{
  "abstract": "The uric-acid-to- high-density lipoprotein-cholesterol ratio (UHR) combines 2 circulating biomarkers related to metabolic and inflammatory processes. Its association with prevalent diabetic kidney disease (DKD) was examined in U.S. adults with type 2 diabetes mellitus. This study aimed to examine the cross-sectional association between UHR and prevalent DKD and assess its incremental discrimination beyond the specified covariate model. We analyzed 4010 adults with type 2 diabetes mellitus from NHANES 2009 to 2018 using the complex survey design. DKD was defined as urinary albumin-to-creatinine ratio ≥30 mg/g and/or estimated glomerular filtration rate <60 mL/min/1.73 m2, calculated using the 2009 chronic kidney disease epidemiology collaboration equation without its race coefficient. Strict DKD required both abnormalities; severe DKD required urinary albumin-to-creatinine ratio ≥300 mg/g. Model 3 was the primary confounder-adjusted model, and model 4 added laboratory indicators as an extended sensitivity analysis. Supplementary analyses assessed nonlinearity, discrimination and graphical calibration. Exploratory unweighted category-based net reclassification improvement used 500 bootstrap replicates and percentile confidence intervals. Of 4010 participants, 1576 had study-defined DKD; the weighted prevalence was 35.4%. In model 3, the highest versus lowest ln-UHR quartile had an odds ratio of 2.43 (95% confidence interval 1.75-3.38) for original DKD, 4.55 (2.81-7.35) for strict DKD and 2.82 (1.57-5.06) for severe DKD. Estimates were attenuated in model 4, with the severe-DKD contrast no longer meeting the 0.05 threshold. The laboratory-adjusted spline indicated nonlinearity (P < .001). In the separate laboratory-inclusive discrimination analysis, adding ln-UHR increased apparent area under the curve from 0.75 to 0.76; the unweighted net reclassification improvement was 1.9% (95% confidence interval 0.8%-3.1%). Higher UHR was associated with prevalent DKD after adjustment for the selected potential confounders. Supplementary analyses showed a small increase in apparent discrimination. These cross-sectional findings require prospective investigation and independent external validation before use for future risk prediction or clinical screening.",
  "abstract_shown": true,
  "affiliations": [
    "Departments of Nephrology, The Affiliated Yongchuan Hospital of Chongqing Medical University, Chongqing, China.",
    "College of Medical Laboratory, Dalian Medical University, Dalian, Liaoning, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ruolan Tan",
      "orcid": "0009-0003-0435-8288"
    },
    {
      "affs": [
        1
      ],
      "name": "Wei Tan",
      "orcid": "0009-0002-6148-8647"
    },
    {
      "affs": [
        0
      ],
      "name": "Yulin Hu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0d884ras14285.bib",
  "cited_by": 0,
  "doi": "10.1097/md.0000000000051033",
  "fulltext_url": "https://europepmc.org/articles/PMC13680938",
  "id": "0d884ras14285",
  "issns": [
    "0304-5412",
    "1536-5964"
  ],
  "landing_url": "https://europepmc.org/article/MED/42888531",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2727|Chronic Kidney Disease and Diabetes"
    ]
  ],
  "openalex": "W7222620181",
  "pdf_url": "https://europepmc.org/articles/PMC13680938?pdf=render",
  "pmcid": "PMC13680938",
  "pmid": "42888531",
  "published": "2026-10-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/0d884ras14285.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:00Z",
      "native_id": "MED:42888531",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42888531"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2727|Chronic Kidney Disease and Diabetes",
      "subfield": "general"
    }
  ],
  "title": "Association between the uric acid to high-density lipoprotein cholesterol ratio and diabetic kidney disease in U.S. adults with type 2 diabetes: A cross-sectional study of NHANES 2009 to 2018.",
  "title_text": "Association between the uric acid to high-density lipoprotein cholesterol ratio and diabetic kidney disease in U.S. adults with type 2 diabetes: A cross-sectional study of NHANES 2009 to 2018.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:00Z",
  "url": "https://research.draconitic.com/paper/0d884ras14285",
  "venue": "Medicine",
  "versions": []
}