Abstract 13753: Cumulative Circulating Monocyte Load is Associated With All-Cause Mortality: A Longitudinal Cohort Study

Abstract

Introduction: Monocytic inflammation has been increasingly linked to diverse cardiometabolic risk factors and many age-related pathologies. Hypothesis: Cumulative monocyte counts (CumMON) are associated with and predictive of all-cause mortality. Methods: Retrospective analyses of data among 43,681 Han Chinese participants from a real-world, prospective cohort (Kailuan Study). Multivariable-adjusted Cox regression analyses were conducted to examine CumMON-associated risks for all-cause mortality. Results: Over a median 7.76 (IQR: 7.47-8.03) years of follow-up, 2,810 all-cause deaths were documented. Elevated monocyte load was significantly associated with higher mortality rates ( Figure 1 ). Each 1-SD increase in CumMON was associated with a 15% increase in all-cause death (1.15, 95% CI: 1.11-1.20) after adjusting for other risk factors. Higher death incidences and CumMON-associated mortality risks (per-SD increment) were observed in elderly individuals, participants with diabetes (1.18, 95% CI: 1.10-1.27), hypertension (1.16, 95% CI: 1.11-1.21), impaired renal function (1.18, 95% CI: 1.13-1.24), increased LDL-C (1.21, 95% CI: 1.15-1.28 for LDL≥2.6 mmol/L) or decreased HDL-C levels (1.21, 95% CI: 1.12-1.31), but not with CVD or cancer. There were significant supra-additive interactions between elevated CumMON and diabetes (RERI: 0.26, 95% CI: 0.04–0.48), hypertension (RERI: 0.35, 95% CI: 0.12–0.57), and old age (≥60 years) (RERI: 0.46, 95% CI: 0.07–0.85). The addition of cumulative monocyte load into the multivariable model significantly improved the prediction performance of all-cause death (net reclassification improvement: 12.05%; P <0.0001). Conclusions: Elevated cumulative monocyte load is significantly associated with all-cause death and improves risk prediction. Chronically elevated monocytes supra-additively enhance the mortality risk among those with old age, diabetes, or hypertension.