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This investigation was designed to elucidate the potential association between RC and HOMA-IR in a cohort of American adults diagnosed with MAFLD. Data from 5533 participants were procured from the 2017\u20132018 US National Health and Nutrition Examination (NHANES) databases. A weighted linear regression model was employed to analyze the association between RC and HOMA-IR in the context of MAFLD. Preliminary analysis revealed that 44.67% of the participants were diagnosed with MAFLD, with a higher prevalence observed in individuals aged 50\u201364\u00a0years (31.84%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and in males compared to females (53.48% vs. 46.52%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). A positive correlation was identified between RC and HOMA-IR in MAFLD patients. The threshold effect analysis model indicated a breakpoint at RC\u2009=\u200930\u00a0mg\/dl, with a more pronounced positive correlation when RC\u2009&lt;\u200930\u00a0mg\/dl (\u03b2\u2009=\u20090.17, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Receiver operating characteristic analysis further demonstrated that among all lipid parameters, RC exhibited the largest area under the curve. The study findings suggest a positive correlation between RC and HOMA-IR in MAFLD patients, indicating that elevated RC may serve as an independent risk factor for MAFLD.<\/jats:p>","DOI":"10.1038\/s41598-024-55282-4","type":"journal-article","created":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T06:02:15Z","timestamp":1708927335000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Association between remnant cholesterol and insulin resistance levels in patients with metabolic-associated fatty liver disease"],"prefix":"10.1038","volume":"14","author":[{"given":"Shuang","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,26]]},"reference":[{"key":"55282_CR1","doi-asserted-by":"publisher","first-page":"2050","DOI":"10.1016\/j.soard.2020.07.009","volume":"16","author":"S Frey","year":"2020","unstructured":"Frey, S. et al. 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