比值增加与心血管状况恶化相关,并在随访期间作为主要心血管事件的独立预测因子。
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.