The Utility of Monocyte-to-High-Density Lipoprotein- Cholesterol Ratio (MHR) in Estimating Renal Function Impairment: Cross-Sectional Data from the National Health and Nutrition Examination Survey (NHANES) 2007-2018

Abstract

Abstract Background Monocyte-to-high-density lipoprotein-cholesterol ratio (MHR) is a good marker to evaluate the development and progression of atherosclerosis. There is a close correlation between atherosclerosis and renal function. However, the predictive values of MHR for renal function impairment have been underutilized. This study investigated the association of MHR with renal function impairment in the adult population of the United States. Methods This study included 31909 participants (≥ 18 years) from the National Health and Nutrition Examination Survey 2007–2018 that were grouped according to MHR tertiles. The estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) were calculated as the main indexes of renal function impairment were employed to investigate differences among the groups. Moreover, the relationship of MHR with renal function impairment was further explored using multivariate logistic regression and restricted cubic spline analysis. Results The MHR tertile ranges are: <0.009, 0.009–0.013, > 0.013. There were statistically significant differences in all baseline variables between MHR groups (all P < 0.05). Overall, heightened MHR levels correlated positively with diminished eGFR as well as the presence of microalbuminuria (eGFR: OR:1.23, 95%CI:1.02–1.48, P = 0.03; microalbuminuria: OR:1.17, 95%CI: 1.01–136, P = 0.04), and there was no significant association with macroalbuminuria after fully adjusting for covariates. Segmenting MHR into tertiles unveiled that the middle tertile (Q2) bore no marked correlation with the trio of outcomes in contrast to the first tertile (Q1). Conversely, the third tertile (Q3) exhibited an amplified association with a reduced eGFR and the onset of microalbuminuria (eGFR: OR:1.52,95%CI:1.06–2.18, P = 0.03; microalbuminuria: OR:1.38, 95%CI: 1.01–1.87, P = 0.04). In RCS model, MHR was still correlated with decreased eGFR and microalbuminuria (P− overall<0.05), but not with macroalbuminuria, and the correlation between MHR and decreased eGFR was non-linear (P− non linear<0.05). In addition, in subgroup analysis, there was a stronger association in populations such as women and hypertension. Conclusions MHR was significantly related to decreased eGFR and microalbuminuria in the general population and this relationship appears even more pronounced in particular demographic subsets.