Monocyte to high-density lipoprotein cholesterol ratio in patients with retinal artery occlusion

GÜNSU DENİZ MİRZA, ENVER MİRZA, Refik OLTULU, GÜNHAL ŞATIRTAV, HÜRKAN KERİMOĞLU, SELMAN BELVİRANLI , MEHMET OKKA

  • GÜNSU DENİZ MİRZA: BEYHEKİM DEVLET HASTANESİ
  • ENVER MİRZA: NECMETTİN ERBAKAN ÜNİVERSİTESİ
  • Refik OLTULU: Necmettin Erbakan University Faculty of Medicine
  • GÜNHAL ŞATIRTAV: NEU
  • HÜRKAN KERİMOĞLU: NECMETTİN ERBAKAN ÜNİVERSİTESİ
  • SELMAN BELVİRANLI: NECMETTİN ERBAKAN ÜNİVERSİTESİ
  • MEHMET OKKA: NECMETTİN ERBAKAN ÜNİVERSİTESİ TIP FAKÜLTESİ
  • Year : 2025
  • Vol : 41
  • Issue : 1
  •  Page : 7-11
ABSTRACT
Aim: Retinal artery occlusion (RAO) is one of the most important emergencies of ophthalmologic diseases. Thromboembolism is the main etiological factor in RAO. Monocyte to HDL cholesterol ratio (MHR) is a novel prognostic biomarker in several inflammatory disorders, various cardiovascular and cerebrovascular diseases. In this study, it was aimed to investigate MHR in RAO patients.
Materials and Methods: In this retrospective study, the record files of subjects who were examined between January 2015 and May 2019 were reviewed. Seventy-six subjects were enrolled in the groups. Thirty-eight patients with RAO were considered as group 1, 38 participants were considered as group 2 (control group). In group 1, 23 patients were classified as central retinal artery occlusion (CRAO), and 15 patients were classified as branch retinal artery occlusion (BRAO).
Results: There was no difference in terms of gender and age among the groups (p=0.231 and p=0.685). As well, the groups were similar in terms of cardiovascular diseases, systemic hypertension, and diabetes mellitus (p=0.341, p=0.427, p=0.554, respectively). The mean MHR was higher in group 1 compared to the group 2, significantly (14.9±5.5 vs 7.9±1.9, p<0.001). The area under the curve for MHR was 0.908 in receiver operating characteristics analysis and an MHR of > 9.95 predicted RAO with a specificity of 84.2% and sensitivity of 89.5%. In univariate logistic regression, MHR was found to be an independent predictor of RAO (OR=1,892; 95% CI=1,398-2,561; p<0,001).
Conclusions: MHR has been shown to be a simple, useful and inexpensive predictive biomarker for systemic inflammation and vascular-occlusive diseases. Our study showed that increased MHR was significantly associated with RAO. Also, we have researched the level of MHR in patients with RAO and presented that MHR is higher in both CRAO and BRAO. Therefore, MHR may be a predictive biomarker for the emergence of RAO in risky patients.
Keywords: Monocyte to high-density lipoprotein cholesterol ratio, central retinal artery occlusion, branch retinal artery occlusion, atherosclerosis, inflammation
Cite this Article As : Mirza GD, Mirza E, Oltulu R, Satirtav Akdeniz G, Kerimoglu H, Belviranli S, Okka M. Monocyte to High-Density Lipoprotein Cholesterol Ratio in Patients with Retinal Artery Occlusion. Selcuk Med J 2025;41(1): 7-11

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Conflict of interest : The authors declare that they have no conflict of interest.
This article is published under the CC BY-NC 4.0 license.
Selcuk Medical Journal
2025, Vol. 41 (1)
ISSN: 1017-6616
E-ISSN: 2149-8059
Received : , Accepted : , Published Online :

References

  1. 1. VonGraefe A. Über embolie der arteria centralis retinae als ursache plötzlicher erblindung. Graefes Arch Ophthalmol. 1859;5:136–85.
  2. 2. Rumelt S, Dorenboim Y, Rehany U. Aggressive systematic treatment for central retinal artery occlusion. Am J Ophthalmol. 1999;128:733–738. doi:10.1016/s0002-9394(99)00359-1.
  3. 3. Park SJ, Choi NK, Seo KH, et al. Nationwide incidence of clinically diagnosed central retinal artery occlusion in Korea, 2008 to 2011. Ophthalmology. 2014;121:1933-38. doi: 10.1016/j.ophtha.2014.04.029.
  4. 4. Greven CM, Slusher MM, Weaver RG. Retinal arterial occlu¬sions in young adults. Am J Ophthalmol. 1995;120:776-83. doi: 10.1016/s0002-9394(14)72731-x.
  5. 5. Hayreh SS, Podhajsky PA, Zimmerman MB. Retinal artery occlusion: associated systemic and ophthalmic abnormalities. Ophthalmology.2009;116:1928–36. doi: 10.1016/j.ophtha.2009.03.006.
  6. 6. Brown GC, Magargal LE, Shields JA, et al. Retinal arterial obstruction in children and young adults. Ophthalmology. 1981;88:18-25. doi: 10.1016/s0161-6420(81)35080-5.
  7. 7. Lane DA, Grant PJ. Role of hemostatic gene polymorphisms in venous and arterial thrombotic disease. Blood. 2000;95:1517-32.
  8. 8. Khyzha N, Alizada A, Wilson MD, et al. Epigenetics of Atherosclerosis: Emerging Mechanisms and Methods. Trends Mol Med. 2017;23:332-47. doi: 10.1016/j.molmed.2017.02.004.
  9. 9. Sodi A, Giambene B, Marcucci R, et al. Atherosclerotic and thrombophilic risk factors in patients with ischemic central retinal vein occlusion. Retina. 2011;31:724–29. doi:10.1097/IAE.0b013e3181eef419.
  10. 10. Hansson GK. Inflammatory mechanisms in atherosclerosis. J Thromb Haemost 2009;1:328-31. doi: 10.1111/j.1538-7836.2009.03416.x.
  11. 11. Tuttolomondo A, Di Raimondo D, Pecoraro R, et al. Atherosclerosis as an inflammatory disease. Curr Pharm Des 2012;18:4266-88. doi: 10.2174/138161212802481237.
  12. 12. Ancuta P, Jianbin W, 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. doi:10.1189/jlb.0206125.
  13. 13. Murphy AJ, Woollard KJ. High-density lipoprotein: a potent inhibitor of inflammation. Clin Exp Pharmacol Physiol. 2010;37:710–18. doi:10.1111/j.1440-1681.2009.05338.x.
  14. 14. Mirza E, Oltulu R, Katipoğlu Z, et al. Monocyte/HDL Ratio and Lymphocyte/Monocyte Ratio in Patients with Pseudoexfoliation Syndrome. Ocul Immunol Inflamm. 2020;28:142-46. doi: 10.1080/09273948.2018.1545913.
  15. 15. Temiz SA, Daye M. Monocyte/High-Density Lipoprotein Ratio: An Indicator of Oxidative Stress and Disease Severity in Lichen Planus Patients. Selcuk Med J 2024;40(1): 29-33. doi:10.30733/std.2023.01684.
  16. 16. Ganjali S, Gotto AM Jr, Ruscica M, et al. Monocyte-to-HDL-cholesterol ratio as a prognostic marker in cardiovascular diseases. J Cell Physiol. 2018;223:9237-46. doi: 10.1002/jcp.27028.
  17. 17. Bolayir A, Gokce SF, Cigdem B, et al. Monocyte/high-density lipoprotein ratio predicts the mortality in ischemic stroke patients. Neurol Neurochir Pol. 2018;52:150-55. doi: 10.1016/j.pjnns.2017.08.011.
  18. 18. Lusis AJ. Atherosclerosis. Nature 2000;407:233–41. doi: 10.1038/35025203.
  19. 19. Ross R. Atherosclerosis-An inflammatory disease. New Engl J Med. 1999;340: 115–26. doi: 10.1056/NEJM199901143400207.
  20. 20. Moreira DM, da Silva RL, Vieira JL, et al. Role of vascular inflammation in coronary artery disease: potential of anti-inflammatory drugs in the prevention of atherothrombosis. Inflammation and anti-inflammatory drugs in coronary artery disease. Am J Cardiovasc Drugs. 2015;15:1-11. doi: 10.1007/s40256-014-0094-z.
  21. 21. Mantovani A, Allavena P, Sica A, et al. Cancer-related inflammation. Nature 2008; 454:436-44. doi: 10.1038/nature07205.
  22. 22. Galkina E, Ley K. Immune and inflammatory mechanisms of atherosclerosis. Annu Rev Immunol. 2009;27:165–97. doi: 10.1146/annurev.immunol.021908.132620.
  23. 23. Falk E. Pathogenesis of atherosclerosis. J Am Coll Cardiol. 2006;47:C7–C12. doi: 10.1016/j.jacc.2005.09.068.
  24. 24. Aukrust P, Halvorsen B, Yndestad A, et al. Chemokines and cardiovascular risk. Arterioscler Thromb Vasc Biol. 2008;28:1909-19. doi: 10.1161/ATVBAHA.107.161240.
  25. 25. Badimon, L, Vilahur G. Thrombosis formation on atherosclerotic lesions and plaque rupture. J Intern Med. 2014;276:618–32. doi: 10.1111/joim.12296.
  26. 26. Oklu R. Thrombosis. Cardiovasc Diagn. 2017;7:S131–S133. doi: 10.21037/cdt.2017.11.08.
  27. 27. Ahuja RM, Chaturvedi S, Eliott D, et al. Mechanisms of retinal arterial occlusive disease in African American and Caucasian patients. Stroke. 1999;30:1506-09. doi: 10.1161/01.str.30.8.1506.
  28. 28. Babikian V, Wijman CA, Koleini B, et al. Retinal ischemia and embolism. Etiologies and outcomes based on a prospective study. Cerobrovasc Disc. 2001;12:108-13. doi: 10.1159/000047689.
  29. 29. Bakri SJ, Luqman A, Pathik B, et al. Is carotid ultrasound necessary in the evaluation of the asymptomatic Hollenhorst plaque? Ophthalmology. 2013;120:2747-2748.e1. doi: 10.1016/j.ophtha.2013.09.005.
  30. 30. Ovbiagele B, Nguyen-Huynh MN. Stroke epidemiology: advancing our understanding of disease mechanism and therapy. Neurotherapeutics. 2011;8:319–29.
  31. 31. Sharma S, Brown GC, Pater JL, et al. Does a Visible Retinal Embolus Increase the Likelihood of Hemodynamically Significant Carotid Artery Stenosis in Patients With Acute Retinal Arterial Occlusion? Arch Ophthalmol. 1998;116:1602-06. doi:10.1001/archopht.116.12.1602
  32. 32. Varma DD, Cugati S, Lee AW, et al. A review of central retinal artery occlusion: clinical presentation and management. Eye (Lond). 2013;27:688–97. doi:10.1038/eye.2013.25
  33. 33. Helenius J, Arsava EM, Goldstein JN, et al. Concurrent acute brain infarcts in patients with monocular visual loss. Ann Neurol. 2012;72:286–93. doi: 10.1002/ana.23597.
  34. 34. Lee J, Kim SW, Lee SC, et al. Co-occurrence of acute retinal artery occlusion and acute ischemic stroke: diffusion-weighted magnetic resonance imaging study. Am J Ophthalmol. 2014;157:1231–38. doi: 10.1016/j.ajo.2014.01.033.
  35. 35. Avery MB, Magal I, Kherani A, et al. Risk of Stroke in Patients With Ocular Arterial Occlusive Disorders: A Retrospective Canadian Study. J Am Heart Assoc. ;8(3):e010509. doi:10.1161/JAHA.118.010509
  36. 36. Park SJ, Choi NK, Yang BR, et al. Risk and risk periods for stroke and acute myocardial infarction in patients with central retinal artery occlusion. Ophthalmology. 2015;122:2336–43. doi: 10.1016/j.ophtha.2015.07.018.
  37. 37. Korkmaz A, Demir M, Unal S, et al. Monocyte-to-high density lipoprotein ratio (MHR) can predict the significance of angiographically intermediate coronary lesions. Int J Cardiovasc Acad. 2017;3:16-20. doi.org/10.1016/j.ijcac.2017.05.008
  38. 38. Cetin MS, Ozcan Cetin EH, Kalender E, et al. Monocyte to HDL Cholesterol Ratio Predicts Coronary Artery Disease Severity and Future Major Cardiovascular Adverse Events in Acute Coronary Syndrome. Heart Lung Circ. 2016;25:1077-86. doi: 10.1016/j.hlc.2016.02.023.
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