# Lymphocyte-to-Monocyte Ratio and All-Cause Mortality in Populations With Abdominal Aortic Calcification: A Prospective Cohort Study

## TL;DR

This study found that higher lymphocyte-to-monocyte ratios are linked to lower mortality risk in people with abdominal aortic calcification.

## Contribution

The study introduces LMR as a potential prognostic marker for all-cause mortality in individuals with abdominal aortic calcification.

## Key findings

- Higher LMR was associated with a 28% reduced risk of all-cause mortality in individuals with abdominal aortic calcification.
- A nonlinear relationship was observed, with significant risk reduction only below an LMR of 4.49.
- The AUC values suggest moderate predictive ability of LMR for survival in this population.

## Abstract

Objective: The identification of reliable prognostic markers is essential for the effective management of abdominal aortic calcification (AAC). This research focused on assessing whether the lymphocyte-to-monocyte ratio (LMR) correlates with long-term mortality risk in the AAC population.

Methods: This analysis included 888 adults with AAC from National Health and Nutrition Examination Survey (NHANES) 2013–2014. Mortality risk was assessed using Cox proportional hazards models and Kaplan–Meier curves. Nonlinear associations between the LMR and mortality were examined with restricted cubic spline (RCS). The predictive ability was evaluated by time-dependent receiver operating characteristic (ROC) analysis.

Results: Over median follow-up for 71 months, 145 deaths were recorded. After adjusting for covariates, higher LMR was found to be significantly associated with a reduced risk of all-cause mortality, with a 28% decrease in risk per one-unit increment in LMR (hazard ratio; HR = 0.72, 95% confidence interval (CI): 0.57–0.91, p=0.02). This was consistent across quartiles. A nonlinear relationship was noted; below LMR 4.49, risk decreased (HR = 0.49, 95% CI: 0.40–0.60, p < 0.0001); above it, LMR was not significantly linked to mortality (HR = 1.14, 95% CI: 0.77–1.7, p=0.51). The area under the curve (AUC) for 2-, 4-, and 6-year survival were 0.647, 0.707, and 0.682, respectively.

Conclusions: Higher LMR is significantly associated with lower all-cause mortality in individuals with AAC, suggesting its potential utility as a prognostic marker in this population.