Association Between Monocyte to High-Density Lipoprotein Cholesterol Ratio and Risk of Non-alcoholic Fatty Liver Disease: A Cross-Sectional Study

Abstract

Background:Non-alcoholic fatty liver disease (NAFLD) is a global health problem affecting more than a quarter of the entire adult population. Both monocytes and high-density lipoprotein cholesterol (HDL-C) were found to participate in the progression of hepatic inflammation and oxidative stress. We speculated that the monocyte-to-HDL-C ratio (MHR) may be associated with the risk of NAFLD.MethodsWe conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 2017–2018. NAFLD was identified using a controlled attenuation parameter (CAP) of ≥274 dB/m. Degree of liver fibrosis were assessed by liver stiffness measurement (LSM) and LSM values≥8.0, ≥ 9.7, and ≥13.7 kPa were defined as significant fibrosis (≥F2), advanced fibrosis (≥F3) and cirrhosis (F4), respectively. The association between MHR and the risk of NAFLD and liver fibrosis was estimated using weighted multivariable logistic regression. The non-linear relationship between MHR and the risk of NAFLD was further described using smooth curve fittings and threshold effect analysis.ResultsOf 4,319 participants, a total of 1,703 (39.4%) participants were diagnosed with NAFLD. After complete adjustment for potential confounders, MHR was positively associated with the risk of NAFLD (OR = 2.87, 95% CI: 1.95–4.22). The risk of NAFLD increased progressively as the MHR quarter increased (P for trend < 0.001). In subgroup analysis stratified by sex, a positive association existed in both sexes; Women displayed higher risk (men: OR = 2.12, 95% CI: 1.33–3.39; women: OR = 2.64, 95%CI: 1.40–4.97). MHR was positively associated with the risk of significant liver fibrosis (OR = 1.60, 95% CI: 1.08–2.37) and cirrhosis (OR = 1.83, 95% CI: 1.08–3.13), but not with advanced liver fibrosis (OR = 1.53, 95% CI: 0.98–2.39) after full adjustment for potential confounders. In the subgroup analysis by sex, the association between MHR and different degrees of liver fibrosis was significantly positive in women. When analyzing the relationship between MHR and NAFLD risk, a reverse U-shaped curve with an inflection point of 0.36 for MHR was found in women.ConclusionHigher MHR was associated with increased odds of NAFLD among Americans of both sexes. However, an association between MHR and liver fibrosis was found mainly among women.

The monocyte-to-high-density lipoprotein ratio is associated with the occurrence of atrial fibrillation among NAFLD patients: A propensity-matched analysis

“…NAFLD is gaining attention as an important independent risk factor for atrial fibrillation. Multiple cross-sectional studies ( 12 , 47 ) have shown that MHR is closely associated with an increased risk of NAFLD and can be used for early monitoring of NAFLD. However, no study has investigated whether MHR predicts the risk of developing AF in the NAFLD population.…”

Mental health status among non-medical college students returning to school during the COVID-19 pandemic in Zhanjiang city: A cross-sectional study

“…D' Agostino-Pearson omnibus test was used to determine normal distribution. Statistical description was expressed as median ± inter-quartile range (IQR) for the variables with (Wang et al, 2022). Raw Cronbach's αs for total and subscale scores and raw corrected item-total, item-component, and component-total Spearman's rho (r s ) correlations were calculated to assess the questionnaires' internal consistency.…”

“…Spearman’s analysis was conducted to examine the correlations between insomnia, anxiety, depression and related parameters like gender, age, income, knowledge about COVID-19 and attitude toward COVID-19. The significant factors were included in the stepwise multivariate logistic regression analysis to study their association with insomnia, anxiety and depression ( Wang et al, 2022 ). Raw Cronbach’s αs for total and subscale scores and raw corrected item-total, item-component, and component-total Spearman’s rho ( r s ) correlations were calculated to assess the questionnaires’ internal consistency.…”

Monocyte to high-density lipoprotein and apolipoprotein A1 ratios are associated with bone homeostasis imbalance caused by chronic inflammation in postmenopausal women with type 2 diabetes mellitus

“…These findings may indicate us that MHR and MAR can reflect bone homeostasis imbalance caused by chronic inflammation. Clinical studies observed MHR and MAR have good predictive values for chronic low inflammatory diseases like peripheral artery disease ( Selvaggio et al, 2020 ), polycystic ovarian syndrome ( Kałużna et al, 2020 ),nonalcoholic fatty liver disease ( Wang et al, 2022 ), metabolic syndrome ( Uslu Ali et al, 2018 ), central retinal artery occlusion ( Guven and Kilic, 2021 ), unstable angina ( Zhang et al, 2016 ) and parkinson’s disease ( Liu et al, 2021 ). To our surprise, the results in our study also found that MHR and MAR were not only a independent risk factor of osteoporosis, they were also seemed to have a good identifying value for osteoporosis with relatively high AUC values of 0.791 and 0.843.…”

“…T2DM are often accompanied with dyslipidemia like increased low-density lipoprotein cholesterol (LDL-c) and decreased high-density lipoprotein cholesterol (HDL-c) and apolipoprotein A1 (APOA1). Recently, the ratios of monocyte to HDL-c (MHR) or APOA1 (MAR) have been considered as pro-inflammatory indexes and were reported to have good predictive values for chronic low inflammatory diseases like peripheral artery disease ( Selvaggio et al, 2020 ), polycystic ovarian syndrome ( Kałużna et al, 2020 ) and nonalcoholic fatty liver disease ( Wang et al, 2022 ). Based on the above studies, we can be hypothesized that MHR and MAR may be able to reflect bone homeostasis imbalance cause by chronic inflammation in T2DM.…”