ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition and Metabolism
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1655817
This article is part of the Research TopicThe role of Lipids in Relation to Preventing Inflammation and Chronic Diseases.View all articles
Assessing the association between the Non-HDL to HDL Cholesterol Ratio and NAFLD in Chinese adults:concentrate on gout populations
Provisionally accepted
- The Affiliated Hospital of Qingdao University, Qingdao, China
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Background The coexistence and synergistic relationship between Non-alcoholic fatty liver disease (NAFLD) and gout necessitate an investigation into the risk factors for NAFLD among individuals with gout. The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) serves as a comprehensive lipid index. This study aimed to investigate the association between NHHR and the risk of NAFLD in patients with gout. Methods A cross-sectional study was conducted involving 1,038 hospitalized patients with gout to examine the relationship between NHHR and NAFLD. NHHR was included in the logistic regression analysis as both a continuous and categorical variable. Restricted cubic splines (RCS) were utilized to assess the dose-response relationship. Additionally, subgroup analyses were performed to identify potential interactions among variables. The predictive capability of NHHR was evaluated using the receiver operating characteristic (ROC) curve based on the basic model. Results The analysis of quartile groups stratified by NHHR levels revealed an increased prevalence of NAFLD corresponding to higher NHHR levels. Multifactorial logistic regression analysis established a significant association between NHHR and NAFLD, yielding an odds ratio (OR) of 1.242 (95% confidence interval [CI]: 1.089-1.416, p = 0.001). When treated as a categorical variable, the OR for NHHR in the fourth quartile were significantly elevated compared to the lowest quartile, with values of 1.993 (95% CI: 1.349 - 2.944, p = 0.001). The RCS analysis demonstrated a non-linear dose-response relationship between NHHR and NAFLD across all models. No significant interactions were detected in the subgroup analysis. Incorporating NHHR into the basic model enhanced the area under the curve (AUC) of the ROC curve to 0.706. Conclusion This study identified a positive correlation between NHHR and the incidence of NAFLD in individuals with gout, suggesting that NHHR may serve as a reliable indicator of NAFLD within the gout patient.
Keywords: Gout, NAFLD, NHHR, Lipid indicator, Non-HDL, HDL, Cross-sectional study
Received: 28 Jun 2025; Accepted: 18 Aug 2025.
Copyright: © 2025 Sun, Si, Zhu, Li, Yu, Jia and Wang. 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:
Changxin Jia, The Affiliated Hospital of Qingdao University, Qingdao, China
Qing Wang, The Affiliated Hospital of Qingdao University, Qingdao, China
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