Remnant cholesterol/high-density lipoprotein cholesterol ratio is a new powerful tool for identifying diabetic kidney...

Remnant cholesterol to high-density lipoprotein cholesterol ratio (RHR) has been identified as a reliable predictor for metabolic disease risk. Nevertheless, its relevance in the context of diabetic kidney disease (DKD) remains unexplored. Therefore, this study seeks to explore the association between the risk of DKD and RHR in individuals with T2DM.

In this cross-sectional study, 2,958 patients diagnosed, as T2DM admitted to the hospital from 2018 to 2023 were assessed. The analysis was conducted through restricted cubic spline (RCS) and logistic regression methodologies, complemented by additional stratified and interaction analyses.

As the quartiles of RHR increase, there is a notable increase in the prevalence of DKD, with the rates of 39.6%, 44.5%, 55.1%, and 60.7%, respectively. Logistic regression analysis showed a positive association between RHR and DKD (OR = 1.14, 95% CI: 1.04-12.25), with this effect being more pronounced in patients over 60 years old. RCS analysis identified an inverted L-shaped association, with an inflection point at 1.31. Mediation analyses identified SBP and FPG as partial mediators of the association between DKD and RHR, accounting for 10.4% and 3.3% of the mediation, respectively. Additionally, AUC for RHR (AUC = 0.654, 95% CI: 0.633-0.676) was significantly higher compared to those of RC, HDL, and TG.

RHR exhibits a positive association with the risk of DKD, underscoring its potential utility as a cost-effective biomarker for stratifying the risk of DKD.