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The Association Between Monocyte Subsets and Cardiometabolic Disorders/Cardiovascular Disease: A Systematic Review
Ester S Oh1, Muzi Na1, Connie J Rogers1,2
1Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States.
Insights
Individuals with cardiometabolic disorders and cardiovascular disease (CVD) show altered monocyte subsets. Intermediate (IM) and non-classical monocytes (NCM) are higher, while classical monocytes (CM) are lower, compared to healthy individuals.
Area of Science:
- Immunology
- Cardiovascular Medicine
- Metabolic Disorders
Background:
- Monocyte subsets (classical, intermediate, non-classical) are implicated in atherosclerosis, a primary cause of cardiovascular disease (CVD).
- The precise relationship between monocyte subset distribution and cardiometabolic disorders/CVD remains unclear.
Approach:
- A systematic review and meta-analysis evaluated clinical studies on monocyte subset distribution in individuals with cardiometabolic disorders and CVD versus healthy controls.
- Data from selected studies were pooled using a random-effects model to calculate standardized mean differences (SMD).
Key Points:
- Individuals with cardiometabolic disorders and CVD exhibited a lower percentage of classical monocytes (CM).
- Conversely, intermediate monocytes (IM) and non-classical monocytes (NCM) were found in higher percentages in subjects with cardiometabolic disorders compared to healthy controls.
- Meta-analysis confirmed these findings: CM (SMD = -1.21), IM (SMD = 0.56), and NCM (SMD = 1.39).
Conclusions:
- Altered distribution of monocyte subsets, specifically increased IM and NCM, may characterize individuals with cardiometabolic disorders and CVD.
- Further research is warranted to elucidate the causal mechanisms and biological significance of these observed monocyte subset alterations.
Abstract:
Background: Monocyte subsets in humans, i.e., classical (CM), intermediate (IM), and non-classical monocytes (NCM), are thought to differentially contribute to the pathogenesis of atherosclerosis, the leading cause of cardiovascular disease (CVD). However, the association between monocyte subsets and cardiometabolic disorders and CVD is not well-understood. Thus, the aim of the current systematic review and meta-analysis was to evaluate recent findings from clinical studies that examined the association between the distribution of monocyte subsets in subjects with cardiometabolic disorders and CVD compared to healthy controls. Methods: Articles were systematically searched in CINAHL, PubMed and Cochrane Library. Articles were independently screened and selected by two reviewers. Studies that reported the percentage of each monocyte subset were included in the systematic review and meta-analysis. For the meta-analysis, a random-effects model was used to generate pooled standardized mean differences (SMD) between subjects with cardiometabolic disorders and healthy controls. Results: A total of 1,693 articles were screened and 27 studies were selected for qualitative analyses. Among them, six studies were included in the meta-analysis. In total, sample size ranged from 22 to 135 and mean or median age from 22 to 70 years old. We found studies that reported higher percentage and number of IM and/or NCM in subjects with cardiometabolic disorders (9 out of 13 studies) and in subjects with CVD (11 out of 15 studies) compared to healthy controls. In the meta-analysis, the percentage of CM was lower [SMD = -1.21; 95% CI (-1.92, -0.50); P = 0.0009; I 2 = 91%] and the percentage of IM [SMD = 0.56; 95% CI (0.23, 0.88); P = 0.0008; I 2 = 65%] and NCM [SMD = 1.39; 95% CI (0.59, 2.19); P = 0.0007; I 2 = 93%] were higher in subjects with cardiometabolic disorders compared to healthy controls. Conclusions: Individuals with cardiometabolic disorders and CVD may have a higher percentage of IM and NCM than healthy controls. Future studies are needed to evaluate the cause and biological significance of this potential altered distribution of monocyte subsets.
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