The Monocyte-to-Lymphocyte Ratio Correlates with Psycho-Neuro-Inflammatory Factors in Patients with Stable Coronary Artery Disease

Gyöngyi Serfőző, Tamás Horváth, I. Földesi, Beatrix Rafael, Roland von Känel, Margit Keresztes

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Psychosocial stress and depression have been recognized as major risk factors of coronary artery disease (CAD). Although monocytes are known to be key players in atherosclerosis, monocyte-based associations with psychoneuroendocrino-immuno-inflammatory (PNI) markers have not been widely investigated in stable CAD. Objective: We examined associations between the monocyte-to-lymphocyte ratio (MLR) and key PNI markers in stable CAD. Methods: We studied 23 patients with stable CAD who completed the Beck Depression Inventory (BDI) and Rahe's Brief Stress and Coping Inventory. A white blood cell differential was performed, and levels of cortisol, chromogranin A (CgA), LL-37, interleukin-6 (IL-6) and C-reactive protein (CRP) were assayed in plasma. Results: Monocyte fraction, MLR and plasma CgA levels exceeded reference values, the social support score was low, and 7 patients had elevated BDI scores. In the multivariate-adjusted analysis, a higher MLR was associated with greater depressive symptom severity (r = 0.624, p <0.01) as well as with higher concentrations of CgA (r = 0.660, p <0.01), LL-37 (r = 0.643, p <0.01), IL-6 (r = 0.532, p <0.05) and CRP (r = 0.470, p <0.05). BDI scores associated with CgA concentration (r = 0.618, p <0.01) and CgA level correlated negatively with the social support score (r = -0.511, p <0.05). Conclusions: Our findings suggest that, in patients with stable CAD, elevated MLR may be associated with depressive symptoms, with increased neuroendocrine-sympathetic activity (marked by CgA) and inflammatory markers that are pertinent to atherosclerosis initiation and progression. The increased neuroendocrine-sympathetic activity correlated with low social support and depressive symptom severity. The MLR might serve as an easy-to-obtain and inexpensive proxy measure of an activated PNI network in stable CAD.

Original languageEnglish
JournalNeuroImmunoModulation
DOIs
Publication statusAccepted/In press - Mar 1 2016

Fingerprint

Chromogranin A
Coronary Artery Disease
Monocytes
Lymphocytes
Depression
Social Support
Equipment and Supplies
C-Reactive Protein
Interleukin-6
Atherosclerosis
Proxy
Hydrocortisone
Reference Values
Leukocytes
Multivariate Analysis

Keywords

  • Atherosclerosis
  • Cardiovascular disease
  • Depressive symptoms
  • Inflammation
  • Monocyte-to-lymphocyte ratio
  • Psychological stress
  • Psychoneuroendocrinology
  • Social support
  • Stable coronary artery disease#

ASJC Scopus subject areas

  • Endocrinology
  • Immunology
  • Endocrine and Autonomic Systems
  • Neurology

Cite this

The Monocyte-to-Lymphocyte Ratio Correlates with Psycho-Neuro-Inflammatory Factors in Patients with Stable Coronary Artery Disease. / Serfőző, Gyöngyi; Horváth, Tamás; Földesi, I.; Rafael, Beatrix; von Känel, Roland; Keresztes, Margit.

In: NeuroImmunoModulation, 01.03.2016.

Research output: Contribution to journalArticle

Serfőző, Gyöngyi ; Horváth, Tamás ; Földesi, I. ; Rafael, Beatrix ; von Känel, Roland ; Keresztes, Margit. / The Monocyte-to-Lymphocyte Ratio Correlates with Psycho-Neuro-Inflammatory Factors in Patients with Stable Coronary Artery Disease. In: NeuroImmunoModulation. 2016.
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abstract = "Background: Psychosocial stress and depression have been recognized as major risk factors of coronary artery disease (CAD). Although monocytes are known to be key players in atherosclerosis, monocyte-based associations with psychoneuroendocrino-immuno-inflammatory (PNI) markers have not been widely investigated in stable CAD. Objective: We examined associations between the monocyte-to-lymphocyte ratio (MLR) and key PNI markers in stable CAD. Methods: We studied 23 patients with stable CAD who completed the Beck Depression Inventory (BDI) and Rahe's Brief Stress and Coping Inventory. A white blood cell differential was performed, and levels of cortisol, chromogranin A (CgA), LL-37, interleukin-6 (IL-6) and C-reactive protein (CRP) were assayed in plasma. Results: Monocyte fraction, MLR and plasma CgA levels exceeded reference values, the social support score was low, and 7 patients had elevated BDI scores. In the multivariate-adjusted analysis, a higher MLR was associated with greater depressive symptom severity (r = 0.624, p <0.01) as well as with higher concentrations of CgA (r = 0.660, p <0.01), LL-37 (r = 0.643, p <0.01), IL-6 (r = 0.532, p <0.05) and CRP (r = 0.470, p <0.05). BDI scores associated with CgA concentration (r = 0.618, p <0.01) and CgA level correlated negatively with the social support score (r = -0.511, p <0.05). Conclusions: Our findings suggest that, in patients with stable CAD, elevated MLR may be associated with depressive symptoms, with increased neuroendocrine-sympathetic activity (marked by CgA) and inflammatory markers that are pertinent to atherosclerosis initiation and progression. The increased neuroendocrine-sympathetic activity correlated with low social support and depressive symptom severity. The MLR might serve as an easy-to-obtain and inexpensive proxy measure of an activated PNI network in stable CAD.",
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AU - Serfőző, Gyöngyi

AU - Horváth, Tamás

AU - Földesi, I.

AU - Rafael, Beatrix

AU - von Känel, Roland

AU - Keresztes, Margit

PY - 2016/3/1

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N2 - Background: Psychosocial stress and depression have been recognized as major risk factors of coronary artery disease (CAD). Although monocytes are known to be key players in atherosclerosis, monocyte-based associations with psychoneuroendocrino-immuno-inflammatory (PNI) markers have not been widely investigated in stable CAD. Objective: We examined associations between the monocyte-to-lymphocyte ratio (MLR) and key PNI markers in stable CAD. Methods: We studied 23 patients with stable CAD who completed the Beck Depression Inventory (BDI) and Rahe's Brief Stress and Coping Inventory. A white blood cell differential was performed, and levels of cortisol, chromogranin A (CgA), LL-37, interleukin-6 (IL-6) and C-reactive protein (CRP) were assayed in plasma. Results: Monocyte fraction, MLR and plasma CgA levels exceeded reference values, the social support score was low, and 7 patients had elevated BDI scores. In the multivariate-adjusted analysis, a higher MLR was associated with greater depressive symptom severity (r = 0.624, p <0.01) as well as with higher concentrations of CgA (r = 0.660, p <0.01), LL-37 (r = 0.643, p <0.01), IL-6 (r = 0.532, p <0.05) and CRP (r = 0.470, p <0.05). BDI scores associated with CgA concentration (r = 0.618, p <0.01) and CgA level correlated negatively with the social support score (r = -0.511, p <0.05). Conclusions: Our findings suggest that, in patients with stable CAD, elevated MLR may be associated with depressive symptoms, with increased neuroendocrine-sympathetic activity (marked by CgA) and inflammatory markers that are pertinent to atherosclerosis initiation and progression. The increased neuroendocrine-sympathetic activity correlated with low social support and depressive symptom severity. The MLR might serve as an easy-to-obtain and inexpensive proxy measure of an activated PNI network in stable CAD.

AB - Background: Psychosocial stress and depression have been recognized as major risk factors of coronary artery disease (CAD). Although monocytes are known to be key players in atherosclerosis, monocyte-based associations with psychoneuroendocrino-immuno-inflammatory (PNI) markers have not been widely investigated in stable CAD. Objective: We examined associations between the monocyte-to-lymphocyte ratio (MLR) and key PNI markers in stable CAD. Methods: We studied 23 patients with stable CAD who completed the Beck Depression Inventory (BDI) and Rahe's Brief Stress and Coping Inventory. A white blood cell differential was performed, and levels of cortisol, chromogranin A (CgA), LL-37, interleukin-6 (IL-6) and C-reactive protein (CRP) were assayed in plasma. Results: Monocyte fraction, MLR and plasma CgA levels exceeded reference values, the social support score was low, and 7 patients had elevated BDI scores. In the multivariate-adjusted analysis, a higher MLR was associated with greater depressive symptom severity (r = 0.624, p <0.01) as well as with higher concentrations of CgA (r = 0.660, p <0.01), LL-37 (r = 0.643, p <0.01), IL-6 (r = 0.532, p <0.05) and CRP (r = 0.470, p <0.05). BDI scores associated with CgA concentration (r = 0.618, p <0.01) and CgA level correlated negatively with the social support score (r = -0.511, p <0.05). Conclusions: Our findings suggest that, in patients with stable CAD, elevated MLR may be associated with depressive symptoms, with increased neuroendocrine-sympathetic activity (marked by CgA) and inflammatory markers that are pertinent to atherosclerosis initiation and progression. The increased neuroendocrine-sympathetic activity correlated with low social support and depressive symptom severity. The MLR might serve as an easy-to-obtain and inexpensive proxy measure of an activated PNI network in stable CAD.

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KW - Stable coronary artery disease#

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