关键词: 2型糖尿病, 单核细胞/高密度脂蛋白胆固醇比值, 体质量指数, 胰岛素抵抗

Abstract: Objective  To explore the value of monocyte/high density lipoprotein-cholesterol ratio (MHR) combined with body mass index (BMI) in evaluating insulin resistance (IR) in the patients with newly diagnosed type 2 diabetes mellitus (T2DM). Methods  A total of 400  T2DM patients who were newly diagnosed in Department of Endocrinology, Beijing Friendship Hospital, Capital Medical University, were enrolled in the study from January 2022 to December 2023. The inflammatory markers included white blood cell, neutrophile granulocyte, lymphocyte, monocyte and high sensitivity C-reactive protein (HsCRP) were examined, together with metabolic indicators included blood glucose, insulin and lipid. According to median value of homeostasis model assessment of insulin resistance (HOMA-IR), participants were divided into high-HOMA-IR and low-HOMA-IR group. According to the MHR tertiles, three groups were divided into Q1(MHR≤0.25)、Q2(0.25<MHR≤0.34) and Q3(MHR>0.34) for analysis and comparison. Spearman correlation analysis and multiple logistic regression were used to analyze the relationship between MHR, BMI and IR. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy of MHR combined with BMI on IR.  Results  Both the HsCRP level ［2.77 (1.06，5.46) vs 1.43(0.69, 2.94), P<0.001］ and the MHR in high-HOMA-IR group ［0.32 (0.26, 0.41) vs 0.27 (0.21, 0.34)］ was significantly higher than that of low-HOMA-IR group (P<0.001). HOMA-IR in MHR Q3 group was significantly higher than that in Q2 and Q1 groups (P<0.001). Spearman correlation analysis showed that HOMA-IR was positively correlated with MHR (r=0.294, P<0. 001)、HsCRP (r=0.281, P<0. 001) and BMI (r=0.501, P<0.001). Logistic regression analysis showed that MHR and BMI were independent influencing factors of HOMA-IR, the OR values are respectively 1.766(95%CI:1.189-2.625, P= 0.005) and 1.192 (95%CI:1.052-1.351, P = 0.006).  ROC curve analysis showed that compared with MHR and BMI, the area under ROC curve by the combined coefficient of MHR and BMI was the largest 0.754 (95%CI:0.706-0.801), with the highest efficiency in the diagnosis of insulin resistance.  Conclusions  MHR combined with BMI has a higher efficiency for evaluating IR in the patients with newly diagnosed T2DM, which could be used as a simple indicator to evaluate IR in these patients.

Key words: type 2 diabetes mellitus, monocyte to high density lipoprotein-cholesterol ratio, body mass index, insulin resistance