Monocyte-to-HDL cholesterol ratio (MHR) as a novel Indicator of gout risk

Gout, a common inflammatory arthritis, is associated with elevated monocyte levels and reduced high-density lipoprotein cholesterol (HDL-C). However, the relationship between the monocyte-to-HDL-C ratio (MHR) and gout risk remains unexplored. This study investigates the association between MHR and gout risk, examines the role of MHR in gout with comorbid renal dysfunction, and provides a theoretical basis for gout prevention and treatment. Using data from the National Health and Nutrition Examination Survey (NHANES, 2005-2016), a cross-sectional analysis was conducted to assess the correlation between MHR levels and gout. Multiple logistic regression, subgroup analyses, and exploration of nonlinear relationships were employed. Among 7247 participants, MHR was significantly higher in gout patients (0.54 ± 0.31) compared to non-gout patients (0.47 ± 0.24). After adjustments, MHR was significantly associated with gout risk (OR = 1.6, 95%CI 1.1-2.2, P = 0.012). Subgroup analyses revealed a positive correlation between MHR and gout risk in males, Mexican Americans, married individuals, those with insufficient physical activity, and diabetic patients. In gout patients with renal dysfunction, MHR was 0.6 ± 0.5, showing a stronger positive association (OR = 7.4, 95%CI 2.2-25.3, P = 0.001). The prevalence of gout with renal dysfunction in the highest MHR quartile was 1.7 times higher than in the lowest quartile (OR = 2.7, 95%CI 1.1-6.7, P = 0.028). These findings suggest a significant positive correlation between MHR and gout risk in U.S. adults, as well as a link between MHR and the severity of renal dysfunction in gout patients. MHR may serve as a valuable indicator for assessing gout risk and its complications, highlighting the need for further large-scale prospective studies to confirm these results.