MHR Was Associated with Hyperuricemia Risk in Patients with Type 2 Diabetes Mellitus: The Mediating Effect of Body Mass Index.

Abstract

Background: The monocyte-to-high-density lipoprotein cholesterol ratio (MHR) reflects systemic inflammation, combining the pro-inflammatory role of monocytes with the anti-atherogenic and anti-inflammatory properties of HDL-cholesterol. Prior studies have established MHR as an independent predictor of hyperuricemia (HUA) prevalence. Emerging evidence further identifies MHR as a potential biomarker for early type 2 diabetes mellitus (T2DM) screening, likely mediated through its association with insulin resistance. Therefore, our study specifically investigates the relationship between MHR and HUA in a T2DM population.

Methods: This cross-sectional study enrolled 1,261 T2DM patients. Logistic regression assessed associations between MHR and HUA. Mediation analysis evaluated body mass index (BMI) as a mediator. Restricted cubic spline (RCS) analysis examined nonlinear relationships. Receiver operating characteristic (ROC) curves compared predictive performance.

Results: Elevated MHR (adjusted OR = 2.040, 95% CI: 1.023 to 4.071, p < 0.05) was independently associated with HUA risk. BMI mediated 18.59% of the associations for MHR, respectively. RCS analysis revealed nonlinear patterns, with HUA risk increasing notably when MHR > 0.47. In ROC analysis, MHR demonstrated significant predictive ability for HUA, with an area under the curve (AUC) of 0.62.

Conclusion: Higher MHR was significantly associated with HUA risk in T2DM patients, with BMI serving as a key mediator. These markers may aid in early identification of patients at risk and underscore the importance of weight and inflammation control in HUA prevention.