Çelik Aziz İnan, Bezgin Tahir, Karaaslan Muhammet Buğra, Coşkun Reşit, Çağdaş Metin
Gebze Fatih Devlet Hastanesi, Kardiyoloji Bölümü, Gebze, Kocaeli, Türkiye.
Department of Cardiology, Gebze Fatih State Hospital, Kocaeli, Turkey.
Turk Kardiyol Dern Ars. 2022 Dec;50(8):583-589. doi: 10.5543/tkda.2022.22412.
Coronary artery calcification is a cornerstone marker for coronary atherosclerosis. Therefore, the calculation of the coronary artery calcium score has become a routine method in diagnosing coronary artery disease in recent years. Monocyte to high-density lipoprotein cholesterol ratio reflects proatherogenic and antiatherogenic balance, and this ratio is associated with coronary atherosclerosis and cardiovascular events. This study aimed to investigate the value of monocyte to high-densitylipoprotein cholesterol ratio in predicting coronary atherosclerosis, which coronary artery calcium score determines.
A total of 276 patients with chest pain who underwent coronary computed tomography angiography were enrolled in the study. The patients were divided into 3 groups according to coronary artery calcium score [coronary artery calcium score=0 for very low risk (n=121), coronary artery calcium score=1-99 for low risk (n=100), coronary artery calcium score ≥ 100 for moderate-high risk (n=55)]. The monocyte to high-density lipoprotein cholesterol ratio, neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, and plateletto-lymphocyte ratio were calculated from venous blood samples.
Monocyte to high-density lipoprotein cholesterol ratio values were significantly higher in patients with moderate-high coronary artery calcium score (1.29 ± 0.59 vs 1.41 ± 0.56 vs 1.56 ± 0.58, P =.009). However, there were no differences between the groups in terms of other inflammatory markers (neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, and platelet-to-lymphocyte ratio). Age (odds ratio: 1.178; 95% CI: 1.107-1.253; P < .001), dyslipidemia (odds ratio: 14.252; 95% CI: 5.459-37.211; P <.001), smoking (odds ratio: 2.893; 95% CI: 1.317-6.358; P=.008), and monocyte to high-density lipoprotein cholesterol ratio (odds ratio: 2.082 per 1-point increase; 95% CI: 1.016-4.268; P=.045) were independent predictors of coronary artery calcium score in multivariate analysis.
Our data showed that high monocyte to high-density lipoprotein cholesterol ratio is significantly associated with increased coronary artery calcium score. Monocyte to highdensity lipoprotein cholesterol ratio indicates that it can be applied easily and swiftly in clinics to help predicting the coronary artery disease.
冠状动脉钙化是冠状动脉粥样硬化的关键标志物。因此，近年来计算冠状动脉钙化积分已成为诊断冠状动脉疾病的常规方法。单核细胞与高密度脂蛋白胆固醇比值反映了促动脉粥样硬化和抗动脉粥样硬化的平衡，且该比值与冠状动脉粥样硬化及心血管事件相关。本研究旨在探讨单核细胞与高密度脂蛋白胆固醇比值在预测冠状动脉粥样硬化方面的价值，而冠状动脉钙化积分可确定冠状动脉粥样硬化情况。
本研究共纳入276例因胸痛接受冠状动脉计算机断层扫描血管造影的患者。根据冠状动脉钙化积分将患者分为3组[极低风险组（冠状动脉钙化积分=0，n=121）、低风险组（冠状动脉钙化积分=1-99，n=100）、中高风险组（冠状动脉钙化积分≥100，n=55）]。从静脉血样本中计算单核细胞与高密度脂蛋白胆固醇比值、中性粒细胞与淋巴细胞比值、全身免疫炎症指数及血小板与淋巴细胞比值。
中高冠状动脉钙化积分患者的单核细胞与高密度脂蛋白胆固醇比值显著更高（1.29±0.59 vs 1.41±0.56 vs 1.56±0.58，P=0.009）。然而，在其他炎症标志物（中性粒细胞与淋巴细胞比值、全身免疫炎症指数及血小板与淋巴细胞比值）方面，各组之间无差异。在多因素分析中，年龄（比值比：1.178；95%可信区间：1.107-1.253；P<0.001）、血脂异常（比值比：14.252；95%可信区间：5.459-37.211；P<0.001）、吸烟（比值比：2.893；95%可信区间：1.317-6.358；P=0.008）及单核细胞与高密度脂蛋白胆固醇比值（每增加1分比值比：2.082；95%可信区间：1.016-4.268；P=0.045）是冠状动脉钙化积分的独立预测因素。
我们的数据表明，单核细胞与高密度脂蛋白胆固醇比值升高与冠状动脉钙化积分增加显著相关。单核细胞与高密度脂蛋白胆固醇比值表明其在临床上可轻松、快速应用，有助于预测冠状动脉疾病。
