Association Between Monocyte-to-High-Density Lipoprotein Cholesterol Ratio And Severity Of Coronary Artery Disease In Non-Alcoholic Fatty Liver Disease Patients

Objective:The purpose of this study was to evaluate the nonalcoholic fatty liver disease(NAFLD)in patients with inflammatory biomarkers MHR and the relationship between coronary artery disease(CAD).Methods:We conducted a retrospective study of 612 patients with NAFLD who underwent ultrasound-confirmed percutaneous coronary intervention(PCI).All patients were divided into NAFLD + CAD group and NAFLD + non-CAD group.Binary logistic regression analysis was used to identify risk and protective factors associated with CAD,and restricted cubic splines(RCS)were used to confirm the correlation between the MHR index and CAD risk.Receiver operating characteristic(ROC)curve was constructed to evaluate the predictive value of MHR to CAD.Trend Chi-square test was used to analyze the distribution of Gensini scores in different levels of MHR.In addition,multiple linear regression method was used to evaluate the relationship between Gensini score and MHR index.Results:A total of 336 patients with CAD and 277 patients without CAD were included in the study.Univariate analysis showed that patients with CAD had higher MHR than those without CAD(P < 0.001).Meanwhile,compared with patients with NAFLD alone,MHR remained an independent risk factor for CAD after adjusting for confounding risk factors(OR = 14.58,95%CI,3.97-53.58,P <0.001).NHR,NLR and MON were also independent risk factors for CAD.RCS showed that the risk of CAD increased linearly with increasing MHR(P nonlinear>0.05)over the entire range of MHR.ROC curves showed that MHR or other inflammatory markers combined with traditional risk factors improved the ability to predict CAD.In further studies,trend chi-square showed that higher MHR predicted more severe CAD(P for trend < 0.05).Multivariate linear regression analysis showed that for every 1 unit increase in Log MHR in NAFLD-CAD group,Gensini score increased by 14.78 points(β=14.78;95%CI,7.47-22.08;P<0.001).Conclusion:The MHR was positively associated with CAD risk among NAFLD patients and reflected the severity of coronary atherosclerosis.