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Predicting cardiovascular disease and all-cause mortality using the lymphocyte-to-monocyte ratio: Insights from
Jichao Wu1, Die Huang1, Jiefang Li1
1Department of Laboratory, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515041, China.
Insights
The lymphocyte-to-monocyte ratio (LMR) can predict cardiovascular disease (CVD) and mortality. Lower LMR levels are linked to increased risks of all-cause and cardiovascular mortality, offering a simple biomarker for chronic inflammation.
Area of Science:
- Immunology
- Cardiology
- Biomarker Discovery
Background:
- Cardiovascular disease (CVD) poses a significant global health challenge with rising mortality rates.
- Traditional biomarkers like LDL-C, HDL-C, and glucose have limitations in predicting CVD.
- The lymphocyte-to-monocyte ratio (LMR), an inflammation-associated immune biomarker, is explored as a novel predictive marker for chronic inflammation in CVD.
Purpose of the Study:
- To investigate the lymphocyte-to-monocyte ratio (LMR) as a potential new biomarker for cardiovascular disease (CVD).
- To assess the association between LMR and chronic inflammation in CVD patients.
- To compare the predictive value of LMR against traditional CVD biomarkers.
Main Methods:
- Cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) data (2007-2018).
- Inclusion of 1518 participants with a median follow-up of 150 months.
- Application of weighted Cox proportional hazards models, restricted cubic spline models, and time-varying ROC curves to analyze LMR and mortality risk.
Main Results:
- An L-shaped relationship was observed between LMR and CVD incidence.
- Lower LMR levels demonstrated a significant negative correlation with both all-cause and cardiovascular mortality.
- XGBoost model and SHAP value analysis confirmed LMR's substantial contribution to predicting CVD outcomes.
Conclusions:
- The lymphocyte-to-monocyte ratio (LMR) serves as a simple, practical, and effective biomarker for predicting cardiovascular disease (CVD) and associated mortality.
- Low LMR levels are strongly associated with an increased risk of both cardiovascular and all-cause mortality.
- LMR offers a valuable tool for assessing chronic inflammation and prognosis in cardiovascular health.
Background:
Cardiovascular disease (CVD) is a leading cause of death globally, with its incidence and mortality rates continuing to rise. While commonly used biomarkers such as low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and blood glucose are widely applied, they have certain limitations. This study investigates the lymphocyte-to-monocyte ratio (LMR), a simple immune biomarker associated with inflammation, to assess whether it can serve as a new marker for predicting chronic inflammation in cardiovascular disease, and compares it to traditional biomarkers.
Methods:
We conducted a cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018, utilizing a cohort of 1518 participants with a median follow-up period of 150 months. During this time, 522 participants died, including 166 from cardiovascular disease. We employed various statistical methods, including weighted Cox proportional hazards models, restricted cubic spline models, and time-varying receiver operating characteristic curves, to examine the association between LMR and mortality risk.
Results:
The analysis revealed an L-shaped relationship between LMR and the incidence of cardiovascular disease. Lower LMR levels were negatively correlated with all-cause and cardiovascular mortality. The XGBoost model yielded the best performance metrics (AUC and F1 scores), and SHAP value analysis indicated that LMR significantly contributes to CVD outcomes. Non-linear analyses confirmed a stable negative correlation between LMR and all-cause mortality.
Conclusion:
The study concludes that LMR is a simple and practical indicator for predicting cardiovascular disease and its mortality. Low levels of LMR significantly increase the risk of both cardiovascular disease and all-cause mortality in patients.
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