Associations of the Monocyte to High-Density Lipoprotein Cholesterol Ratio With Stroke Prevalence and All-Cause...

Monocyte to high-density lipoprotein cholesterol ratio (MHR) is a biomarker of inflammation and metabolic disorders. However, the correlation between MHR and stroke is not well-studied. This study aims to examine how MHR correlates with stroke prevalence and prognosis.

We used cross-sectional and longitudinal methods to analyze data from the National Health and Nutrition Examination Survey (NHANES) spanning 2009-2018. The subjects were divided into four groups based on the MHR quartiles. We evaluated the correlation between MHR and the incidence of stroke through weighted multivariate logistic regression and curve fitting. In order to test whether there were differences between the different subgroups, stratified analyses were constructed, and the capacity of MHR to predict stroke was assessed using receiver operating characteristic (ROC) curves. Furthermore, we explored the connection between MHR and all-cause mortality by performing Cox proportional hazards models and Kaplan-Meier survival curves in stroke individuals.

We had a total of 17,161 adult participants with a mean age of 49.07 ± 17.58 years of which 593 were diagnosed with stroke, with a prevalence of 3.46%. MHR was found to have a positive correlation with the incidence of stroke when fully adjusting for potential confounding variables. For each unit increase in MHR, the probability of stroke is elevated by 61% (OR: 1.61; 95% CI, 1.17-2.44, p = 0.022). Curve fitting analysis revealed a linear relationship between baseline MHR index and stroke (nonlinearity p = 0.963). Subgroup analyses indicated that most stratified variables did not significantly interact with the relationship between MHR and stroke, but the effect of MHR was stronger in individuals without coronary heart disease. Furthermore, weighted Cox regression analyses revealed that the odds of all-cause mortality 72% higher (HR: 1.72; 95% CI, 1.16-2.78, p = 0.027) for stroke patients in the highest quartile (Q4), compared with the lowest quartile (Q1) of MHR. Kaplan-Meier curves revealed that all-cause mortality significantly increased as MHR index values rose.

In this cross-sectional study of US adults, MHR maintains a linear positive relationship with stroke. In addition, MHR can help predict long-term mortality in individuals with stroke. The analyses demonstrate that MHR may serve as an effective predictor of stroke and its mortality.