Abstract
Background: The escalating prevalence of childhood obesity has rendered pediatric metabolic-associated fatty liver disease (MAFLD) one of the foremost health concerns. Objectives: This investigation aims to examine the relationship between MAFLD and the monocyte-to-high-density lipoprotein cholesterol ratio (MHR) in children and adolescents with obesity. Methods: In this retrospective study, we conducted a comparative analysis of MHR values for MAFLD and non-MAFLD cases in children and adolescents with obesity, aged 6 - 18, from 1 October, 2022 to 30 September 2023. To determine the prognostic value of MHR in relation to MAFLD, we implemented ROC analysis. Additionally, logistic regression analysis was utilized to examine the association between each variable and MAFLD. Results: A total of 211 children diagnosed with obesity (67 boys and 144 girls) were included in the study, comprising 121 MAFLD patients and 90 simple obesity controls. The monocyte/HDL-C ratio was significantly higher in the MAFLD group compared to the simple obesity group (0.56 ± 0.19 vs. 0.46 ± 0.14, P < 0.001). There was a positive correlation between MHR and fasting insulin, HOMA-IR, TG/HDL-C, TyG, triglyceride levels, and the grade of hepatosteatosis (P = 0.011, r = 0.184; P = 0.029, r = 0.159; P < 0.001, r = 0.374; P = 0.005, r = 0.203; P < 0.001, r = 0.257; P < 0.001, r = 0.272, respectively). The ROC curve analysis revealed that the cut-off value for MHR to predict MAFLD was 0.43 (× 109/mmol), with a sensitivity of 75.45% and a specificity of 46.34%. The area under the curve for MHR in distinguishing children with MAFLD from those without was 0.656 (P = 0.002). Logistic regression analysis indicated that male gender (OR: 3.825; P = 0.001), high ALT (OR: 1.035; P = 0.025), and high MHR (OR: 16.166; P = 0.025) had significant positive associations with the presence of MAFLD. Conclusions: We established a correlation between MHR and MAFLD in children and adolescents with obesity. High MHR was significantly related to the risk of MAFLD. The monocyte/HDL-C ratio, a noninvasive marker, may be used as an inflammatory biomarker in predicting MAFLD.
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