Monocyte‐to‐HDL‐cholesterol ratio as a prognostic marker in cardiovascular diseases

Abstract

Inflammation and lipid accumulation are two basic hallmarks of atherosclerosis as a chronic disease. Inflammation not only is a local response but can also be considered as a systemic process followed by an elevation of inflammatory mediators. Monocytes are a major source of proinflammatory species during atherogenesis. In atherosclerosis, modified low-density lipoproteins (LDLs) are removed by macrophages; these are recruited in the vessel wall, inducing the release of inflammatory cytokines in inflamed tissue. Hence, inflammatory cholesterol ester-loaded plaque is generated. High-density lipoprotein-cholesterol (HDL-C) exhibits antiatherosclerotic effects by neutralizing the proinflammatory and pro-oxidant effects of monocytes via inhibiting the migration of macrophages and LDL oxidation in addition to the efflux of cholesterol from these cells. Furthermore, HDL plays a role in suppressing the activation of monocytes and proliferation-differentiation of monocyte progenitor cells. Thus, accumulation of monocytes and reduction of HDL-C may participate in atherosclerosis and cardiovascular diseases (CVD). Given that the relationship between the high number of monocytes and low HDL-C levels has been reported in inflammatory disorders, this review focused on understanding whether the monocyte-to-HDL ratio could be a convenient marker to predict atherosclerosis development and progression, hallmarks of CV events, instead of the individual monocyte count or HDL-C level.

Neutrophil to high-density lipoprotein ratio has a superior prognostic value in elderly patients with acute myocardial infarction: a comparison study

“…In addition, as for single lipids, some lipid ratios could be well applied to predict CAD and the associations were of comparable magnitude [7]. For instance, the ratio of monocyte to highdensity lipoprotein cholesterol (HDL-C) (MHR) [8,9] and the ratio of low-density lipoprotein cholesterol (LDL-C) to HDL-C (LDL-C/HDL-C) were found to have correlation with poor prognosis in cardiovascular diseases [10,11].…”

Monocyte to high-density lipoprotein ratio was associated with the severity of coronary artery disease: results from a large cohort study

“…Increased monocyte counts and decreased HDL-C levels have been reported to be associated with inflammatory disorders. Recently, monocyte to HDL-C ratio (MHR) has emerged as a novel and useful marker in different disease models, such as CAD, diabetes mellitus (DM), saphenous vein graft disease (SVGD) and acute ischemic stroke (AIS) 7 .…”

Monocyte Count to HDL-Cholesterol Ratio May Be a Novel Cardiometabolic Marker in Patients With Functional Adrenal Tumors

“…Monocytes are major source of pro-inflammatory and pro-oxidant cytokines (1,2). Monocytes interact with platelets and endothelial cells, which initiates pro-thrombotic and pro-inflammatory process (3).…”

“…High-density lipoproteins cholesterol (HDL-C) decreases atherosclerosis by inhibiting pro-inflammatory and pro-oxidant effects of monocytes (2,4). Hence, decreased of HDL-C and accumulation of monocyte may participate in CVD and atherosclerosis (1). Previous studies have reported that the monocyte-to-HDL ratio (MHR) increased in the inflammatory disorders (3,7), and atherosclerosis (8,9).…”

“…The elevated MHR value was suggested as a novel prognostic marker to predict patients who have a greater risk for CVD (1). Patients with functional and nonfunctional adrenal adenoma are at higher risk of CVD, than in general population (12,13).…”