Monocyte-to-HDL-C Ratio Correlated With Gout Risk and Renal Injury

Monocyte-to-HDL-C ratio (MHR) was found to be correlated with gout risk and renal dysfunction severity in a new cross-sectional study.1

“High monocyte counts and low HDL-C levels positively correlate with inflammation, and the MHR is recognized as a potential marker for inflammation and oxidative stress. The strong association between MHR and hyperuricemia suggests its utility in optimizing risk stratification for hyperuricemia.2 Despite the biological plausibility of MHR as a marker, its relationship with gout risk remains underexplored,” lead investigator Liangyu Mi, Shanxi Bethune Hospital, Third Hospital of Shanxi Medical University, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China, and colleagues wrote.1

Mi and colleagues used data from the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2016 to conduct a cross-sectional analysis to assess the correlation between MHR levels and gout. They used multiple logistic regression, subgroup analyses, and exploration of nonlinear relationships to analyze data from 7247 participants, 373 with gout.

The investigators found that MHR was significantly higher in gout patients (0.54; standard deviation [SD], 0.31) compared to non-gout patients (0.47; SD, 0.24). After adjusting for confounding factors, MHR was significantly associated with gout risk (odds ratio [OR], 1.6 [95%CI, 1.1–2.2]; P = .012). They also found that after adjustments, each unit increase in MHR significantly raised the risk of gout by approximately 0.6-fold.1

Furthermore, subgroup analyses revealed a positive correlation between MHR and gout risk in males, Mexican Americans(OR, 5.0 [95% CI, 1.5–17.4]; P = .011), and participants who were married (OR, 1.8 [95% CI, 1.2–2.8]; P = .008), had insufficient physical activity (OR, 1.6; P <.05), and diabetes(OR, 3.5; P <.05).1

Notably, MHR had a stronger positive association in patients who had gout with renal dysfunction (OR, 7.4 [95% CI, 2.2–25.3]; P = .001). Patients in the highest MHR quartile had a 1.7-fold higher prevalence of gout with renal dysfunction than the lowest quartile (OR, 2.7 [95% CI, 1.1-6.7]; P = .028).1

“The findings of this study indicate a substantial positive correlation between the MHR and gout, highlighting its potential as a useful biomarker for evaluating the risk and severity of the disease and its complications. Moreover, the study reveals that MHR is linked to the progression of renal impairment in individuals with gout. These results underscore the importance of considering MHR as a valuable indicator in the management and assessment of gout-related health issues,” Mi and colleagues concluded.1

The investigators noted several limitations of the study, including its cross-sectional design which cannot fully eliminate potential recall and selection biases. They emphasized that their findings should be validatedthrough future prospective cohort studies. They also noted that the study had a relatively low sample size of the study and the single-time laboratory measurements, which are subject to variability.

REFERENCES

1. Mi L, He X, Gao J, Xu K. Monocyte-to-HDL cholesterol ratio (MHR) as a novel Indicator of gout risk. Sci Rep. 2025; 15 (12188). doi.org/10.1038/s41598-025-97373-w

2. Chen, M. Q., Shi, W. R., Shi, C. N., Zhou, Y. P. & Sun, Y. X. Impact of monocyte to High-Density lipoprotein ratio on prevalent hyperuricemia: findings from a rural Chinese population. Lipids Health Dis. 19, 48. https://doi.org/10.1186/s12944-020-01226-6 (2020).