Association Between Monocyte-to-High Density Lipoprotein-Cholesterol Ratio and COPD Among US Adults: Findings from NHANES 1999–2018

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Xiaohua Li,* Xianhong Chi,* Xinyan Chen, Mingsi Huang, Mianluan Pan, Zhimin Peng, Weibin Ruan, Yaqin Wei, Jiehua Deng, Ziqing Mai, Mengxin Tang, Haojun Sha, Jianquan Zhang Department of Respiratory and Critical Medicine, the Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong Province, 518000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jianquan Zhang, Email jqzhang2002@126.comBackground: The monocyte to high-density lipoprotein–cholesterol ratio (MHR) has been significantly associated with inflammation. However, there is a paucity of research exploring the association between MHR and the susceptibility to chronic obstructive pulmonary disease (COPD).Methods: The study cohort comprised participants from ten cycles of the National Health and Nutrition Examination Survey, covering the period from 1999 to 2018. COPD was identified through self-reported diagnoses. Mobile Examination Center weights were applied in accordance with guidelines from National Center for Health Statistics. The multivariate logistic regression analysis was conducted to determine the association between MHR and COPD. Restricted cubic spline curves were employed to investigate the potential dose–response relationship between COPD and MHR. Subgroup analyses and interaction tests were finally performed.Results: The study included a total of 39,646 participants, including 2,876 COPD participants. After controlling for all potential covariates, weighted logistic regression analysis demonstrated a significant association between MHR and COPD. When MHR was treated as a categorical variable, the risk of COPD increased significantly after adjusting for all potential covariates. The dose–response curve suggested a non-linear relationship between MHR and COPD risk. Subgroup analysis revealed significant interactive effects between MHR and COPD among individuals with varying BMI, marital status and smoking status.Conclusion: MHR was significantly associated with COPD among US adults. There is a need for further longitudinal cohort studies to explore the relationship between MHR and COPD. Keywords: chronic obstructive pulmonary disease, monocyte-to-high density lipoprotein–cholesterol ratio, NHANES, inflammation, monocytes, HDL-C

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