Association of monocyte-to-high-density lipoprotein cholesterol ratio with peripheral artery disease and long-term mortality

Abstract

Background

This study aims to investigate the association of monocyte-to-high-density lipoprotein cholesterol ratio (MHR) with peripheral artery disease (PAD) and long-term mortality.

Methods

Data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004 were analyzed, with mortality follow-up tracked via the National Death Index until December 31, 2019. Logistic regression was used to examine the relationship between MHR and PAD, while Cox proportional hazards regression assessed the association of MHR with mortality in individuals with PAD.

Results

A total of 6319 participants were included, among whom 550 were identified as having PAD. In weighted multivariate logistic regression analysis, participants in the third (odds ratio [OR]: 1.031, 95% confidence interval [CI]: 1.009–1.053, p = 0.007) and fourth (OR: 1.034, 95% CI: 1.011–1.057, p = 0.006) quartiles of MHR demonstrated significantly higher risks of PAD compared to those in the first quartile. Among PAD individuals, during a median follow-up period of 136 (71, 197) months, 422 deaths occurred. Higher MHR was associated with an increased risk of long-term mortality in females (hazard ratio [HR]: 1.695, 95% CI: 1.222–2.350, p = 0.002) but not in males (HR: 0.761, 95% CI: 0.554–1.044 p = 0.090).

Conclusions

Elevated MHR is independently associated with PAD among U.S. population. The association between MHR and long-term prognosis of PAD exhibits gender differences, with a significant relationship observed between elevated MHR and long-term mortality risk in females, but not in males.