Background Diabetic nephropathy (DN) is a major microvascular complication of diabetes mellitus and a leading cause of chronic kidney disease worldwide. Inflammation and dyslipidemia play central roles in its pathogenesis. The monocyte‐to‐high‐density lipoprotein cholesterol ratio (MHR) has emerged as a composite biomarker integrating proinflammatory and anti‐inflammatory pathways, but its association with DN has not been systematically synthesized. Objective This systematic review and meta‐analysis evaluated the association between MHR and DN and quantified the differences in MHR between diabetic patients with and without nephropathy. Methods A comprehensive literature search of PubMed, the Cochrane Library, and Google Scholar was conducted from inception to 2025. Observational studies reporting MHR in adult diabetes mellitus patients with and without DN were included. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were pooled using random effects models. Heterogeneity was assessed using the I 2 statistic. Risk of bias was evaluated using the Newcastle–Ottawa Scale, and publication bias was examined using funnel plots and Egger′s test. Results (9) observational studies comprising 1797 participants were included. Across most studies, MHR was significantly higher in patients with DN compared with those without DN. The pooled analysis demonstrated a significantly elevated MHR in the DN group, with a positive SMD favoring DN. Substantial between‐study heterogeneity was observed. Risk of bias was low to moderate in most studies. Funnel plot inspection and Egger′s regression test did not indicate significant publication bias ( p = 0.486). Conclusions This meta‐analysis demonstrates that MHR is significantly elevated in patients with DN, supporting its role as a marker of inflammation–lipid imbalance in diabetic kidney disease. Given its availability from routine laboratory parameters, MHR may serve as a practical adjunct biomarker for DN risk stratification.
Goumboundi et al. (Thu,) studied this question.