Correlation of the monocyte to high-density lipoprotein cholesterol ratio and neutrophil to high-density lipoprotein cholesterol ratio with the severity of acute ischemic stroke

Background Stroke as the major cause of mortality and morbidity worldwide, requires early assessment of severity and prognosis for effective treatment. There is an emerging role of inflammatory markers in stroke severity. Thus, we aimed to determine the correlation of neutrophil to HDL-cholesterol ratio (NHR) and monocyte to HDL-cholesterol ratio (MHR) with the severity of acute ischemic stroke (AIS).Methodology A single Centre cross-sectional study involving adult patients with AIS. Patients were grouped into mild and moderate-severe stroke by National Institute of Health Severity Scale (NIHSS). Demographic, clinical and laboratory data of participants were collected.Spearman correlation analysis, univariate and multiple logistic regression analysis were utilized to explore the correlation between MHR with AIS severity. A receiver operating characteristic curve was created to determine the discriminatory ability of MHR in assessing stroke severity.Results Male gender, diabetes, hypertension, monocyte count, triglyceride, total cholesterol, CRP, uric acid and MHR were found statistically significant between the mild and moderate-severe stroke groups. Spearman correlation analysis produced a weak but statistically significant positive correlation between MHR and NIHSS score with a correlation coefficient of 0.201 (P = 0.026). Binary logistic regression analysis demonstrated that MHR had statistically insignificant positive association with higher NIHSS scores (OR = 2.275, 95% CI: 0.924-5.6, p = 0.074). Multiple logistic regression analysis revealed that MHR was not independently associated with stroke severity scale (adjusted OR = 1.527, 95% CI: 0.559-4.173, p = 0.409). The area under the curve (AUC) for MHR association with AIS was 0.588 (95% CI: 0.485-0.691, p = 0.101) with specificity of 87.5% and sensitivity of 40.5%.Conclusion MHR could serve as a new, readily accessible and inexpensive indicator of the severity of AIS.