Gout, a prevalent form of inflammatory arthritis, is often linked to increased monocyte levels and decreased high-density lipoprotein cholesterol (HDL-C). Despite these known associations, the potential of the monocyte-to-HDL-C ratio (MHR) as a marker for gout risk has not been thoroughly examined.
To address this gap, Ke Xu, Tongji Shanxi Hospital, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Taiyuan, China, and colleagues explore the relationship between MHR and the risk of developing gout, with a particular focus on cases complicated by renal dysfunction. The findings aim to offer a theoretical foundation that could support improved strategies for managing and preventing gout.
For this purpose, the researchers conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES, 2005–2016) to examine the association between monocyte-to-HDL-C ratio (MHR) levels and gout. They employed multiple logistic regression models, performed subgroup analyses, and explored potential nonlinear relationships to better understand the correlation and its implications.
The study revealed the following findings:
- Among 7,247 participants, gout patients had significantly higher MHR levels (0.54 ± 0.31) than those without gout (0.47 ± 0.24).
- After adjusting for confounding factors, a significant association was observed between elevated MHR and increased gout risk (OR = 1.6).
- Subgroup analysis showed a positive correlation between higher MHR and gout risk in males, Mexican Americans, married individuals, people with insufficient physical activity, and those with diabetes.
- In gout patients with renal dysfunction, MHR levels were even higher (0.6 ± 0.5), with a stronger association with gout risk (OR = 7.4).
- The prevalence of gout with renal dysfunction was 1.7 times higher in participants in the highest MHR quartile compared to those in the lowest quartile (OR = 2.7).
“These findings indicate a strong positive correlation between the monocyte-to-HDL-C ratio (MHR) and gout risk in U.S. adults, along with a clear association between MHR levels and the severity of renal dysfunction in individuals with gout,” the authors wrote. They added that the results underscore the potential of MHR as a valuable biomarker for assessing both the risk and complications of gout, including renal involvement.
They concluded that incorporating MHR into clinical evaluations could improve the management of gout. However, they emphasized the need for large-scale prospective studies to validate these findings and further explore their clinical applicability.
Reference:
Mi, L., He, X., Gao, J. et al. Monocyte-to-HDL cholesterol ratio (MHR) as a novel Indicator of gout risk. Sci Rep 15, 12188 (2025). https://doi.org/10.1038/s41598-025-97373-w
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