ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Predictive value of serum uric acid to High-density lipoprotein cholesterol ratio for MAFLD in non-obese type 2 diabetes patients based on nomogram
Provisionally accepted
- Department of Endocrinology, International Hospital, Peking University, Beijing, China
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Objective: The incidence of metabolic dysfunction associated fatty liver disease (MAFLD) in non-obese type 2 diabetes (T2DM) patients is very insidious and easily overlooked in clinical examinations. The aim of our article is to explore whether the serum uric acid to High-density lipoprotein cholesterol (HDL-C) ratio (UHR) can be used for independent assessment of the risk of MAFLD in non-obese T2DM patients. Methods: 1622 T2DM patients were analyzed, and 506 non-obese patients were ultimately included in the study. Routine clinical and laboratory date were collected. In the non-obese T2DM population, we evaluated the stability of UHR in predicting MAFLD through subgroup analysis, and compared UHR with other indicators. Finally, we used logistic regression and established a nomogram model to determine the diagnostic efficacy of UHR for MAFLD. We evaluated nomograms through receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). Results: As UHR levels increased, the prevalence of MAFLD gradually increased in non-obese T2DM patients. Logistic regression indicated that UHR was associated with MAFLD in non-obese T2DM participants. A nomogram model was constructed using UHR, body mass index (BMI), 2 hour postprandial glucose (2h-PG), 2 hour C-Peptide (2hC-P), triglycerides (TG), serum creatinine (CRE), and C-reactive protein (CRP) as predictive factors to predict the risk of MAFLD in non-obese T2DM subjects. The calibration curve and DCA had the best predictive ability. The DCA results indicated that the model had clinical application value. Conclusions: In non-obese T2DM subjects, the morbidity rate of MAFLD was significantly higher in high level UHR subjects than that in low level UHR subjects. The Nomogram model constructed based on UHR, BMI, 2h-PG, 2hC-P, TG, CRE, and CRP had good predictive ability for the risk of MAFLD in non-obese T2DM patients.
Keywords: metabolic dysfunction associated fatty liver disease, non-obese type 2 diabetes mellitus (T2DM), Serum uric acid (UA), High-density lipoprotein cholesterol (HDL-C), UA to HDL-C ratio (UHR)
Received: 09 Apr 2025; Accepted: 29 Oct 2025.
Copyright: © 2025 Ma, Sun, Yuan, Zhao, Xin, Xu and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaomei Zhang, zhangxiaomei@pkuih.edu.cn
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