Abstract: Objective To explore the relationship between monocyte to high density lipoprotein-cholesterol ratio (MHR) and aortic arch calcification in the elderly patients undergoing maintenance hemodialysis(MHD). Methods A total of sixty-one elderly MHD patients who met the inclusion criteria were selected, and the clinical data of the patients were collected. According to the chest X-ray calcification rating of aortic arch calcification degree, the patients were divided into mild calcification group, moderate calcification group and severe calcification group. Spearman correlation analysis was used to analyze the relationship between the aortic arch calcification and the related indexes. Multiple Logistic regression analysis was used to analyze the risk factors of the aortic arch calcification. Results Compared with mild calcification group, the levels of MHR, neutrophil count / lymphocyte count (NLR), platelet to lymphocyte ratio (PLR),alkaline phosphatase (ALP) and corrective calcium were significantly increased, while the level of albumin was significantly decreased in moderate and severe calcification groups(P<0.05). Aortic arch calcification was positively correlated with MHR, NLR, PLR,corrected calcium and ALP(r=0.611,0.376,0.339,0.322,0.519, respectively, all P<0.05), and negatively correlated with albumin(r=-0.309,P<0.05). Multivariate regression analysis showed that MHR(OR=6.612,95%CI: 2.697-10.528,P=0.001)was an independent risk factor for aortic arch calcification in the elderly MHD patients. ROC curve showed that MHR had value in predicting moderate and severe aortic arch calcification, with a sensitivity of 87% and the optimal cut-off value of 0.407. Conclusions MHR has clinical predictive value for aortic arch calcification in the elderly MHD patients.

Key words: aged, maintenance hemodialysis, aortic arch calcification, monocyte to high density lipoprotein-cholesterol ratio