{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:24:34Z","timestamp":1788265474860,"version":"build-2803163510"},"reference-count":49,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Metabolic Syndrome and Related Disorders"],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Although metabolic dysfunction-associated steatotic liver disease (MASLD) has traditionally been regarded as a disease closely related to obesity, its prevalence is gradually rising in nonobese populations. The uric acid-to-high-density lipoprotein cholesterol ratio (UHR) is a novel metabolic biomarker that has been shown to be associated with MASLD. However, its role in nonobese individuals remains unclear. This study aimed to investigate the association between UHR and nonobese MASLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Data from the 2017 to 2020 National Health and Nutrition Examination Survey (NHANES) were analyzed. UHR was calculated as the serum uric acid (UA) divided by the high-density lipoprotein cholesterol (HDL). Liver steatosis (using controlled attenuation parameters, CAP) and fibrosis (using liver stiffness measurement, LSM) were evaluated through vibration-controlled transient elastography (VCTE). Multivariate linear regression was employed to evaluate associations. Nonlinear relationships were examined using smoothed curve fitting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      This analysis included 3573 participants (47.41% male; aged 20\u201380 years). Log\n                      <jats:sub>2<\/jats:sub>\n                      -UHR was positively associated with CAP (\u03b2 = 9.96, 95% CI: 6.93\u201312.98,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and MASLD prevalence (OR = 1.64, 95% CI: 1.38\u20131.95,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Subgroup analyses revealed significant interactions by sex, age, ethnicity, and smoking status (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      for interaction &lt; 0.05), with stronger associations in females, adults aged 40\u201359 years, individuals of other Hispanic ethnicity, and never-smokers. Moreover, the association between log\n                      <jats:sub>2<\/jats:sub>\n                      -UHR and CAP was linear and positive (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01). No significant association was found between log\n                      <jats:sub>2<\/jats:sub>\n                      -UHR and LSM (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>UHR is independently associated with hepatic steatosis but not fibrosis in nonobese US adults, suggesting its potential utility as an early risk assessment to tool. Large scale prospective studies are needed in the future to further validate the conclusions of this study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15578518261470095","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T09:47:39Z","timestamp":1784627259000},"page":"383-391","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Uric Acid-to-HDL Cholesterol Ratio is Associated with Hepatic Steatosis but Not Fibrosis in Nonobese Adults: A NHANES 2017\u20132020 Study"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7227-7903","authenticated-orcid":false,"given":"Linwan","family":"Li","sequence":"first","affiliation":[{"name":"Northern Jiangsu People\u2019s Hospital Affiliated to Yangzhou University\/Clinical Medical College, Yangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang\u2019an","family":"Zhao","sequence":"additional","affiliation":[{"name":"Northern Jiangsu People\u2019s Hospital Affiliated to Yangzhou University\/Clinical Medical College, Yangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31173"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-024-00915-2"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2025.0045"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000539371"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aohep.2023.101182"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-023-02030-z"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1089\/dtom.2025.0015"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.857930"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2468-1253(20)30077-7"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.12.036"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-022-00980-1"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.01.042"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.2147\/dmso.S448638"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1159248"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.plipres.2021.101109"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1354098"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.23736\/S0026-4806.25.09712-5"},{"key":"e_1_3_3_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-94651-5"},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-07986-4"},{"issue":"155","key":"e_1_3_3_21_1","first-page":"1","article-title":"The National Health and Nutrition Examination Survey: Sample design, 1999\u20132006","volume":"2","author":"Curtin LR","year":"2012","unstructured":"20.Curtin LR, , Mohadjer LK, , Dohrmann SM, et al. The National Health and Nutrition Examination Survey: Sample design, 1999\u20132006. Vital Health Stat 2 2012;2(155):1\u201339.","journal-title":"Vital Health Stat 2"},{"key":"e_1_3_3_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1164096"},{"key":"e_1_3_3_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41043-023-00458-3"},{"key":"e_1_3_3_24_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365521.2014.958099"},{"key":"e_1_3_3_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.06.029"},{"key":"e_1_3_3_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0252164"},{"key":"e_1_3_3_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-021-01974-4"},{"key":"e_1_3_3_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.24225"},{"key":"e_1_3_3_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/00325481.2023.2263372"},{"key":"e_1_3_3_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/edm2.446"},{"key":"e_1_3_3_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-022-02263-4"},{"key":"e_1_3_3_32_1","doi-asserted-by":"publisher","DOI":"10.1590\/1806-9282.65.1.9"},{"key":"e_1_3_3_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-025-04258-z"},{"key":"e_1_3_3_34_1","doi-asserted-by":"publisher","DOI":"10.3967\/bes2022.111"},{"key":"e_1_3_3_35_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/5953461"},{"key":"e_1_3_3_36_1","doi-asserted-by":"publisher","DOI":"10.20945\/2359-4292-2022-0138"},{"key":"e_1_3_3_37_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgac565"},{"key":"e_1_3_3_38_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2025.1686975"},{"key":"e_1_3_3_39_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2024.0631"},{"key":"e_1_3_3_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/mco.0000000000000485"},{"issue":"4","key":"e_1_3_3_41_1","first-page":"264","article-title":"Higher levels of serum uric acid influences hepatic damage in patients with non-alcoholic fatty liver disease (NAFLD)","volume":"111","author":"Fern\u00e1ndez Rodr\u00edguez CM","year":"2019","unstructured":"40.Fern\u00e1ndez Rodr\u00edguez CM, , Aller R, , Guti\u00e9rrez Garc\u00eda ML, et al. Higher levels of serum uric acid influences hepatic damage in patients with non-alcoholic fatty liver disease (NAFLD). Rev Esp Enferm Dig 2019;111(4):264\u2013269; doi: 10.17235\/reed.2019.5965\/2018","journal-title":"Rev Esp Enferm Dig"},{"key":"e_1_3_3_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2008.11.021"},{"key":"e_1_3_3_43_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v25.i24.3009"},{"key":"e_1_3_3_44_1","doi-asserted-by":"publisher","DOI":"10.1177\/17455057241227362"},{"key":"e_1_3_3_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2021.103257"},{"key":"e_1_3_3_46_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyy124"},{"key":"e_1_3_3_47_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells14030221"},{"key":"e_1_3_3_48_1","doi-asserted-by":"publisher","DOI":"10.14218\/JCTH.2021.00188"},{"key":"e_1_3_3_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11547-022-01475-8"},{"key":"e_1_3_3_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.12.022"}],"container-title":["Metabolic Syndrome and Related Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15578518261470095","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15578518261470095","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15578518261470095","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:04:13Z","timestamp":1788264253000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15578518261470095"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":49,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,10,1]]}},"alternative-id":["10.1177\/15578518261470095"],"URL":"https:\/\/doi.org\/10.1177\/15578518261470095","relation":{},"ISSN":["1540-4196","1557-8518"],"issn-type":[{"value":"1540-4196","type":"print"},{"value":"1557-8518","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,21]]}}}