Clinical Research Progress of the Ratio of Inflammatory Index Monocytes to High-density Lipoprotein Cholesterol in Postmenopausal Women with Osteoporosis

Fu Qin; Shunjin Wen; Hongcheng Yao; Jinggui Huang; Qiaoyin Ran

doi:10.54097/xgw58d73

Authors

Fu Qin
Shunjin Wen
Hongcheng Yao
Jinggui Huang
Qiaoyin Ran

DOI:

https://doi.org/10.54097/xgw58d73

Keywords:

Monocyte/HDL Cholesterol Ratio, Inflammation, Postmenopausal Osteoporosis, Bone Metabolism, Risk Prediction

Abstract

Postmenopausal osteoporosis is a major disease causing fractures and disability in elderly women, and its onset is closely related to chronic low-grade inflammation. The ratio of monocytes to high-density lipoprotein cholesterol, as an emerging comprehensive inflammation indicator, simultaneously reflects the imbalance of pro-inflammatory cell activation and anti-inflammatory lipoprotein protective function, providing a new perspective for understanding the inflammatory mechanism of postmenopausal osteoporosis. This article reviews the biological basis of MHR, explores its potential mechanisms involved in bone metabolism disorders by mediating oxidative stress, osteoclast activation and other pathways, and systematically evaluates its clinical application value and prospects in postmenopausal women's osteoporosis risk prediction, severity assessment and treatment response monitoring. Existing evidence shows that MHR is expected to become a convenient and economical auxiliary biomarker, but its clinical application still requires more prospective studies to verify.

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References

[1] CHENG C H, CHEN L R, CHEN K H. Osteoporosis Due to Hormone Imbalance: An Overview of the Effects of Estrogen Deficiency and Glucocorticoid Overuse on Bone Turnover[J]. Int J Mol Sci, 2022,23(3).

[2] WANG L T, CHEN L R, CHEN K H. Hormone-Related and Drug-Induced Osteoporosis: A Cellular and Molecular Overview[J]. Int J Mol Sci, 2023,24(6).

[3] LUO J, LI L, SHI W, et al. Oxidative stress and inflammation: roles in osteoporosis[J]. Front Immunol, 2025,16: 1611932.

[4] AL-LAMI R, AL-HILFY J. Role of Interleukins-8, -17 and -22 in Iraqi postmenopausal women with Osteoporosis[J]. Cytokine, 2025,187: 156853.

[5] LIU Y Z, DVORNYK V, LU Y, et al. A novel pathophysiological mechanism for osteoporosis suggested by an in vivo gene expression study of circulating monocytes[J]. J Biol Chem, 2005,280(32): 29011-29016.

[6] XIAO K W, LI J L, ZENG Z H, et al. Monocytes affect bone mineral density in pre- and postmenopausal women through ribonucleoprotein complex biogenesis by integrative bioinformatics analysis[J]. Sci Rep, 2019,9(1): 17290.

[7] ARUN A J, KANEKI S, BAIG M, et al. High-Density Lipoprotein Dysfunction and Atherosclerotic Cardiovascular Disease: From Quantity to Quality[J]. Cardiol Rev, 2025.

[8] TANAKA S, COURET D, TRAN-DINH A, et al. High-density lipoproteins during sepsis: from bench to bedside[J]. Crit Care, 2020,24(1): 134.

[9] WU D, LAN Y, DING X, et al. Imbalances in circulating monocyte and high-density lipoprotein cholesterol exacerbates the residual risk of incident myocardial infarction beyond LDL-C: a real-life, prospective cohort study[J]. J Transl Med, 2025,23(1): 1433.

[10] SOYSAL C, BıYıK İ, İNCE O, et al. Comparison of the different PCOS phenotypes based on monocyte to HDL cholesterol ratio[J]. J Obstet Gynaecol, 2022,42(6): 2089-2094.

[11] ERDEN E, TURK A C, FIDAN N, et al. Relationship Between Blood Monocyte-HDL Ratio and Carotid Intima Media Thickness in with Postmenopausal Women[J]. J Clin Densitom, 2023,26(4): 101428.

[12] LIU Z, LIANG W, KANG D, et al. Increased Osteoblastic Cxcl9 Contributes to the Uncoupled Bone Formation and Resorption in Postmenopausal Osteoporosis[J]. Clin Interv Aging, 2020,15: 1201-1212.

[13] CATALANO J C, GUO Y, BORDEAU B M, et al. HDL in Abdominal Aortic Aneurysm: Mechanistic Insight and Therapeutic Potential[J]. Curr Atheroscler Rep, 2026,28(1): 6.

[14] LEE M, PARK S J, MOON Y J, et al. Combination of Sargassum fusiforme and Pueraria lobata Extracts Alleviates Postmenopausal Symptoms in Ovariectomized Rats[J]. J Med Food, 2020,23(7): 735-744.

[15] LI G F, GAO Y, WEINBERG E D, et al. Role of Iron Accumulation in Osteoporosis and the Underlying Mechanisms[J]. Curr Med Sci, 2023,43(4): 647-654.

[16] DZIEDZIC E A, GĄSIOR J S, TUZIMEK A, et al. Correlation between Serum 25-Hydroxyvitamin D Concentration, Monocyte-to-HDL Ratio and Acute Coronary Syndrome in Men with Chronic Coronary Syndrome-An Observational Study[J]. Nutrients, 2023,15(20).

[17] OH M S, KIM S I, SIM Y E, et al. Cirsium Setidens Water Extracts Containing Linarin Block Estrogen Deprivation-Induced Bone Loss in Mice[J]. Int J Mol Sci, 2023,24(2).

[18] HU X, ZHANG H, WANG Z, et al. Exercise-derived irisin prevents bone loss via Nrf2 activation and inhibition of STING/NF-κB signaling[J]. Free Radic Biol Med, 2026,246: 51-68.

[19] SUN S, XIU C, CHAI L, et al. HDAC inhibitor quisinostat prevents estrogen deficiency-induced bone loss by suppressing bone resorption and promoting bone formation in mice[J]. Eur J Pharmacol, 2022,927: 175073.

[20] WU Z, WANG J, CHEN K, et al. Therapeutic potential of Sweroside in postmenopausal osteoporosis: Inhibition of osteoclast differentiation and promotion of osteoclast apoptosis via NF-κB and MAPK pathways[J]. Int Immunopharmacol, 2025,155: 114630.

[21] FENG Y, LI W, SUN H, et al. Dual suppression of AKT/MAPK signaling and activation of Nrf2 by methylnissolin attenuates osteoclastogenesis and prevents postmenopausal osteoporosis[J]. Int Immunopharmacol, 2026,169: 115942.