Sun Cunwei, Si Ke, Zhu Youzhuang, Li Chengqian, Yu Yang, Jia Changxin, Wang Qing
Department of Endocrinology and Metabolism, Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Anesthesiology, Affiliated Hospital of Qingdao University, Qingdao, China.
Front Nutr. 2025 Sep 1;12:1655817. doi: 10.3389/fnut.2025.1655817. eCollection 2025.
The coexistence and synergistic relationship between Nonalcoholic 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.
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 a 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.
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, = 0.001]. When treated as a categorical variable, the OR for NHHR in the fourth quartile was significantly elevated compared to the lowest quartile, with values of 1.993 (95% CI: 1.349-2.944, = 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.
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.
非酒精性脂肪性肝病（NAFLD）与痛风之间的共存及协同关系，使得有必要对痛风患者中NAFLD的危险因素进行调查。非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇之比（NHHR）是一项综合血脂指标。本研究旨在探讨NHHR与痛风患者NAFLD风险之间的关联。
进行了一项横断面研究，纳入1038例住院痛风患者，以研究NHHR与NAFLD之间的关系。NHHR作为连续变量和分类变量纳入逻辑回归分析。采用限制立方样条（RCS）评估剂量反应关系。此外，进行亚组分析以识别变量之间的潜在相互作用。基于基本模型，使用受试者工作特征（ROC）曲线评估NHHR的预测能力。
根据NHHR水平分层的四分位数组分析显示，NAFLD患病率随NHHR水平升高而增加。多因素逻辑回归分析确定NHHR与NAFLD之间存在显著关联，比值比（OR）为1.242[95%置信区间（CI）：1.089 - 1.416，P = 0.001]。当作为分类变量处理时，第四四分位数的NHHR的OR与最低四分位数相比显著升高，值为1.993（95%CI：1.349 - 2.944，P = 0.001）。RCS分析表明，在所有模型中NHHR与NAFLD之间存在非线性剂量反应关系。亚组分析未检测到显著的相互作用。将NHHR纳入基本模型可使ROC曲线下面积（AUC）提高到0.706。
本研究发现痛风患者中NHHR与NAFLD发病率之间存在正相关，提示NHHR可能是痛风患者中NAFLD的可靠指标。
