Assessing the performance of monocyte to high-density lipoprotein ratio for predicting ischemic stroke: insights from a population-based Chinese cohort

Abstract

Background Monocyte to high-density lipoprotein cholesterol ratio (MHR) is a recently emerged measure of inflammation and oxidative stress and has been used to predict multiple cardiovascular abnormalities, but data relative to ischemic stroke are lacking. The goal of this study was to estimate the associations of MHR and prevalent ischemic stroke among a large cohort of general Chinese population. Method The study analyzed 8148 individuals (mean age: 54.1 years; 45.7% males) enrolled in a cross-sectional population-based Northeast China Rural Cardiovascular Health Study (NCRCHS). We identified 194 patients admitted from January and August 2013 with ischemic stroke. Results After adjustment for age, sex, and potential confounders, each standard deviation (SD) increment of MHR was predictive to a greater odd of ischemic stroke (odds ratio, 1.276; 95% confidence interval [CI], 1.082–1.504), with subjects in the highest quartile of MHR levels having a 1.6-fold higher risk of prevalent ischemic stroke (95% CI, 1.045–2.524) as compared with those in the lowest quartile. Moreover, smoothing curve showed a linear positive pattern of this association. The area under the curve (AUC) significantly increased ( P = 0.042) to 0.808 (95% CI, 0.779–0.837) when the combined MHR was added to the baseline logistic regression model with ischemic stroke risk factors. Also, MHR (0.004) significantly improved integrated discrimination improvement when added to the baseline model. Conclusions The present study demonstrated for the first time a linear relation between MHR levels and the odds of ischemic stroke in a large community-based population. The MHR, a marker of high atherosclerotic burden, demonstrated incremental predictive value over traditional clinical risk factors, thus providing clinical utility in risk stratification in subjects presenting with ischemic stroke. These findings had implications for strategies aimed at lowering MHR to prevent adverse cardiovascular and cerebrovascular outcomes.

The association between monocyte to high-density lipoprotein ratio and hemorrhagic transformation in patients with acute ischemic stroke

“…Findings from a population-based Chinese cohort indicated elevated MHR levels were significantly associated with higher prevalence of ischemic stroke [23]. In addition, MHR has been reported to be an independent predictor of 30-day mortality in patients with acute ischemic stroke [24].…”

Predictive value of monocyte to high-density lipoprotein ratio for the estimation of diabetes mellitus risk: Insights from a general population

“…HDL can prevent and reverse the activation of monocytes, which is of great significance for the treatment of many inflammatory diseases [33]. HDL can also protect endothelial cells from the adverse effects of LDL and prevent LDL oxidation [34,35]. Existing evidence suggests that HDL conversion appears to be accelerated in patients with diabetes, and low concentrations of HDL cholesterol in plasma are the result of increased conversion rates.…”

Prognostic Value of Inflammation Parameters in Patients With Non-ST Elevation Acute Coronary Syndromes

“…17 A large-scale study suggested that MHR may be a marker of atherosclerotic load and found a linear relationship between MHR levels and ischemic stroke. 18 Ç icek et al suggested that MHR is an independent and important variable in short-and long-term mortality. 19 Saskin et al claimed that preoperative MHR values were associated with postoperative atrial fibrillation and mortality.…”