[Neutrophil-to-lymphocyte ratio, monocyte-to-high-density lipoprotein cholesterol ratio, and their correlation and predictive value for cardiovascular calcification in patients on maintenance hemodialysis].

Abstract

Objective: To investigate the correlation between the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-high-density lipoprotein cholesterol ratio (MHR), and cardiovascular calcification in patients on maintenance hemodialysis (MHD), and to evaluate their predictive value for cardiovascular calcification. Methods: This retrospective case-control analysis was conducted on the clinical data of 362 patients with chronic kidney disease who underwent regular hemodialysis for >3 months at the Hemodialysis Center of the Second People's Hospital of Hefei from December 2018 to December 2023. Patients were divided into a cardiovascular calcification group (216 cases) and a cardiovascular non-calcification group (146 cases). The cardiovascular calcification group was further categorized according to different calcification sites, with 69 cases in the vascular calcification group, 79 in the valve calcification group, and 68 in the vascular and valve calcification group. Spearman correlation analysis was used to assess the correlation between cardiovascular calcification and various indicators. Risk factors for cardiovascular calcification in patients with MHD were analyzed using binary logistic regression analysis. The predictive value of the NLR and MHR for cardiovascular calcification was analyzed using the receiver operating characteristic (ROC) curve. Results: This study enrolled 362 cases, including 233 males and 129 females aged 29-89 years. Age, the NLR, and the MHR were positively correlated with cardiovascular calcification in patients on MHD (r=0.338, 0.383, and 0.391, respectively, all P<0.05). In contrast, serum magnesium was negatively correlated with cardiovascular calcification (r=-0.169, P<0.05). Age (OR=1.063, 95%CI 1.036-1.092, P<0.001), male sex (OR=2.017, 95%CI 1.104-3.685, P=0.023), neutrophil count (OR=1.737, 95%CI 1.326-2.276, P<0.001), the NLR (OR=1.722, 95%CI 1.310-2.263, P<0.001), and the MHR (OR=1.352, 95%CI 1.153-1.586, P<0.001) were identified as independent risk factors for cardiovascular calcification in patients on MHD. Serum magnesium (OR=0.034, 95%CI 0.001-0.797, P=0.036) was a protective factor. The combined area under the curve (AUC) of the NLR and MHR was the largest (AUC=0.804, 95%CI 0.759-0.850); the AUC for the NLR and MHR used alone was 0.725 (95%CI 0.672-0.779) and 0.730 (95%CI 0.677-0.783), respectively. Conclusions: The MHR, and the NLR are independent risk factors for cardiovascular calcification in patients with MHD. The combination of the MHR and NLR has a greater clinical predictive value for cardiovascular calcification.