Abstract:Objective To explore the correlation between monocyte to high-density lipoprotein cholesterol ratio（MHR） and type 2 diabetes mellitus（T2DM） complicated with osteoporosis. Methods A total of 158 patients hospitalized in Spinal Surgery Department of Wuhan Hospital of Integrated Traditional Chinese and Western Medicine from September 2019 to November 2021 were selected and were divided into normal bone mineral density（BMD） group（group A, n=40）, osteoporosis group（group B, n=62） and osteoporosis combined with T2DM group（group C, n=56） according to BMD measurement and blood glucose level. The following indicators were observed and compared among three groups, including general information, white blood cells, monocytes, lymphocytes, neutrophils, CRP, erythrocyte sedimentation rate, TP, electrolytes, TC, TG, LDL-C, HDL-C, creatinine, uric acid and 25 hydroxyvitamin D ［25（OH）D）］ levels, BMD and markers of bone turnover. MHR values of the patients were calculated. Results In group C，monocytes, blood sugar and MHR were higher than those in group A and B, while age, CRP, alkaline phosphatase(ALP), neutrophils and PTH were higher than those in group A (P＜0.05). In group C, 25(OH)D was lower than that in group A and B, lymphocytes, BMI and osteocalcin were lower than those in group A, and the difference was statistically significant(P＜0.05). Multiple logistic regression analysis showed that higher levels of MHR and ALP, lower levels of 25（OH）D, osteocalcin and BMI were the independent risk factors of T2MD complicated with osteoporosis（P＜0.05, P＜0.01）. ROC curve showed that the area under the curve（AUC） of MHR was 0.771（95%CI: 0.670-0.871）, the cut-off value was 0.347, and the sensitivity and specificity were 0.893 and 0.625, respectively in diagnosing T2MD complicated with osteoporosis. Its AUC is second only to 25(OH)D. Conclusion Peripheral blood MHR has a high reference significance for the diagnosis of T2DM complicated with osteoporosis.