Monocyte-to-high-density lipoprotein cholesterol ratio and carotid atherosclerosis in patients with metabolic dysfunction-associated steatotic liver disease: a comparative analysis of systemic inflammatory indices.
5 affiliations
- 1Department of Radiology, Shanghai Healthcare Medical Center, Wuxi, 214065, China.
- 2School of Artificial Intelligence, Jiangnan University, Wuxi, 214122, China.
- 3Department of Radiology, Shanghai Healthcare Medical Center, Wuxi, 214065, China. [email protected].
- 4Department of School and Food Hygiene, Wuxi Center for Disease Control and Prevention, Wuxi, 214023, China. [email protected].
- 5Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi, 214100, China. [email protected].
Abstract
Background
Systemic inflammation indices have been linked to carotid atherosclerosis (CAS); however, their comparative performance and relative independence within the metabolic-inflammatory milieu of metabolic dysfunction-associated steatotic liver disease (MASLD) remain unclear. We aimed to identify the inflammatory index showing the strongest and most consistent association with CAS and to exploratorily assess potential mediating pathways.Methods
In this cross-sectional study of 24,683 adults with MASLD, eight systemic inflammation indices were calculated. Associations with ultrasonography-defined CAS were evaluated using multivariable logistic regression. All indices were entered into a mutually adjusted model to identify the most independent marker. Dose-response relationships, subgroup analyses, and exploratory mediation analyses were performed.Results
After full adjustment, the monocyte-to-high-density lipoprotein cholesterol ratio (MHR) showed the strongest association with CAS (odds ratio [OR] per 1-standard deviation increase: 1.092, 95% confidence interval [CI] 1.054-1.132). In the mutually adjusted model including all eight indices, only MHR remained independently associated with CAS (OR: 1.062, 95% CI 1.005-1.123). The MHR-CAS association was linear (P for nonlinearity = 0.416) and stronger among individuals without hypertension (P for interaction = 0.027). Exploratory mediation analysis suggested that approximately 4.0% of the association was statistically mediated by fasting plasma glucose (FPG)-related pathways, observed exclusively in non-lean MASLD.Conclusion
Among commonly used systemic inflammation indices, MHR appears to be a robust and independent marker associated with carotid atherosclerosis in MASLD. Its association is linear, modified by hypertension status, and modestly linked to glucose-related pathways in a phenotype-specific manner, supporting its potential role as a complementary biomarker for vascular risk stratification in MASLD.Clinical trial number
Not applicable.
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BibTeX
@article{qu2026monocytetohighdensity,
title = {{Monocyte-to-high-density lipoprotein cholesterol ratio and carotid atherosclerosis in patients with metabolic dysfunction-associated steatotic liver disease: a comparative analysis of systemic inflammatory indices.}},
author = {Mingyue Qu and Yang Qu and Haixia Huang and Yang Luo and Xiaona Wang and Yang Wang},
journal = {BMC endocrine disorders},
year = {2026},
month = aug,
doi = {10.1186/s12902-026-02458-w},
url = {https://europepmc.org/article/MED/42963552},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Monocyte-to-high-density lipoprotein cholesterol ratio and carotid atherosclerosis in patients with metabolic dysfunction-associated steatotic liver disease: a comparative analysis of systemic inflammatory indices.
AU - Mingyue Qu
AU - Yang Qu
AU - Haixia Huang
AU - Yang Luo
AU - Xiaona Wang
AU - Yang Wang
PY - 2026
DA - 2026/08/03
JO - BMC endocrine disorders
DO - 10.1186/s12902-026-02458-w
UR - https://europepmc.org/article/MED/42963552
AB - Background Systemic inflammation indices have been linked to carotid atherosclerosis (CAS); however, their comparative performance and relative independence within the metabolic-inflammatory milieu of metabolic dysfunction-associated steatotic liver disease (MASLD) remain unclear. We aimed to identify the inflammatory index showing the strongest and most consistent association with CAS and to exploratorily assess potential mediating pathways.Methods In this cross-sectional study of 24,683 adults with MASLD, eight systemic inflammation indices were calculated. Associations with ultrasonography-defined CAS were evaluated using multivariable logistic regression. All indices were entered into a mutually adjusted model to identify the most independent marker. Dose-response relationships, subgroup analyses, and exploratory mediation analyses were performed.Results After full adjustment, the monocyte-to-high-density lipoprotein cholesterol ratio (MHR) showed the strongest association with CAS (odds ratio [OR] per 1-standard deviation increase: 1.092, 95% confidence interval [CI] 1.054-1.132). In the mutually adjusted model including all eight indices, only MHR remained independently associated with CAS (OR: 1.062, 95% CI 1.005-1.123). The MHR-CAS association was linear (P for nonlinearity = 0.416) and stronger among individuals without hypertension (P for interaction = 0.027). Exploratory mediation analysis suggested that approximately 4.0% of the association was statistically mediated by fasting plasma glucose (FPG)-related pathways, observed exclusively in non-lean MASLD.Conclusion Among commonly used systemic inflammation indices, MHR appears to be a robust and independent marker associated with carotid atherosclerosis in MASLD. Its association is linear, modified by hypertension status, and modestly linked to glucose-related pathways in a phenotype-specific manner, supporting its potential role as a complementary biomarker for vascular risk stratification in MASLD.Clinical trial number Not applicable.
SN - 1472-6823
ER -