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Association between monocyte-to-lymphocyte ratio and cardiovascular diseases: insights from NHANES data
Xiaowan Li1, Liyan Zhang1, Yingying Du1,2
1Intensive Care Medical Center, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China.
Insights
The monocyte-to-lymphocyte ratio (MLR) is a better predictor of cardiovascular diseases (CVD) than other inflammatory markers. Elevated MLR indicates increased risk for heart attack, stroke, and heart failure.
Area of Science:
- Cardiology
- Inflammation Research
- Public Health
Background:
- Cardiovascular diseases (CVD) represent a significant global health burden.
- Identifying reliable inflammatory markers for CVD risk prediction is crucial.
Purpose of the Study:
- To investigate the correlation between monocyte-to-lymphocyte ratio (MLR) and various cardiovascular diseases (CVD).
- To compare the predictive performance of MLR against other inflammatory indices.
Main Methods:
- Analysis of National Health and Nutrition Examination Survey (NHANES) data (1999-2020).
- Investigated relationships between MLR, SIRI, AISI, CAR, and CVD events (heart attack, angina, CHF, CHD, stroke).
- Utilized receiver operating characteristic (ROC) curves to assess diagnostic capacities.
Main Results:
- A positive, non-linear correlation was observed between MLR and CVD prevalence.
- Higher MLR levels were associated with increased incidence of CHF, CHD, and stroke.
- MLR demonstrated superior discriminative capacity and accuracy in predicting CVD and its subtypes compared to SIRI, AISI, and CAR.
Conclusions:
- MLR serves as a more effective inflammatory index for predicting CVD and its specific events than SIRI, AISI, and CAR.
- Elevated MLR and SIRI warrant attention for potential CVD risk in American adults.
- Further longitudinal studies are recommended to confirm these findings due to the cross-sectional design.
Background:
This study intends to examine any possible correlation between monocyte-to-lymphocyte ratio (MLR) and cardiovascular diseases (CVD).
Methods:
Data from the 1999-2020 National Health and Nutrition Examination Survey (NHANES) in the USA were analyzed. Heart attacks, angina pectoris, congestive heart failure (CHF), coronary heart disease (CHD), and stroke were all covered by CVD. The independent relationships between these cardiovascular events and MLR levels, as well as other inflammatory indices (system inflammation response index (SIRI), aggregate index of systemic inflammation (AISI), and C-reactive protein-to-albumin ratio (CAR)), were investigated. Furthermore, interaction tests and subgroup analysis were performed. Diagnostic capacities were also predicted and compared using receiver operating characteristic (ROC) curves.
Results:
Males made up 49.63% of the 46,289 people who were recruited in this study. The prevalence of CVD and its events were as follows: CHF at 2.99%, CHD at 3.72%, angina pectoris at 2.57%, heart attacks at 3.94%, and stroke at 3.48%, with CVD itself at 7.98%. MLR and CVD were positively correlated. Specifically, smooth curve fittings also found a non-linear relationship between MLR and CVD. Moreover, higher MLR levels were linked to increased rates of CHF, CHD, and strokes. SIRI was also found to have a positive correlation with CVD. MLR outperformed other inflammatory indices (SIRI, AISI, and CAR) in terms of discriminative capacity and accuracy in predicting CVD, CHF, CHD, angina pectoris, heart attack, and stroke, according to ROC analysis.
Conclusions:
Compared with other inflammatory indicators (SIRI, AISI, and CAR), MLR appears to be a better inflammatory index for predicting CVD, CHF, CHD, angina pectoris, heart attack, and stroke. American adults with elevated MLR and SIRI should be aware of the possible harm caused by CVD. Causal inference is, however, limited by the cross-sectional design and dependence on self-reported data. Further longitudinal studies are needed to validate these findings.
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