Nonlinear Association Between Monocyte-to-HDL Ratio and Mortality in COPD: Evidence from NHANES

作者：Tulei Tian, Tianyu She, Xiangkun Qu, Rui Li · 发表于：International Journal of COPD · 年份：2025 · DOI：10.2147/copd.s563173 · 被引用次数：1 · 研究领域：Chronic Obstructive Pulmonary Disease (COPD) Research、Inflammatory Biomarkers in Disease Prognosis、Pulmonary Hypertension Research and Treatments

Background: Chronic Obstructive Pulmonary Disease (COPD) represents a leading cause of mortality worldwide, with systemic inflammation being a key pathological feature. The association between the emerging inflammatory marker monocyte to high-density lipoprotein cholesterol ratio (MHR) and the risk of all-cause mortality in COPD patients remains unclear. Methods: Data from COPD patients in the 1999-2018 NHANES database were analyzed using Cox regression models to assess the association between MHR and all-cause mortality risk. Restricted cubic spline (RCS) modeling was used to explore nonlinear associations and identify inflection points. Time-dependent ROC curves were utilized to evaluate the predictive accuracy of MHR. Subgroup and sensitivity analyses were performed to ensure the robustness of the results. Results: This study included 1768 COPD patients and observed 606 all-cause deaths during a mean follow-up of 92 months. After adjusting for confounding factors, MHR level was significantly and positively associated with all-cause mortality risk (HR = 2.10, 95% CI: 1.53-2.89). RCS analysis revealed a nonlinear relationship between MHR and all-cause mortality risk (non-linear P = 0.004). A turning point analysis indicated a threshold effect of MHR at 0.29: mortality risk increased significantly above this value (HR = 2.52, P < 0.001) and decreased significantly below it (HR = 0.02, P = 0.006). Sex-stratified analysis showed that the association between MHR and mortality ri...