JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

ISSN: Active
eISSN: 2636-8579
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Submit Manuscript

Index
Original Article
The role of elevated monocyte and high-density lipoprotein cholesterol ratio in endothelial dysfunction and cardiovascular risk in acromegaly patients
Abstract
Aims: This study aimed to investigate the role of the monocyte-to-high-density lipoprotein ratio (MHR) as an indicator of endothelial dysfunction and cardiovascular risk in patients with acromegaly.
Methods: The study group consisted of 125 patients diagnosed with acromegaly, while the control group included 123 healthy individuals who visited the endocrine clinic due to pituitary incidentaloma but had no acromegaly diagnosis. Medical and laboratory records of all participants were reviewed retrospectively.
Results: The average MHR in patients with acromegaly was found to be statistically significantly higher than that in the healthy control group. In the acromegaly group, systolic blood pressure, glucose, HbA1c, lipids (total cholesterol, LDL, triglycerides), sedimentation rate, CRP, and neutrophils were significantly higher to the control group. The optimal MHR cutoff for acromegaly was 12.01, with 85.1% sensitivity, 85% specificity, and an AUC of 0.64.
Conclusion: MHR, a potential biomarker considered an indicator of inflammation, was significantly higher in patients with acromegaly compared to the healthy control group. This finding suggests that MHR may serve as a useful marker for assessing cardiovascular risk and endothelial dysfunction in patients with acromegaly.

Keywords : Acromegaly, monocyte to HDL cholesterol ratio, cardiovascular risk, cardiovascular markers

Download Article


1. Ren J, Anversa P. The insulin-like growth factor I system: physiological and pathophysiological implication in cardiovascular diseases associated with metabolic syndrome. Biochem Pharmacol. 2015;93(4):409-417. doi: 10.1016/j.bcp.2014.12.006
2. Colao A. The GH-IGF-I axis and the cardiovascular system: clinical implications. Clin Endocrinol. 2008;69(3):347-358. doi:10.1111/j.1365-2265. 2008.03292.x
3. Colao A, Ferone D, Marzullo P, Lombardi G. Systemic compli- cations of acromegaly: epidemiology, pathogenesis, and management. Endocr Rev. 2004;25(1):102-152. doi:10.1210/er. 2002-0022
4. Melmed S, Casanueva FF, Klibanski A, et al. A consensus on the diagnosis and treatment of acromegaly complications. Pituitary. 2013; 16(3):294-302. doi:10.1007/s11102-012-0420-x
5. Wolters TLC, Netea MG, Riksen NP, Hermus ARMM, Netea-Maier RT. Acromegaly, inflammation and cardiovascular disease: a review. Rev Endocr Metab Disord. 2020;21(4):547-568. doi:10.1007/s11154-020-09560-x
6. 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(1):55. doi:10.1186/s12944-020-01242-6
7. Ridker PM, Everett BM, Thuren T, et al. Anti-inflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med. 2017;377(12): 1119-1131. doi:10.1056/NEJMoa1707914
8. Higashi Y, Quevedo HC, Tiwari S, et al. Interaction between insulin-like growth factor-1 and atherosclerosis and vascular aging. Front Horm Res. 2014;43:107-124. doi:10.1159/000360571
9. Maffei P, Dassie F, Wennberg A, Parolin M, Vettor R. The endothelium in acromegaly. Front Endocrinol (Lausanne). 2019;10:437. doi:10.3389/fendo.2019.00437
10. Hong FF, Liang XY, Liu W, et al. Roles of eNOS in atherosclerosis treatment. Inflamm Res. 2019;68(6):429-441. doi:10.1007/s00011-019-01229-9
11. Caicedo D, Díaz O, Devesa P, Devesa J. Growth hormone (GH) and cardiovascular system. Int J Mol Sci. 2018;19(1):290. doi:10.3390/ijms 19010290
12. Groh L, Keating ST, Joosten LAB, Netea MG, Riksen NP. Monocyte and macrophage immunometabolism in atherosclerosis. Semin Immunopathol. 2018;40(2):203-214. doi:10.1007/s00281-017-0656-7
13. Choi SH, Kim JH, Lim S, et al. Monocyte count as a predictor of cardiovascular mortality in older Korean people. Age Ageing. 2017;46(3): 433-438. doi:10.1093/ageing/afw226
14. Açıkgöz SK, Açıkgöz E, Şensoy B, Topal S, Aydoğdu S. Monocyte to high-density lipoprotein cholesterol ratio is predictive of in-hospital and five-year mortality in ST-segment elevation myocardial infarction. Cardiol J. 2016;23(5):505-512. doi:10.5603/CJ.a2016.0026
15. 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(11):1077-1086. doi:10.1016/j.hlc.2016.02.023
16. Karatas A, Turkmen E, Erdem E, Dugeroglu H, Kaya Y. Monocyte to high-density lipoprotein cholesterol ratio in patients with diabetes mellitus and diabetic nephropathy. Biomark Med. 2018;12(9):953-959. doi:10.2217/bmm-2018-0048
17. Celermajer DS, Sorensen KE, Bull C, Robinson J, Deanfield JE. Endothelium-dependent dilation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interaction. J Am Coll Cardiol. 1994;24(6):1468-1474. doi:10.1016/0735-1097(94)90141-4
18. Paulus WJ. Unfolding discoveries in heart failure. N Engl J Med. 2020; 382(7):679-682. doi:10.1056/NEJMcibr1913825
19. Ronconi V, Giacchetti G, Mariniello B, et al. Reduced nitric oxide levels in acromegaly: cardiovascular implications. Blood Press. 2005;14(4):227-232. doi:10.1080/08037050510034293
20. Soeki T, Sata M. Inflammatory biomarkers and atherosclerosis. Int Heart J. 2016;57(2):134-139. doi:10.1536/ihj.15-346
21. Ridker PM. From C-reactive protein to Interleukin-6 to Interleukin-1: moving upstream to identify novel targets for atheroprotection. Circ Res. 2016;118(1):145-156. doi:10.1161/CIRCRESAHA.115.306656
22. Moore KJ, Sheedy FJ, Fisher EA. Macrophages in atherosclerosis: a dynamic balance. Nat Rev Immunol. 2013;13(10):709-721. doi:10.1038/nri3520
23. Vacek TP, Rehman S, Neamtu D, Yu S, Givimani S, Tyagi SC. Matrix metalloproteinases in atherosclerosis: role of nitric oxide, hydrogen sulfide, homocysteine, and polymorphisms. Vasc Health Risk Manag. 2015;11:173-183. doi:10.2147/ VHRM.S68415
24. Brown RA, Shantsila E, Varma C, Lip GY. Current understanding of atherogenesis. Am J Med. 2017;130(3):268-282. doi:10.1016/j.amjmed.2016.10.022
25. Boero L, Manavela M, Gomez Rosso L, et al. Alterations in biomarkers of cardiovascular disease (CVD) in active acromegaly. Clin Endocrinol. 2009;70(1):88-95. doi:10.1111/j.1365-2265.2008.03323.x
26. Boero L, Manavela M, Merono T, Maidana P, Gomez Rosso L, Brites F. GH levels and insulin sensitivity are differently associated with biomarkers of cardiovascular disease in active acromegaly. Clin Endocrinol. 2012;77(4):579-585. doi:10.1111/j.1365-2265.2012.04414.x
27. Ueland T, Fougner SL, Godang K, et al. Associations between body composition, circulating interleukin-1 receptor antagonist, osteocalcin, and insulin metabolism in active acromegaly. J Clin Endocrinol Metab. 2010;95(1):361-368. doi:10.1210/jc.2009-0422
28. Sodhi A, Tripathi A. Prolactin and growth hormone induce differential cytokine and chemokine profile in murine peritoneal macrophages in vitro: involvement of p-38 MAP kinase, STAT3 and NF-kappaB. Cytokine. 2008;41(2):162-173. doi:10. 1016/j.cyto.2007.11.007
29. CDC, Adult BMI calculator 2020. https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html (Accessed 21/04/2021 2021).
30. Meidert AS, Saugel B. Techniques for non-invasive monitoring of arterial blood pressure. Front Med (Lausanne). 2018;4:231. doi:10.3389/fmed.2017.00231
31. D’Agostino RB Sr, Vasan RS, Pencina MJ, et al. General cardiovascular risk profile for use in primary care: the Framingham heart study. Circulation. 2008;117(6):743-753. doi:10.1161/CIRCULATIONAHA.107.699579
32. Katznelson L, Laws ER Jr, Melmed S, et al. Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014;99(11): 3933-3951. doi:10.1210/jc.2014-2700
33. 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;233(12):9237-9246. doi:10.1002/jcp.27028
34. Selcuk M, Yildirim E, Saylik F. Comparison of monocyte with high density lipoprotein cholesterol ratio in dipper and nondipper hypertensive patients. Biomark Med. 2019;13(15):1289-1296. doi:10.2217/ bmm-2019-0062
35. Kaplan IG, Kaplan M, Abacioglu OO, Yavuz F, Saler T. Monocyte/HDL ratio predicts hypertensive complications. Bratisl Lek Listy. 2020;121(2): 133-136. doi:10.4149/BLL_2020_018
36. Gökçay Canpolat A, Emral R, Keskin Ç, Canlar Ş, Şahin M, Çorapçioğlu D. Association of monocyte-to-high density lipoprotein-cholesterol ratio with peripheral neuropathy in patients with type II diabetes mellitus. Biomark Med. 2019;13(11):907-915. doi:10.2217/bmm-2018-0451
37. Onalan E. The relationship between monocyte to high-density lipoprotein cholesterol ratio and diabetic nephropathy. Pak J Med Sci. 2019;35(4): 1081-1086. doi:10.12669/pjms.35.4.534 </ol> </div> <p>
Article available in :
Volume 8, Issue 3, 2025
Page : 435-440
https://doi.org/10.32322/jhsm.1668960
Article Information
Received : 01 Nis 2025
Accepted : 24 Nis 2025
Published : 30 May 2025
Corresponding Author :

Mustafa Aydemir: Department of Internal Medicine, Faculty of Medicine, Akdeniz University, Antalya, Turkiye

[email protected]
Citation : Aydemir M, Sarı R. The role of elevated monocyte and high-density lipoprotein cholesterol ratio in endothelial dysfunction and cardiovascular risk in acromegaly patients. J Health Sci Med. 2025;8(3):435-440.

Read: 31
Cited: 0
Download : 19
_Footer