Monocyte and neutrophil to high density lipoprotein cholesterol ratios are elevated in patients with vitamin D deficiency

Year 2022, , 119 - 123, 17.01.2022

Derya Köseoğlu , Özden Özdemir Başer , Zeynep Çetin , Merve Çatak

https://doi.org/10.32322/jhsm.1001090

Abstract

Aim: It is suggested that Vitamin D deficiency may lead to cardiovascular diseases. Monocyte-High density lipoprotein cholesterol (HDL) ratio (MHR) and Neutrophil-HDL ratio (NHR) are markers which may be used as cardiovascular risk factors, which are associated with inflammation. The purpose of this study is to evaluate the MHR and NHR levels in patients with Vitamin D deficiency.
Material and Method: This retrospective study included patients who were tested for Vitamin D levels in our clinic. The subjects were separated into two groups based on their Vitamin D levels and laboratory variables including MHR and NHR were compared.
Results: The subjects with serum 25 OH D level lower and higher than 20 ng/ml were compared, and MHR and NHR were detected significantly higher in subjects with Vitamin D deficiency (p:0.003 and p<0.001).
Conclusion: Our study indicates for the first time in the literature that MHR and NHR levels increase in Vitamin D deficiency. Our findings suggest that the cardiovascular risk which occurs in Vitamin D deficiency may be associated with the observed increased inflammation. It was detected that MHR and NHR ratios may be used to predict cardiovascular diseases in people with Vitamin D deficiency. Our study also showed that the increased cardiovascular risk which occurs in vitamin D deficiency may be associated with the increased inflammation.

Keywords

Atherosclerosis, Vitamin D, Inflammation, Monocyte, Neutrophil, High Density Lipoprotein Cholesterol

References

• Christakos S, Dhawan P, Verstuyf A, Verlinden L, Carmeliet G. Vitamin D: metabolism, molecular mechanism of action, and pleiotropic effects. Physiol Rev 2016; 96: 365-408.
• Khazai N, Judd SE, Tangpricha V. Calcium and vitamin D: skeletal and extraskeletal health. Curr Rheumatol Rep 2008; 10: 110–7.
• Wang TJ, Pencina MJ, Booth SL, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation 2008; 117: 503–11.
• Wimalawansa SJ. Vitamin D and cardiovascular diseases: Causality. J Steroid Biochem Mol Biol 2018; 175: 29-43.
• Mandarino NR, Junior F, Salgado JV, Lages JS, Filho NS. Is vitamin D deficiency a new risk factor for cardiovascular disease? Open Cardiovasc Med J 2015; 9: 40-9.
• Pacifico L, Anania C, Osborn JF, et al. Low 25(OH)D3 levels are associated with total adiposity, metabolic syndrome, and hypertension in Caucasian children and adolescents. Eur J Endocrinol 2011; 165: 603-11.
• Tepper S, Shahar DR, Geva D, Ish-Shalom S. Differences in homeostatic model assessment (HOMA) values and insulin levels after vitamin D supplementation in healthy men: a double-blind randomized controlled trial. Diabetes Obes Metab 2016; 18: 633-7.
• Reis JP, von Mühlen D, Michos ED, et al. Serum vitamin D, parathyroid hormone levels and carotid atherosclerosis. Atherosclerosis 2009; 207: 585-90.
• Ancuta P, Wang J, Gabuzda D. CD16 monocytes produce IL-6, CCL2, and matrix metalloproteinase-9 upon interaction with CX3CL1-expressing endothelial cells. J Leukoc Biol 2006; 80: 1156-64.
• Weber C, Shantsila E, Hristov M, et al. Role and analysis of monocyte subsets in cardiovascular disease. Joint consensus document of the European Society of Cardiology (ESC) Working Groups ‘‘Atherosclerosis & Vascular Biology’’ and ‘‘Thrombosis.’’ Thromb Haemost 2016; 116: 626-37.
• Hosokawa T, Kumon Y, Kobayashi T, et al. Neutrophil infiltration and oxidant-production in human atherosclerotic carotid plaques. Histol Histopathol 2011; 26: 1–11.
• Meng LB, Yu ZM, Guo P, et al. Neutrophils and neutrophil-lymphocyte ratio: Inflammatory markers associated with intimal-media thickness of atherosclerosis. Thromb Res 2018; 170: 45-52.
• Zhang X, Hou XH, Ma YH, et al. Association of peripheral neutrophil count with intracranial atherosclerotic stenosis. BMC Neurology 2020; 20: 65.
• Murphy AJ. High density lipoprotein: assembly, structure, cargo, and functions. ISRN Physiology 2013; 2013: 20, 20 pages.
• Li XP, Zhao SP, Zhang XY, Liu L, Gao M, Zhou QC. Protective effect of high density lipoprotein on endothelium-dependent vasodilatation. Int J Cardiol 2000; 73: 231-6.
• Van den Bogaard B, Holleboom AG, Duivenvoorden R, et al. Patients with low HDL-cholesterol caused by mutations in LCAT have increased arterial stiffness. Atherosclerosis 2012; 225: 481-5.
• Canpolat U, Aytemir K, Yorgun H, et al. The role of preprocedural monocyte-to-high-density lipoproteinratioinprediction ofatrial fibrillation recurrence after cryoballoon-based catheter ablation. Europace 2015; 17: 1807-15.
• Cetin EH, Cetin MS, Canpolat U, et al. Monocyte/HDL-cholesterol ratio predicts the definite stent thrombosis after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Biomark Med 2015; 9: 967-77.
• Kundi H, Gok M, Kiziltunc E, et al. Relation between monocyte to high-density lipoprotein cholesterol ratio with presence and severity of ssolated coronary artery ectasia. Am J Cardiol 2015; 116: 1685-9.
• Huang JB, Chen YS, Ji HY, et al. Neutrophil to high-density lipoprotein ratio has a superior prognostic value in elderly patients with acute myocardial infarction: a comparison study. Lipids Health Dis 2020; 19: 59.
• Bonakdaran S, Varasteh AR. Correlation between serum 25 hydroxy vitamin D3 and laboratory risk markers of cardiovascular diseases in type 2 diabetic patients. Saudi Med J 2009; 30(4): 509-14.
• Ullah MI, Uwaifo GI, Nicholas WC, Koch CA. Does vitamin d deficiency cause hypertension? Current evidence from clinical studies and potential mechanisms. Int J Endocrinol 2010; 2010: 579640.
• Lu L, Yu Z, Pan A, et al. Plasma 25-hydroxyvitamin D concentration and metabolic syndrome among middle-aged and elderly Chinese individuals. Diabetes Care 2009; 32: 1278-83.
• Scragg R, Sowers M, Bell C. Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the 3 rd national health and nutrition examination survey. Diabetes Care 2004; 27: 2813-8.
• Ginde AA, Scragg R, Schwartz RS, Camargo CA, Jr. Prospective study of serum 25-hydroxyvitamin D level, cardiovascular disease mortality, and all-cause mortality in older U.S. adults. J Am Geriatr Soc 2009; 57: 1595-603.
• Wang L, Song Y, Manson JE, et al. Circulating 25-hydroxyvitamin D and risk of cardiovascular disease: A meta-analysis of prospective studies. Circ Cardiovasc Qual Outcomes 2012; 5: 819-29.
• Ammirati E, Moroni F, Magnoni M, et al. Circulating CD14+ and CD14 high CD16‐classical monocytes are reduced in patients with signs of plaque neovascularization in the carotid artery. Atherosclerosis 2016; 255: 171–8.
• Ghattas A, Griffiths HR, Devitt A, Lip GY, Shantsila E. Monocytes in coronary artery disease and atherosclerosis: where are we now? J Am Coll Cardiol 2013; 62: 1541-51.
• Villanueva DLE, Tiongson MD, Ramos JD, Llanes EJ. Monocyte to High-Density Lipoprotein Ratio (MHR) as a predictor of mortality and Major Adverse Cardiovascular Events (MACE) among ST Elevation Myocardial Infarction (STEMI) patients undergoing primary percutaneous coronary intervention: a meta-analysis. Lipids Health Dis 2020; 19: 55.
• Qi H, Yang S, Zhang L. Neutrophil extracellular traps and endothelial dysfunction in atherosclerosis and thrombosis. Front Immunol 2017; 8: 928.
• Davignon J, Ganz P. Role of endothelial dysfunction in atherosclerosis. Circulation 2004; 109: III27–32.
• Chung JW, Oh MJ, Cho YH, et al. Distinct roles of endothelial dysfunction and inflammation in intracranial atherosclerotic stroke. Eur Neurol 2017; 77: 211–9.
• Stewart RA, White HD, Kirby AC, et al. White blood cell count predicts reduction in coronary heart disease mortality with pravastatin. Circulation. 2005; 111: 1756–62.
• Tong C, Chen H, Xiao H, et al. Comparison of the value of neutrophil to high-density lipoprotein cholesterol ratio and lymphocyte to high-density lipoprotein cholesterol ratio for predicting metabolic syndrome among a population in the Southern Coast of China. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2020; 13: 597-605.
• Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357: 266-81.