The Relationship Between Monocyte/High-Density Lipoprotein Cholesterol Ratio and Microvascular Complications in Patients with Type 2 Diabetes Mellitus

Yıl 2026, Cilt: 16 Sayı: 1, 23 - 28, 19.03.2026

Ahmet Düzgün , Eyyüp Çavdar , Nida Öztop , Egemen Cebeci , Namık Yiğit

https://izlik.org/JA94NT69TT

Öz

Aim: This study investigates the relationship between the monocyte-
to-high-density lipoprotein cholesterol ratio (MHR) and microvascular
complications (nephropathy, retinopathy, and neuropathy)
in patients with type 2 diabetes mellitus (T2DM). With the
increasing global burden of diabetes and its associated complications,
identifying simple and accessible biomarkers for early prediction
and management is of great importance.
Materials and Methods: The data of 229 T2DM patients who applied
to the internal medicine and diabetes outpatient clinics of
Haseki Training and Research Hospital between June 1, 2012, and
June 1, 2017, were retrospectively analyzed. Demographic, clinical,
and laboratory data, including MHR values, were collected.
Statistical analyses were performed using IBM Statistical Package
for Social Sciences (SPSS) program version 23.0, and a significance
level of p<0.05 was considered. The Mann-Whitney U test
was used for data that did not show a normal distribution.
Results: Of the 229 patients included in the study, 52.8% were female,
and the mean age was 56.7 years. Diabetic retinopathy (DRP)
was detected in 28.8% of the patients, diabetic nephropathy (DN)
in 34.5%, and diabetic neuropathy in 42.8%. A statistically significant
relationship was found between MHR and DRP (p=0.015) and
between MHR and DN (p<0.001); however, no significant association
was found between MHR and neuropathy (p=0.124).
Conclusion: Monocyte-to-high-density lipoprotein cholesterol ratio
may be a useful and easily calculable marker for predicting diabetic
retinopathy and nephropathy in patients with type 2 diabetes.
However, no significant relationship was found between MHR and
diabetic neuropathy. Further prospective studies are needed to
confirm the prognostic value of MHR in clinical practice.
Key words: monocyte-to-HDL cholesterol ratio; type 2 diabetes mellitus;
microvascular complications; diabetic nephropathy; diabetic retinopathy;
diabetic neuropathy

Anahtar Kelimeler

Monocyte-to-HDL cholesterol ratio , type 2 diabetes mellitus , microvascular complications , diabetic nephropathy , diabetic retinopathy , diabetic neuropathy

Kaynakça

• 1. Du QH, Zhang ZC, Yang Y, Luo XX, Liu L, Jia HH. How health seeking behavior develops in patients with type 2 diabetes: a qualitative study based on health belief model in China. Front Public Health. 2024;12:1414903. https://doi.org/10.3389/fpubh.2024.1414903
• 2. Cole JB, Florez JC. Genetics of diabetes mellitus and diabetes complications. Nat Rev Nephrol. 2020;16(7):377–390. https://doi.org/10.1038/s41581-020-0278-5
• 3. He Z, King GL. Microvascular complications of diabetes. Endocrinol Metab Clin North Am. 2004;33(1):215–238. https://doi.org/10.1016/j.ecl.2003.12.003
• 4. Crasto W, Patel V, Davies MJ, Khunti K. Prevention of microvascular complications of diabetes. Endocrinol Metab Clin North Am. 2021;50(3):431–455. https://doi.org/10.1016/j.ecl.2021.05.005
• 5. Calles-Escandon J, Cipolla M. Diabetes and endothelial dysfunction: a clinical perspective. Endocr Rev. 2001;22(1):36–52. https://doi.org/10.1210/edrv.22.1.0417
• 6. Bayraktutan U. Free radicals, diabetes and endothelial dysfunction. Diabetes Obes Metab. 2002;4(4):224–238. https://doi.org/10.1046/j.1463-1326.2002.00184.x
• 7. Auffray C, Sieweke MH, Geissmann F. Blood monocytes: development, heterogeneity, and relationship with dendritic cells. Annu Rev Immunol. 2009;27:669–692. https://doi.org/10.1146/annurev.immunol.021908.132557
• 8. Lowenstein CJ, Cameron SJ. High-density lipoprotein metabolism and endothelial function. Curr Opin Endocrinol Diabetes Obes. 2010;17(2):166–170. https://doi.org/10.1097/MED.0b013e32833727ee
• 9. Çetiner Ö, Rakıcıoğlu N. Hiperglisemi, oksidatif stres ve tip 2 diyabette oksidatif stres belirteçlerinin tanımlanması. Turk J Diab Obes. 2020;4(1):60–68. https://doi.org/10.25048/tudod.638744
• 10. Arslan S, Erdoğdu Hİ, Atalay E. Tip 2 diyabetes mellitus hastalarında HbA1c ile serum magnezyum düzeylerinin karşılaştırılması: relationship between HbA1c and serum magnesium levels in patients with type 2 diabetes mellitus. Kafkas J Med Sci. 2021;11(1):125–130. https://doi.org/10.5505/kjms.2021.68878
• 11. Liu X, Zhang Y, Jin F, Liu H, Li Q, Gao Y, et al. Correlation between GPR, MHR and elderly essential hypertension with unstable angina pectoris. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2021;46(4):373–378.
• 12. Du GL, Liu F, Liu H, Meng Q, Tang R, Li XM, et al. Monocyte-to-high density lipoprotein cholesterol ratio positively predicts coronary artery disease and multi-vessel lesions in acute coronary syndrome. Int J Gen Med. 2023;16:3857–3868. https://doi.org/10.2147/IJGM.S419579
• 13. Balta S, Celik T, Ozturk C, Kaya MG, Aparci M, Yildirim AO, et al. The relation between monocyte to HDL ratio and no-reflow phenomenon in the patients with acute ST-segment elevation myocardial infarction. Am J Emerg Med. 2016;34(8):1542–1547. https://doi.org/10.1016/j.ajem.2016.05.031
• 14. Yıldırım ÖT, Akşit E, Aydın F, Hüseyinoğlu Aydın A. Üçüncü basamak bir merkezde diabetes mellitus hastalarının önerilen LDL-K hedefine ulaşma düzeyleri. Kafkas J Med Sci. 2019;9(1):29–33. https://doi.org/10.5505/kjms.2019.45556
• 15. Aiello LM. Perspectives on diabetic retinopathy. Am J Ophthalmol. 2003;136(1):122–135. https://doi.org/10.1016/S0002-9394(03)00219-8
• 16. Erdem B, Kaya Y. Prediction of diabetic retinopathy in patients with type 2 diabetes mellitus by using monocyte to high-density lipoprotein-cholesterol ratio. Int J Diabetes Dev Ctries. 2022;42:741–746. https://doi.org/10.1007/s13410-021-01024-5
• 17. Tang X, Tan Y, Yang Y, Li M, He X, Lu Y, et al. Association of the monocyte-to-high-density lipoprotein cholesterol ratio with diabetic retinopathy. Front Cardiovasc Med. 2021;8:707008. https://doi.org/10.3389/fcvm.2021.707008
• 18. Batioğlu F, Yanık Ö, Abdullayev A. Diyabetik retinopati epidemiyolojisi. Turkiye Klinikleri J Ophthalmol Spec Top. 2014;7(2):12–20.
• 19. Fang YQ, Wang WW, Liu HH, Tang FL, Yau-Jiunn TJ, Lou QQ. [Correlation between weight variability and the risk of diabetic nephropathy in patients with type 2 diabetes mellitus]. Zhonghua Yi Xue Za Zhi. 2024;104(10):742–750. https://doi.org/10.3760/cma.j.cn112137-20230724-00081
• 20. Bonakdaran S, Hami M, Hatefi A. The effects of calcitriol on albuminuria in patients with type 2 diabetes mellitus. Saudi J Kidney Dis Transpl. 2012;23(6):1215–1220. https://doi.org/10.4103/1319-2442.103562
• 21. Xu L, Li D, Song Z, Liu J, Zhou Y, Yang J, et al. The association between monocyte to high-density lipoprotein cholesterol ratio and chronic kidney disease in a Chinese adult population: a cross-sectional study. Ren Fail. 2024;46(1):2331614. https://doi.org/10.1080/0886022X.2024.2331614
• 22. Karatas A, Turkmen E, Erdem E, Dugeroglu H, Kaya Y. Monocyte to high-density lipoprotein cholesterol ratio in patients with diabetes mellitus and diabetic nephropathy. Biomark Med. 2018;12(9):953–959. https://doi.org/10.2217/bmm-2018-0048
• 23. Saini DC, Kochar A, Poonia R. Clinical correlation of diabetic retinopathy with nephropathy and neuropathy. Indian J Ophthalmol. 2021;69(11):3364–3368. https://doi.org/10.4103/ijo.IJO_1237_21
• 24. Jia S, Yang H, Huang F, Fan W. Systemic inflammation, neuroinflammation and perioperative neurocognitive disorders. Inflamm Res. 2023;72(9):1895–1907. https://doi.org/10.1007/s00011-023-01792-2
• 25. Said G. Focal and multifocal diabetic neuropathies. Arq Neuropsiquiatr. 2007;65(4B):1272–1278. https://doi.org/10.1590/S0004-282X2007000700037
• 26. Gökçay Canpolat A, Emral R, Keskin Ç, Canlar Ş, Şahin M, Çorapçioğlu D. Association of monocyte-to-high density lipoprotein-cholesterol ratio with peripheral neuropathy in patients with type II diabetes mellitus. Biomark Med. 2019;13(11):907–915. https://doi.org/10.2217/bmm-2018-0451
• 27. Terzi DM, Cengiz DN, Onar DMK. Diyabetik nöropati. J Exp Clin Med. 2009;21(1):39–49.