Monocyte-to-HDL-cholesterol ratio as a prognostic marker in cardiovascular diseases

Shiva Ganjali, Antonio M. Gotto, Massimiliano Ruscica, Stephen L. Atkin, Alexandra E. Butler, Maciej Banach, Amirhossein Sahebkar

Research output: Contribution to journalReview articlepeer-review

121 Scopus citations


Inflammation and lipid accumulation are two basic hallmarks of atherosclerosis as a chronic disease. Inflammation not only is a local response but can also be considered as a systemic process followed by an elevation of inflammatory mediators. Monocytes are a major source of proinflammatory species during atherogenesis. In atherosclerosis, modified low-density lipoproteins (LDLs) are removed by macrophages; these are recruited in the vessel wall, inducing the release of inflammatory cytokines in inflamed tissue. Hence, inflammatory cholesterol ester-loaded plaque is generated. High-density lipoprotein-cholesterol (HDL-C) exhibits antiatherosclerotic effects by neutralizing the proinflammatory and pro-oxidant effects of monocytes via inhibiting the migration of macrophages and LDL oxidation in addition to the efflux of cholesterol from these cells. Furthermore, HDL plays a role in suppressing the activation of monocytes and proliferation–differentiation of monocyte progenitor cells. Thus, accumulation of monocytes and reduction of HDL-C may participate in atherosclerosis and cardiovascular diseases (CVD). Given that the relationship between the high number of monocytes and low HDL-C levels has been reported in inflammatory disorders, this review focused on understanding whether the monocyte-to-HDL ratio could be a convenient marker to predict atherosclerosis development and progression, hallmarks of CV events, instead of the individual monocyte count or HDL-C level.

Original languageEnglish (US)
Pages (from-to)9237-9246
Number of pages10
JournalJournal of Cellular Physiology
Issue number12
StatePublished - Dec 2018


  • atherosclerosis
  • cardiovascular diseases (CVD)
  • high-density lipoprotein (HDL)
  • inflammation
  • monocyte

ASJC Scopus subject areas

  • Physiology
  • Clinical Biochemistry
  • Cell Biology


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