Could monocyte level/HDL cholesterol ratio predict cardiovascular diseases in patients with COPD?

The role of monocytes and high-density lipoprotein (HDL) levels in the pathophysiology of cardiovascular disease (CVD) is well known. However, the relationship between monocytes to HDL-cholesterol ratio (MHR) and CVD in chronic obstructive pulmonary disease (COPD) patients has not been investigated previously. We, therefore, aimed to investigate the predictor role of MHR in the development of CVD in subjects with COPD.

185 COPD patients and 89 control subjects were enrolled. Demographic data and laboratory parameters were recorded and MHR was calculated for all participants. CVDs were defined if hypertension, ischemic heart disease, congestive heart failure, or stroke present. MHR levels were compared between the two groups in terms of CVD. Receiver operating characteristic analysis was used to determine the MHR cutoff value that predicts CVD in COPD patients.

We found positive correlation between MHR and COPD (r = 0.24, P = 0.001). However, there was no statically significant association between MHR and severity of COPD defined by the Global Initiative for Chronic Obstructive Lung Disease criteria (P = 0.78). MHR was significantly higher in COPD patients with CVD compared to without CVD (P = 0.007). In subgroups' analysis, COPD patients with CVD, MHR was significantly higher in COPD patients with ischemic heart diseases (P < 0001). Similarly, MHR was higher in subjects with CVD compared to the subjects without CVD, but it was not statistically significant (P = 0.68). In the ROC analysis, the MHR cutoff value that predicts CVD in COPD patients was found to be 12.50 (sensitivity of 64.9% and specificity of 65.4%) (area under the receiver operating characteristic curve [AUC] = 0.73, P = 0.001).

MHR is significantly associated with CVD in COPD patients. Further prospective studies are warranted to elucidate the predictive value of MHR in COPD patients.