In adults with type 2 diabetes mellitus (T2DM), differences in visceral fat distribution raise questions about associated circulating biomarkers. In Diabetes, Metabolic Syndrome and Obesity, a cross-sectional observational study examined the association between the monocyte-to-high-density lipoprotein cholesterol ratio (MHR) and visceral fat area (VFA) in patients with T2DM. The analysis included 2,156 patients receiving medical treatment at Zhejiang Provincial People’s Hospital. VFA was measured using bioelectrical impedance analysis and categorized as increased VFA (100 cm² or higher) or normal VFA (below 100 cm²).

MHR levels were higher in the increased VFA group than in the normal VFA group (p<0.001). Spearman correlation analysis showed a positive association between MHR and VFA (r=0.366; p<0.001). In multivariable linear regression analysis, elevated MHR remained independently associated with greater VFA (β=20.64; 95% confidence interval, 13.46-27.82; p<0.001), including after stratification by hemoglobin A1c levels and diabetes duration. Receiver operating characteristic analysis showed an area under the curve of 0.708, with sensitivity of 73% and specificity of 58% for identifying increased VFA.

In this cross-sectional study of adults with T2DM, higher MHR was associated with greater VFA and showed modest predictive value for increased visceral adiposity.