Uric acid to high-density lipoprotein cholesterol ratio is associated with the prevalence of diabetic kidney disease in euthyroid patients with type 1 diabetes mellitus in China: A multicenter cross-sectional study

J Diabetes Investig. 2025 Jun 27. doi: 10.1111/jdi.70107. Online ahead of print.

Abstract

Introduction: Globally, the inadequate diagnosis and treatment of diabetic kidney disease remains a significant challenge, impeding effective management. The uric acid to high-density lipoprotein cholesterol ratio (UHR) has been associated with type 2 diabetes; however, its role in euthyroid patients with type 1 diabetic kidney disease (T1DKD) remains unclear. The aim of this study was to assess the association between UHR and T1DKD in patients with euthyroidism.

Methods: This cross-sectional study included 335 euthyroid patients with type 1 diabetes mellitus (T1DM) from 1,485 eligible participants. Sociodemographic and blood test data were collected from inpatients of the endocrinology departments of 18 hospitals in Gansu Province.

Results: Among the 335 euthyroid patients with T1DM (mean age 35.5 years, 57.6% males), 49.6% had T1DKD. In the fully adjusted model, T1DKD was positively associated with UHR (odds ratio [OR] = 2.29; 95% confidence interval [CI]: 1.36-3.87; P = 0.002). A positive relationship between T1DKD and UHR was also observed (nonlinear, P = 0.575). Subgroup analysis showed that this independent association remained consistent regardless of sex, body mass index, nationality, and marital status. The predictive value of UHR was ~22% higher in adults than in individuals aged <18 years.

Conclusions: UHR is positively related to DKD in patients with euthyroid T1DM. Assessing the UHR might be a valuable part of follow-up visits for patients with T1DM.

Keywords: Euthyroid; Type 1 diabetic kidney disease; Uric acid to high‐density lipoprotein cholesterol ratio.