{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T06:06:14Z","timestamp":1784009174822,"version":"3.55.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"\n Background<\/jats:title>\n The uric acid to high-density lipoprotein cholesterol ratio (UHR), a composite biomarker integrating pro-inflammatory stress and vascular protection loss, has been linked to diabetic kidney disease (DKD) in cross-sectional studies, but longitudinal evidence on its association with continuous eGFR decline remains limited.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective cohort study included 8,827 community-managed type 2 diabetes patients from 54 health centers in Shenzhen, China, followed for 3 years (2023\u20132025). Baseline UHR was calculated as serum uric acid (\u03bcmol\/L) divided by HDL-C (mmol\/L). The primary outcome was annual eGFR slope, derived from individual linear regressions. Multivariable linear regression, restricted cubic spline analysis, model comparison, and pre-specified subgroup and sensitivity analyses were performed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In fully adjusted models, each 1-unit increase in baseline UHR was associated with greater annual eGFR decline (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.002, 95% CI\u202f\u2212\u202f0.003 to \u22120.001,\n p<\/jats:italic>\n \u202f=\u202f0.002). In model comparison, UHR demonstrated a larger standardized effect (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.052) than UA alone (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.045) or HDL-C alone (\n \u03b2<\/jats:italic>\n \u202f=\u202f0.028) and achieved explanatory power comparable to the joint UA\u202f+\u202fHDL-C model with a lower AIC, indicating superior parsimony. Comparing extreme tertiles, the highest UHR tertile (T3) exhibited an additional 0.56\u202fmL\/min\/1.73\u202fm\n 2<\/jats:sup>\n \/year decline versus the lowest (T1) (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.558,\n p<\/jats:italic>\n \u202f=\u202f0.001; P for trend\u202f=\u202f0.001), cumulating to 5.6\u202fmL\/min\/1.73\u202fm\n 2<\/jats:sup>\n over 10\u202fyears. Truly negative eGFR slopes were more frequent in T3 (44.3%) than T1 (21.4%), and T3 had 34% higher odds of rapid eGFR decline (OR 1.34, 95% CI 1.11\u20131.61,\n p<\/jats:italic>\n \u202f=\u202f0.002). RCS analysis confirmed linearity (P for nonlinearity\u202f=\u202f0.301). The association was stronger in patients aged &gt;60\u202fyears and those with HbA1c\u202f\u2265\u202f7% (P for interaction\u202f=\u202f0.005 and &lt;0.001) and remained robust in sensitivity analyses, including three-year average UHR (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.009,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Higher baseline UHR independently predicted faster eGFR decline in community-managed type 2 diabetes patients. As an inexpensive, readily available index, UHR may serve as a biomarker for identifying patients at elevated risk of progressive renal function loss.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fnut.2026.1879633","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T05:40:28Z","timestamp":1784007628000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between the uric acid to high-density lipoprotein cholesterol ratio and estimated glomerular filtration rate decline in community-managed patients with type 2 diabetes: a retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Jian","family":"Yang","sequence":"first","affiliation":[{"name":"Department of General Medicine, Longhua District People\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Longhua District People\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Shenzhen Second People\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hairong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Longhua District People\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhifu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Longhua District People\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1038\/nrneph.2015.173","article-title":"Changing epidemiology of type 2 diabetes mellitus and associated chronic kidney disease","volume":"12","author":"Thomas","year":"2016","journal-title":"Nat Rev Nephrol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2032","DOI":"10.2215\/CJN.11491116","article-title":"Diabetic kidney disease: challenges, progress, and possibilities","volume":"12","author":"Alicic","year":"2017","journal-title":"Clin J Am Soc Nephrol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1016\/S0140-6736(20)30045-3","article-title":"Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the global burden of Disease study 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