Association of monocyte/high-density lipoprotein cholesterol ratio and platelet/high-density lipoprotein cholesterol ratio with stroke risk in maintenance hemodialysis patients

doi:10.3877/cma.j.issn.2095-3216.2025.03.004

Abstract

Abstract:

Objective

To investigate the association of monocyte/high-density lipoprotein cholesterol ratio （MHR） and platelet/high-density lipoprotein cholesterol ratio （PHR） with the risk of acute ischemic stroke （AIS） in maintenance hemodialysis patients.

Methods

A retrospective analysis was conducted on patients who underwent maintenance hemodialysis at Beijing Chao-Yang Hospital from January 1，2015 to June 30， 2023， and the patients were divided into the AIS group and the non-AIS group.The univariate and multivariate Cox regression models were used to analyze the predictive value of MHR and PHR for stroke risk in the patients.

Results

A total of 258 maintenance hemodialysis patients were included，with 67 patients in the AIS group and 191 patients in the non-AIS group.The median follow-up time was 63 months.There were significant differences between the AIS group and the non-AIS group in age，hypertension history， diabetes history， smoking history， MHR， and PHR （P ＜0.05）.The univariate Cox regression model analysis showed that the patients with high MHR （HR=7.439， P=0.001） and high PHR（HR=1.006， P ＜0.001） had a high risk of ischemic stroke.After adjusting for confounding factors， high MHR （HR=7.277， P=0.004） and high PHR （HR =1.007， P ＜0.001） remained the independent risk factors for AIS in the maintenance hemodialysis patients.

Conclusion

MHR and PHR were the independent risk factors for the AIS in the maintenance hemodialysis patients， and might have certain predictive value.

Key words: Maintenance hemodialysis, Acute ischemic stroke, Monocyte/high-density lipoprotein cholesterol ratio, Platelet/high-density lipoprotein cholesterol ratio

Qiuxia Han, Hanyu Zhu, Yingjie Duan, Mingwei Tian, Kaiyi Zhu, Lijie Ma, Qianmei Sun. Association of monocyte/high-density lipoprotein cholesterol ratio and platelet/high-density lipoprotein cholesterol ratio with stroke risk in maintenance hemodialysis patients[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2025, 14(03): 140-145.

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References 24

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项目	AIS组(67例)	非AIS组(191例)	t/x²/Z值	P值
性别[男性，例(%)]	41(61.2)	101(52.9)	1.386	0.256
年龄[岁，(x̄±5)]	62.12±10.12	57.45±13.44	3.015	0.003^a
吸烟史[例(%)]	17(25.4)	20(10.5)	8.966	0.004^a
饮酒史[例(%)]	5(7.5)	19(10.0)	0.363	0.633
高血压病史[例(%)]	63(94.0)	153(80.1)	7.057	0.007^a
糖尿病病史[例(%)]	36(53.7)	61(31.9)	10.042	0.002^a
心血管疾病史[例(%)]	29(43.2)	62(32.4)	2.545	0.111
服用阿司匹林[例(%)]	10(14.9)	24(12.6)	0.241	0.623
服用氯吡格雷[例(%)]	3(4.5)	8(4.2)	0.010	0.920
服用降脂药物[例(%)]	21(31.3)	57(29.8)	0.053	0.877

项目	AIS组(67例)	非AIS组(191例)	t/x²/Z值	P值
性别[男性，例(%)]	41(61.2)	101(52.9)	1.386	0.256
年龄[岁，(x̄±5)]	62.12±10.12	57.45±13.44	3.015	0.003^a
吸烟史[例(%)]	17(25.4)	20(10.5)	8.966	0.004^a
饮酒史[例(%)]	5(7.5)	19(10.0)	0.363	0.633
高血压病史[例(%)]	63(94.0)	153(80.1)	7.057	0.007^a
糖尿病病史[例(%)]	36(53.7)	61(31.9)	10.042	0.002^a
心血管疾病史[例(%)]	29(43.2)	62(32.4)	2.545	0.111
服用阿司匹林[例(%)]	10(14.9)	24(12.6)	0.241	0.623
服用氯吡格雷[例(%)]	3(4.5)	8(4.2)	0.010	0.920
服用降脂药物[例(%)]	21(31.3)	57(29.8)	0.053	0.877

项目	AIS组(67例)	非AIS组(191例)	t/x²/Z值	P值
红细胞(×10¹²/L)	3.74±0.43	3.74±0.57	0.092	0.927
血红蛋白(g/L)	114.00(104.50,120.50)	113.00(103.00,123.00)	-0.214	0.830
中性粒细胞(×10⁹/L)	3.92(3.46,5.07)	4.00(3.09,4.83)	-0.838	0.402
淋巴细胞计数(×10⁹/L)	1.18(0.98,1.34)	1.31(1.10,1.71)	-2.821	0.005^b
血小板(×10⁹/L)	181.00(148.00,213.50)	174.50(142.00,223.00)	-0.247	0.805
HDL-C(mmol/L)	0.94(0.73,1.08)	1.09(0.89,1.36)	-4.800	< 0.001^c
血尿素氮(mmol/L)	26.00(21.22,29.48)	23.64(19.37,28.37)	-1.079	0.281
血清肌酐(μmol/L)	898.30(711.60,1028.65)	830.05(679.30,1031.20)	-1.129	0.259
MHR	0.404(0.27,0.54)	0.34(0.25,0.46)	-2.295	0.022^a
PHR	186.57(147.14,269.41)	154.39(121.62,214.99)	-3.614	< 0.001^c

项目	AIS组(67例)	非AIS组(191例)	t/x²/Z值	P值
红细胞(×10¹²/L)	3.74±0.43	3.74±0.57	0.092	0.927
血红蛋白(g/L)	114.00(104.50,120.50)	113.00(103.00,123.00)	-0.214	0.830
中性粒细胞(×10⁹/L)	3.92(3.46,5.07)	4.00(3.09,4.83)	-0.838	0.402
淋巴细胞计数(×10⁹/L)	1.18(0.98,1.34)	1.31(1.10,1.71)	-2.821	0.005^b
血小板(×10⁹/L)	181.00(148.00,213.50)	174.50(142.00,223.00)	-0.247	0.805
HDL-C(mmol/L)	0.94(0.73,1.08)	1.09(0.89,1.36)	-4.800	< 0.001^c
血尿素氮(mmol/L)	26.00(21.22,29.48)	23.64(19.37,28.37)	-1.079	0.281
血清肌酐(μmol/L)	898.30(711.60,1028.65)	830.05(679.30,1031.20)	-1.129	0.259
MHR	0.404(0.27,0.54)	0.34(0.25,0.46)	-2.295	0.022^a
PHR	186.57(147.14,269.41)	154.39(121.62,214.99)	-3.614	< 0.001^c

变量	β 值	HR(95%CI)	瓦尔德	P值
年龄(岁)	0.021	1.022(1.002～1.041)	4.791	0.029
性别(男性/女性)	-0.309	0.734(0.449～1.201)	1.516	0.218
高血压史(有/无)	1.294	3.648(1.327～10.028)	6.292	0.012
糖尿病史(有/无)	0.838	2.312(1.428～3.743)	11.630	0.001
心血管疾病史(有/无)	0.396	1.486(0.916～2.411)	2.570	0.109
服用阿司匹林(有/无)	0.247	1.281(0.654～2.509)	0.520	0.471
服用氯吡格雷(有/无)	0.039	1.040(0.327～3.310)	0.004	0.947
服用降脂药物(有/无)	0.105	1.110(0.662～1.862)	0.158	0.691
吸烟史(有/无)	0.869	2.385(1.374～4.140)	9.541	0.002
饮酒史(有/无)	-0.255	0.775(0.311～1.928)	0.301	0.583
淋巴细胞计数(×10⁹/L)	-0.906	0.404(0.226～0.721)	9.395	0.002
HDL-C(mmol/L)	-3.099	0.045(0.015～0.140)	28.781	<0.001
MHR	2.007	7.439(2.185～25.333)	10.303	0.001
PHR	0.006	1.006(1.004～1.009)	22.431	<0.001

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