Objective To investigate the relationship between the ratio of monocyte to high-density lipoprotein cholesterol(MHR)and non-alcoholic fatty liver disease(NAFLD)in patients with type 2 diabetes mellitus(T2DM)and gouty arthritis(GA),and to analyze the influencing factors of NAFLD.Methods A total of 214 patients with T2DM and GA hospitalized in The First Clinical Medical School of Anhui University of Chinese Medicine from December 2019 to December 2022 were enrolled,who were divided into NAFLD group and non-NAFLD group according to whether they had NAFLD or not.General data and laboratory indicators of the two groups were compared.Subgroup analysis was performed in NAFLD group according to HOMA-IR level.They were divided into Qi MHR,Q2MHR and Q3MHR groups according to the MHR tertile,and the differences in HOMA-IR levels and the incidence of NAFLD among the Q1MHR,Q2MHR and Q3MH groups were compared.Logistic regression analysis was performed to analyze the risk factors of NAFLD in T2DM patients with GA,and Receiver Operating Characteristic Curve(ROC)was used to evaluate the clinical value of MHR in T2DM patients with GA.Results Compared with non-NAFLD group,Fins,HOMA-IR,AST,ALT,TG,CRP,MON and MHR in NAFLD group were increased(P＜0.05),while HDL-C decreased(P＜0.05).In NAFLD group,compared with HOMA-IR＜2.5 subgroup,BMI,WHR,FPG,SUA,TC,TG,LDL-c,CRP,MON and MHR levels in HOMA-IR≥2.5 subgroup were increased(P＜0.05).According to the MHR tertile,the level of HOMA-IR in Q3MHR[4.67(2.93,7.29)]subgroup was significantly higher than that in Q1MHR[3.44(1.85,4.89)]and Q2MHR[4.15(2.13,6.03)]subgroup(P＜0.05).The incidence of NAFLD in Q3MHR subgroup was higher than that in Q1MHR and Q2MHR subgroups(74.51％vs.23.08％,39.22％,P＜0.05)and Q2MHR subgroup was higher than Q1MHR subgroup(39.22％vs.23.08％,P＜0.05).Multivariate Logistic regression analysis showed that LDL-c,CRP and MHR were risk factors for NAFLD in T2DM patients with GA(P＜0.05).ROC curve results showed that the area under the curve(AUC)of MHR in predicting NAFLD in T2DM patients with GA was 0.759,with a sensitivity of 72.9％and a specificity of 71.4％.Conclusion MHR is correlated with the occurrence of NAFLD in patients with T2DM and GA.Moreover,MHR has some predictive value for the occurrence of NAFLD in T2DM patients with gouty arthritis.
type 2 diabetes mellitusgouty arthritismonocyte/HDL cholesterol rationon-alcoholic fatty liver disease
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