Monocyte-to-High-Density Lipoprotein Cholesterol Ratio asa Clinical Marker of Gastrointestinal Involvement in BehcetSyndrome

초록

Background/Purpose: Behcet syndrome (BS) is a chronic multisystem vasculitis marked by recurrentmucocutaneous and ocular inflammation, and in a subset of patients, gastrointestinal (GI)involvement. Gastrointestinal BS (GIBS) is a clinically important phenotype due to its potential forsevere morbidity and its diagnostic overlap with other inflammatory bowel disorders. Timelyidentification of GIBS remains a clinical challenge, often requiring invasive procedures such ascolonoscopy. Thus, there is growing interest in identifying noninvasive biomarkers that can aid in riskstratification and guide diagnostic decision-making. The monocyte-to-high-density lipoproteincholesterol ratio (MHR), reflecting both systemic inflammation and lipid-related oxidative stress, hasemerged as a potential biomarker in several immune-mediated diseases. However, its utility inBehcet syndrome, particularly in detecting GI involvement, has not been established. This studyaimed to evaluate the clinical significance of MHR in identifying gastrointestinal involvement in BSpatients. Methods: We retrospectively analyzed 2,074 patients with BS registered in the Clinical DataWarehouse of Inha University Hospital from January 1997 to December 2024. Diagnosis was basedon the ISG (1990) and ICBD (2013) criteria. Patients were included if they underwent colonoscopy ator after diagnosis and had HDL cholesterol measured at a time point close to the colonoscopy.Exclusion criteria were infectious colitis, malignancies, or MHR data obtained outside the clinicallyrelevant time window. MHR was calculated by dividing absolute monocyte count (/mm³) by HDLcholesterol (mg/dL). Statistical analysis was performed using independent t-tests, with p < 0.05considered significant.