Potential predictive role of Non-HDL to HDL Cholesterol Ratio (NHHR) in MASLD: focus on obese and type 2 diabetic populations.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968547 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-230X (Electronic) Linking ISSN: 1471230X NLM ISO Abbreviation: BMC Gastroenterol Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Diabetes Mellitus, Type 2*/complications ; Diabetes Mellitus, Type 2*/blood ; Obesity*/complications ; Obesity*/blood ; Cholesterol, HDL*/blood ; Cholesterol*/blood ; Fatty Liver*/blood ; Fatty Liver*/epidemiology; Humans ; Male ; Female ; Middle Aged ; Cross-Sectional Studies ; Adult ; Nutrition Surveys ; Prevalence ; Body Mass Index ; Aged ; Risk Factors ; Predictive Value of Tests

Introduction: This cross-sectional study was conducted to examine the association between the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) and metabolic dysfunction-associated steatotic liver disease (MASLD), particularly in populations with obesity and type 2 diabetes (T2D).
Methods: The analysis included 3784 participants who were 20 years and older, using data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018. The prevalence of MASLD was determined using multivariable logistic regression analysis, which calculated odds ratios (ORs) and 95% confidence intervals (CIs). Conducted was an analysis employing a smooth curve fitting approach to explore the potential nonlinear association between NHHR and MASLD. Subgroup analyses were performed based on age, sex, body mass index (BMI) and T2D status to evaluate the robustness of the results, with interaction tests conducted.
Results: NHHR showed a consistently positive association with MASLD across all models. In the fully adjusted model, compared with the low NHHR group, participants in the middle and high NHHR group were associated with higher prevalence of MASLD (OR = 1.51, 95%CI = 1.25-1.83, p < 0.001, OR = 1.97, 95%CI = 1.62-2.41, p < 0.001, respectively). This positive relationship was significant across all subgroups, confirming a robust association between NHHR and MASLD.
Conclusions: This cross-sectional study found a significant linear positive relationship between NHHR and MASLD, which remained significant across different age, sex, BMI and T2D groups. These findings suggest that NHHR may have the potential to serve as a predictor for screening MASLD in populations with obesity or T2D.
(© 2025. The Author(s).)

Declarations. Ethics approval and consent to participate: The survey protocol for the NHANES received approval from the Institutional Research Ethics Review Board of CDC's National Center for Health Statistics. All participants gave written informed consent, and the NCHS Research Ethics Review Board also approved the study ( https://wwwn.cdc.gov/nchs/nhanes/default.aspx ). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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82201954 to Z.R. the Natural Science Foundation of China

Keywords: MASLD; NHHR; Obesity; Screening; T2D

0 (Cholesterol, HDL)
97C5T2UQ7J (Cholesterol)

Date Created: 20250213 Date Completed: 20250507 Latest Revision: 20250507

20260130

PMC11827471

10.1186/s12876-025-03659-8

39948471