Predictive value of the monocyte/HDL ratio for vascular calcification and the occurrence of cardiovascular and cerebrovascular events in patients undergoing maintenance hemodialysis
Objective To investigate the predictive value of monocyte/high-density lipoprotein ratio(MHR)for the occurrence of vascular calcification and cardiovascular events in patients on maintenance hemodialysis.Methods The clinical data of 85 patients admitted to Dongfang People's Hospital from May 2021 to May 2023 were divided into calcification group(62 cases)and non-calcification group(23 cases).and then,the calcification group was subdivided into 3 subgroups according to abdominal aortic calcification score(AACS),including 15 patients in mild calcification group,29 patients in moderate calcification group and 18 patients in severe calcification group.Baseline data were collected from all study subjects.We tested and compared their laboratory indicators,MHR and calcium/magnesium ratio in patients with mild,moderate and severe calcification group.Multivariate logistic regression analysis was used to screen the risk factors of vascular calcification in maintenance hemodialysis patients,receiver working characteristic(ROC)curve was used to analyze the predictive value of MHR and calcium/magnesium ratio for vascular calcification in maintenance hemodialysis patients,and the incidence of cerebrovascular events in the patients with calcification and non-calcified group was compared.Results In non-calcication group,patients had a shorter dialysis age than those in the calcified group.Blood calcium,parathyroid hormone(iPTH),MHR,calcium/magnesium ratio,fibroblast growth factor 23(FGF-23)levels were lower than those in the calcified group.The hemoglobin was higher than that in the calcification group(all P＜0.05).The moderate and calcium/magnesium ratio had higher MHR than the mild calcification group.Moreover,the above indexes were higher in patients with severe calcification than those in moderate calcification group(P＜0.05).The results of the multivariate logistic regression analysis concluded,dialysis age,blood phosphorus,iPTH,MHR,calcium/magnesium ratio,and FGF-23 were all risk factors for vascular calcification in patients on maintenance hemodialysis[OR(95％CI)=7.838(3.368,18.243)、7.360(2.132,25.399)、8.306(2.369,29.119)、8.793(2.070,37.355)、2.457(1.096,5.510)、2.344(1.025,5.361),All P＜0.05].The area under the ROC of MHR and calcium/magnesium ratio for predicting vascular calcification in maintenance hemodialysis patients was 0.705 and 0.691,respectively.Higher incidence of cardiovascular and cerebrovascular events in the calcified group than in the non-calcified group,however,the difference was not significant(P＞0.05).Conclusion There is close relationship between MHR,calcium/magnesium ratio and the severity of maintenance hemodialysis patients,and it has high clinical value to use MHR and calcium/magnesium ratio to predict the occurrence of vascular calcification and cardiovascular and cerebrovascular events in maintenance hemodialysis patients.
MonocyteCholesterol,HDLRenal dialysisVascular calcificationForecastingCar-diovascular and cerebrovascular events
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