Diabetic nephropathy (DN) is a common microvascular complication of diabetes mellitus and remains a major contributor to chronic kidney disease globally. Clinical assessment often reflects overlapping inflammatory and lipid abnormalities, and composite indices may provide additional insight. A systematic review and meta-analysis published in Biomed Research International examined differences in the monocyte-to-high-density lipoprotein cholesterol ratio (MHR) between patients with diabetes with and without DN.

The analysis pooled data from 9 observational studies that included 1,797 adult patients with diabetes. Eligible studies reported MHR values in patients with and without DN and were identified through database searches of PubMed, the Cochrane Library, and Google Scholar up to 2025. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random effects models. Heterogeneity was evaluated using the I² statistic. Risk of bias assessment was performed with the Newcastle-Ottawa Scale, and publication bias was assessed using funnel plots and Egger’s regression test.

Across the included studies, MHR values were consistently higher in patients with DN compared with those without DN. The pooled analysis demonstrated a significantly higher MHR in the DN group, with a positive SMD favoring DN. Substantial heterogeneity was observed between studies. Risk of bias was generally low to moderate, and no evidence of publication bias was identified (p=0.486).

These findings indicate that higher MHR levels are observed in patients with DN, supporting its use as a practical adjunct marker derived from routine laboratory parameters in clinical assessment.