Monocyte-to-HDL Cholesterol Ratio As A New Parameter of Systemic Inflammation and Disease Severity in Treatment-Resistant Chronic Spontaneous Urticaria

Abstract

Background and Purpose: Chronic spontaneous urticaria (CSU) is characterized by inflammation and increased oxidative stress in its pathogenesis. The study aims to evaluate new inflammatory markers indicating systemic inflammation in resistant CSU and to determine their relationship with disease severity. Methods: The files of CSU patients and matched healthy volunteers were reviewed and compared in terms of demographics, medical history, clinical features, laboratory parameters, and new inflammatory markers [NLR:neutrophil-lymphocyte ratio, MLR: monocyte-lymphocyte ratio, MHR:monocyte-to-high-density lipoprotein cholesterol (HDL-C)]. Results: Sixty-one CSU patients and 50 healthy controls were evaluated (female: male ratio=1.9:1, mean age=43.97 ± 14.88 years). The median erythrocyte sedimentation rate, C-reactive protein (CRP), white blood cell, monocyte count, and MHR were higher in the CSU group; in contrast, the mean HDL-C level was lower. The median NLR and MLR were also higher in the CSU group but were not statistically significant. Urticaria activity score 7 (UAS7) was positively correlated with MHR and negatively correlated with HDL-C. MHR was positively correlated with MLR, CRP, and UAS7. Conclusions: MHR might serve as an indicator of inflammation intensity and predisposition to MS in CSU patients. It might also be used as an objective tool for evaluating disease severity and treatment response in CSU.