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Published on: October 17, 2017
Sex-Specific Associations of Monocyte-Based Inflammatory Indices with Renal Dysfunction and Hyperuricemia in the
Hamood AlSudais1, Dalal Alsowaida1, Rehab B Albakr2
1Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia.
Insights
The monocyte-to-high-density lipoprotein cholesterol ratio (MHR) is a key indicator for kidney dysfunction and high uric acid levels. This simple marker shows significant sex-specific differences in risk assessment for the Saudi population.
Area of Science:
- Nephrology
- Clinical Biochemistry
- Epidemiology
Background:
- Chronic kidney disease (CKD) presents a significant global health challenge, often linked to chronic inflammation.
- Monocyte-based inflammatory indices like MHR, MLR, and MNR are implicated in metabolic and inflammatory conditions.
- The specific associations of these indices with renal dysfunction and hyperuricemia, particularly sex-specific variations, require further investigation.
Purpose of the Study:
- To investigate the relationship between monocyte-to-high-density lipoprotein cholesterol ratio (MHR), monocyte-to-lymphocyte ratio (MLR), and monocyte-to-neutrophil ratio (MNR) with renal dysfunction and hyperuricemia.
- To explore potential sex-specific differences in these associations within the Saudi general population.
Main Methods:
- A retrospective cross-sectional study involving 9657 Saudi adults.
- Calculation of estimated glomerular filtration rate (eGFR) using the 2021 CKD-EPI equation.
- Sex-stratified analysis including correlation, risk assessment, ROC analysis, and regression modeling to examine associations.
Main Results:
- The monocyte-to-high-density lipoprotein cholesterol ratio (MHR) emerged as the most robust marker for renal dysfunction.
- Significant sex-specific differences were observed: higher MHR and MLR correlated with reduced eGFR in females, while lower MHR, MLR, and MNR correlated with reduced eGFR in males.
- MHR demonstrated the strongest association with hyperuricemia in both sexes and maintained an independent inverse relationship with eGFR.
Conclusions:
- MHR is a consistent and valuable index for assessing renal dysfunction and hyperuricemia.
- The findings highlight the importance of considering sex-specific differences when utilizing MHR for risk assessment.
- MHR offers a simple, accessible biomarker for sex-informed renal and metabolic risk evaluation in the general population.
Abstract:
Background/Objectives: Chronic kidney disease (CKD) is a major global health burden and is closely linked to persistent low-grade inflammation. Monocyte-based inflammatory indices, including the monocyte-to-high-density lipoprotein cholesterol ratio (MHR), monocyte-to-lymphocyte ratio (MLR), and monocyte-to-neutrophil ratio (MNR), have been associated with various metabolic and inflammatory disorders; however, their relationships with renal dysfunction and hyperuricemia remain insufficiently explored. This study examined the associations of these indices with renal dysfunction and hyperuricemia in the Saudi general population, with particular emphasis on sex-specific differences. Materials and Methods: This retrospective cross-sectional study included 9657 Saudi adults. Estimated glomerular filtration rate (eGFR) was calculated using the 2021 CKD-EPI creatinine equation. Associations of MHR, MLR, and MNR with reduced eGFR and hyperuricemia were examined using sex-stratified comparisons, correlation, risk assessment, receiver operating characteristic analysis, and regression modeling. Results: MHR was the strongest and most consistent marker associated with renal dysfunction. In females, reduced eGFR was associated with higher MHR and MLR, whereas in males it was associated with lower MHR, MLR, and MNR, indicating clear sex-specific divergence. Elevated MHR was associated with higher odds of reduced eGFR in females but lower odds in males. MHR also showed the strongest association with hyperuricemia in both sexes and remained independently inversely associated with eGFR. Conclusions: MHR showed the most consistent overall association with renal dysfunction and hyperuricemia among the evaluated indices. These findings suggest that MHR may provide a simple and accessible marker for sex-informed renal and metabolic risk assessment in the general population.
