Monocyte Count To High-density Lipoprotein Ratio And Cardiovascular Mortality In Hemodialysis Patients

Objectives:The purpose of this study was to investigate the relationship between the monocyte to HDL cholesterol ratio(MHR)and the occurrence of cardiovascular mortality in patients on hemodialysis(HD)and to evaluate the significance of elevated MHR in HD patients at high risk of cardiovascular events.Methods:Newly admitted hemodialysis patients from May 14,2010 to March 31,2019 at the Hemodialysis Center of the First Affiliated Hospital of Nanchang University were retrospectively collected and followed up until June 30,2019.The endpoint event was a cardiovascular event death.Based on the baseline monocyte to HDL cholesterol ratio(MHR)ratio,these patients were divided into three groups according to the trichotomous method,group TI {low MHR ratio group(MHR ≤ 0.252)},group T2{medium MHR ratio group(0.252 < MHR < 0.443)},and group T3 {high MHR ratio group(MHR ≥ 0.443)}.The chi-square test,rank sum test,one-way ANOVA,or Kruskal-Wallis test were used to test for differences between categorical or continuous variables in the MHR values of different groups.Survival curves were constructed from Kaplan-Meier curves estimating cumulative occurrence of cardiovascular deaths and compared using the log-rank test.The association between MHR ratios and cardiovascular events was tested in a Cox risk model.Results:A total of 409 patients were included according to the inclusion criteria,of whom the mean age was 60.6 ± 15.3 years and 252 were men(61.6%).The median follow-up time was 26.4 months(interquartile range 14.3-45.9 months).By the endpoint of follow-up,49 cardiovascular deaths were recorded.All-cause death was the outcome for a total of 95,with CVD deaths accounting for 51.6%.There was a statistical difference in the number of cardiovascular death outcomes(P=0.008)occurring between the three groups according to the MHR ratio divided into three groups to the follow-up endpoint;we applied the COX proportional risk model to assess the long-term prognostic value of MHR for cardiovascular events.Compared with the T1 group,the risk of cardiovascular mortality was higher in the T2 and T3 groups in all three models,with statistically significant differences,but no significant increase was seen in the T2 group.Conclusion:This study investigated the relationship between MHR values and cardiovascular death in maintenance hemodialysis patients and found that high MHR values were strongly associated with the risk of cardiovascular death in hemodialysis patients after correcting for multiple risk factors.