Ali KOÇ, İdris KİRHAN, Velat AYTEKİN
Eastern Journal of Medicine (EJM) - 2026;31(3):583-591
This study was designed to examine the relationship of hepatic steatosis severity with biochemical parameters, serum vitamin D levels, and the monocyte-to-HDL cholesterol ratio (MHR), and to evaluate whether the MHR may serve as a supportive biomarker in hepatic steatosis. In this retrospective cross-sectional study, 201 adults evaluated between 2020 and 2025 were included. Hepatic steatosis and its severity were assessed by hepatobiliary ultrasonography, and biochemical, haematological, and metabolic parameters, including serum vitamin D levels and the MHR, were analyzed. The mean age was 41.04 +/- 16.49 years. Mean vitamin D level was 16.44 +/- 9.86 ng/mL, and the mean MHR was 0.01398 +/- 0.00616. Vitamin D levels were not significantly correlated with the MHR (r=0.019, p=0.790). In contrast, the MHR showed a weak but significant positive correlation with steatosis grade on ultrasonography (r=0.151, p=0.033). ROC analysis demonstrated poor discriminatory performance of the MHR for hepatic steatosis (AUC = 0.592, 95% CI: 0.513-0.672, p = 0.026). Age, HbA1c, glucose, AST, ALT, GGT, triglycerides, HDL cholesterol, lymphocyte count, haemoglobin, and haematocrit differed significantly between participants with and without hepatic steatosis (p<0.05). whereas vitamin D levels did not (p=0.357). Hepatic steatosis was associated with markers of glucose metabolism, liver injury, and lipid profile. Participants with hepatic steatosis had higher HbA1c, glucose, AST, ALT, GGT, and triglyceride levels and lower HDL cholesterol levels than participants without hepatic steatosis. The MHR showed a weak association with ultrasonographic steatosis severity and poor discriminatory performance for the presence of hepatic steatosis. Serum vitamin D levels were not significantly associated with steatosis severity. Therefore, the MHR should not be used as a stand-alone diagnostic marker.
