Association between monocyte-to-high-density lipoprotein cholesterol ratio and nonalcoholic fatty liver disease / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the association between monocyte-to-high-density lipoprotein cholesterol ratio (MHR) and nonalcoholic fatty liver disease (NAFLD). MethodsA total of 208 patients who were admitted to Department of Gastroenterology, Zhongshan Hospital Affiliated to Dalian University, from January 2018 to October 2020 and were diagnosed with NAFLD by abdominal CT were enrolled as NAFLD group, and 210 healthy individuals were enrolled as control group. All subjects underwent routine blood test, biochemical examination, and abdominal CT examination, and serum MHR was calculated. In addition, according to abdominal CT findings, the patients with NAFLD were divided into mild NAFLD group with 148 patients and moderate-to-severe NAFLD group with 60 patients, and the variables such as white blood cell count (WBC) and MHR were compared between the three groups. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and a one-way analysis of variance was used for comparison between multiple groups; the Mann-Whitney U test was used for comparison of data with skewed distribution between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups. The fourfold table chi-square test was used for comparison of categorical data between two groups, and the R×C table chi-square test was used for comparison between three groups. A Spearman correlation analysis was used to investigate the correlation of MHR with metabolic markers and the severity of NAFLD. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of MHR in predicting NAFLD. ResultsCompared with the control group, the NAFLD group had significant increases in body weight (t=-10.573, P＜0.001), body mass index (BMI) (t=-13.112, P＜0.001), smoking history (Z=14.667, P＜0.001), WBC (t=-7.359, P＜0.001), monocytes (Z=-9.932, P＜0001), low-density lipoprotein cholesterol (t=-3.394, P=0.001), triglyceride (TG) (Z=-11.737, P＜0001), cholesterol (t=-2.985, P=0.003), fasting blood glucose (FBG) (Z=-7.827, P＜0.001), alanine aminotransferase (ALT) (Z=-12.583, P＜0.001), and aspartate aminotransferase (AST) (Z=-9.514, P＜0.001) and a significant reduction in serum high-density lipoprotein cholesterol (HDL-C) (t=10.440, P＜0.001); in addition, MHR level had gender differences, and male patients had a significantly higher level than female patients (P＜0.001). Compared with the control group and the mild NAFLD group, the moderate-to-severe NAFLD group had a significant increase in serum MHR level (P＜0.001). The correlation analysis showed that serum MHR level was negatively correlated with HDL-C (r=-0.565, P＜0.001) and were positively correlated with smoking history, body weight, BMI, WBC, monocytes, TG, FBG, ALT, and AST (r=0.449, 0.482, 0.430, 0.478, 0.892, 0.333, 0.157, 0.386, and 0281, all P＜0.01). At the same time, MHR level was positively correlated with the severity of NAFLD (r=0.629, P＜0.001). The ROC curve showed that MHR had an area under the ROC curve of 0.846 (95% confidence interval 0.810-0.882, P＜0.001), with a sensitivity of 77.9% and a specificity of 74.3%. ConclusionSerum MHR level is associated with NAFLD and can be used as a predictive index for evaluating the progression of NAFLD.