{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:31:05Z","timestamp":1792024265309,"version":"4.4.0"},"reference-count":63,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Noncommunicable Chronic Diseases-National Science and Technology Major Project","award":["2023ZD0509800"],"award-info":[{"award-number":["2023ZD0509800"]}]},{"name":"Noncommunicable Chronic Diseases-National Science and Technology Major Project","award":["2023ZD0509806"],"award-info":[{"award-number":["2023ZD0509806"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Objectives: The objective of this study was to examine the association between non-high-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C) ratio (NHHR) and chronic kidney disease (CKD) in Chinese adults with type 2 diabetes mellitus (T2DM). Methods: This study originated from a survey carried out in Zhejiang Province, located in eastern China, between March and November 2018. To explore the relationship between NHHR and CKD, a multivariable logistic regression model was employed. The dose\u2013response relationship was assessed using restricted cubic spline (RCS) analysis, while generalized additive models (GAMs) were applied to examine the associations between NHHR and urinary albumin-to-creatinine ratio (UACR) as well as estimated glomerular filtration rate (eGFR). Subgroup analyses were performed across various demographic and clinical categories to assess the consistency of the NHHR\u2013CKD association. The optimal NHHR cutoff for CKD diagnosis, its predictive accuracy, and its comparison with its components and HbA1c were determined through receiver operating characteristic (ROC) curve analysis. Results: The study enrolled 1756 participants, including 485 individuals with CKD and 1271 without CKD. Multivariable logistic regression revealed a significant positive association between NHHR and CKD, with each standard deviation (SD) increase in NHHR linked to a 23% higher odds of CKD (OR = 1.23, 95% CI: 1.09\u20131.37) after adjusting for potential confounders. When comparing quartiles, the fully adjusted ORs for Q2, Q3, and Q4 were 1.29 (0.92\u20131.79), 1.31 (0.94\u20131.83), and 1.87 (1.34\u20132.60), respectively, relative to Q1 (p for trend &lt; 0.01). RCS analysis confirmed a linear dose\u2013response relationship between NHHR and CKD in both sexes (p for nonlinearity &gt; 0.05). GAMs indicated a significant positive correlation between NHHR and UACR (\u03c1 = 0.109, p &lt; 0.001) but no significant association with eGFR (\u03c1 = \u22120.016, p = 0.502). Subgroup analyses demonstrated consistent associations across most subgroups, except for the 18\u201344 years age group, the well-controlled glycemic group, and the non-alcohol drinking group (p &gt; 0.05). ROC curve analysis identified an optimal NHHR cutoff of 3.48 for CKD prediction, with an area under the curve (AUC) of 0.606 (95% CI: 0.577\u20130.635). Notably, NHHR outperformed its individual components and HbA1c in predictive performance. Conclusions: This study revealed a linear link between higher NHHR levels and increased CKD prevalence in Chinese T2DM patients. NHHR may also serve as a potential complementary biomarker for early CKD detection, though further prospective studies are needed to confirm its predictive value and clinical utility in high-risk T2DM populations.<\/jats:p>","DOI":"10.3390\/nu17071125","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T12:01:50Z","timestamp":1742817710000},"page":"1125","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The Non-High-Density Lipoprotein Cholesterol (Non-HDL-C) to HDL-C Ratio (NHHR) and Its Association with Chronic Kidney Disease in Chinese Adults with Type 2 Diabetes: A Preliminary Study"],"prefix":"10.3390","volume":"17","author":[{"given":"Xiangyu","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingbin","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3592-7423","authenticated-orcid":false,"given":"Chunxiao","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruying","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jieming","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Deng, W., Zhao, L., Chen, C., Ren, Z., Jing, Y., Qiu, J., and Liu, D. (2024). National burden and risk factors of diabetes mellitus in China from 1990 to 2021: Results from the Global Burden of Disease study 2021. J. Diabetes, 16.","DOI":"10.1111\/1753-0407.70012"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2498","DOI":"10.1001\/jama.2021.22208","article-title":"Prevalence and Treatment of Diabetes in China, 2013\u20132018","volume":"326","author":"Wang","year":"2021","journal-title":"JAMA-J. Am. Med. Assoc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"531","DOI":"10.2337\/dci23-0041","article-title":"Cardiovascular and Kidney Risks in Individuals with Type 2 Diabetes: Contemporary Understanding with Greater Emphasis on Excess Adiposity","volume":"47","author":"Sattar","year":"2024","journal-title":"Diabetes Care"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1111\/dom.15765","article-title":"Chronic kidney disease in type 2 diabetes: The size of the problem, addressing residual renal risk and what we have learned from the CREDENCE trial","volume":"26","author":"Chaudhry","year":"2024","journal-title":"Diabetes Obes. Metab."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Sardar, M.B., Nadeem, Z.A., and Babar, M. (2024). Tirzepatide: A novel cardiovascular protective agent in type 2 diabetes mellitus and obesity. Curr. Probl. Cardiol., 49.","DOI":"10.1016\/j.cpcardiol.2024.102489"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Triozzi, J.L., Parker, G.L., Virani, S.S., and Navaneethan, S.D. (2021). Management of type 2 diabetes in chronic kidney disease. BMJ Open Diab. Res. Care, 9.","DOI":"10.1136\/bmjdrc-2021-002300"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Pan, X., Lin, X., Huang, X., Xu, J., Ye, L., Zhang, T., Hu, S., Jiang, H., Ren, Y., and Shan, P.F. (2022). The Burden of Diabetes-Related Chronic Kidney Disease in China From 1990 to 2019. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.892860"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Giardini, E., Moore, D., Sadlier, D., Godson, C., and Brennan, E. (2024). The dual role of lipids in chronic kidney disease: Pathogenic culprits and therapeutic allies. Atherosclerosis, 398.","DOI":"10.1016\/j.atherosclerosis.2024.118615"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s10557-018-06846-w","article-title":"High-Density Lipoprotein Function and Dysfunction in Health and Disease","volume":"33","author":"Chiesa","year":"2019","journal-title":"Cardiovasc. Drugs Ther."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1724","DOI":"10.1161\/01.ATV.0000094961.74697.54","article-title":"Endothelial protection by high-density lipoproteins: From bench to bedside","volume":"23","author":"Calabresi","year":"2003","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1038\/s41581-018-0098-z","article-title":"Endothelium structure and function in kidney health and disease","volume":"15","author":"Fakhouri","year":"2019","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2478","DOI":"10.1093\/eurheartj\/ehx163","article-title":"Extreme high high-density lipoprotein cholesterol is paradoxically associated with high mortality in men and women: Two prospective cohort studies","volume":"38","author":"Madsen","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Kaur, N., Pandey, A., Negi, H., Shafiq, N., Reddy, S., Kaur, H., Chadha, N., and Malhotra, S. (2014). Effect of HDL-raising drugs on cardiovascular outcomes: A systematic review and meta-regression. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0094585"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Guan, X.M., Shi, H.P., Xu, S., Chen, Y., Zhang, R.F., Dong, Y.X., Gao, L.J., Wu, S.L., and Xia, Y.L. (2023). Cumulative non-high-density lipoprotein cholesterol burden and risk of atherosclerotic cardiovascular disease: A prospective community-based study. Front. Cardiovasc. Med., 10.","DOI":"10.3389\/fcvm.2023.1105342"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Roumeliotis, S., Roumeliotis, A., Georgianos, P.I., Stamou, A., Manolopoulos, V.G., Panagoutsos, S., and Liakopoulos, V. (2021). Oxidized LDL Is Associated with eGFR Decline in Proteinuric Diabetic Kidney Disease: A Cohort Study. Oxidative Med. Cell. Longev., 2021.","DOI":"10.1155\/2021\/2968869"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Zhang, F., Li, Z., Wang, M., Wang, Y., and Lu, C. (2025). Association of non-highdensity lipoprotein cholesterol to highdensity lipoprotein cholesterol ratio (NHHR) and subsequent hypertension and heart diseases: Findings from the CHARLS cohort. Aging Clin. Exp. Res., 37.","DOI":"10.1007\/s40520-024-02919-z"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Han, Y.Z., Du, B.X., Zhu, X.Y., Wang, Y.Z., Zheng, H.J., and Liu, W.J. (2024). Lipid metabolism disorder in diabetic kidney disease. Front. Endocrinol., 15.","DOI":"10.3389\/fendo.2024.1336402"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Lu, C.F., Liu, W.S., Chen, Z.H., Hua, L.Y., Wang, X.Q., and Huang, H.Y. (2022). Comparisons of the Relationships Between Multiple Lipid Indices and Diabetic Kidney Disease in Patients with Type 2 Diabetes: A Cross-Sectional Study. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.888599"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Su, X., Rao, H., Zhao, C., Wu, J., Zhang, X., and Li, D. (2025). Association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and mortality among hypertension patients. Sci. Rep., 15.","DOI":"10.1038\/s41598-025-88539-7"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1001\/jamacardio.2022.0912","article-title":"Association Between High-Density Lipoprotein Cholesterol Levels and Adverse Cardiovascular Outcomes in High-risk Populations","volume":"7","author":"Liu","year":"2022","journal-title":"JAMA Cardiol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Hashem, C., Altin, S.E., Guyton, J.R., and Boden, W.E. (2024). Nonlinearity of the inverse relationship between high-density lipoprotein (HDL) cholesterol and incident cardiovascular risk: Is it time to revisit the \u201cHDL hypothesis\u201d?. J. Clin. Lipidol., in press.","DOI":"10.1016\/j.jacl.2024.12.009"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Galicia-Garcia, U., Benito-Vicente, A., Jebari, S., Larrea-Sebal, A., Siddiqi, H., Uribe, K.B., Ostolaza, H., and Martin, C. (2020). Pathophysiology of Type 2 Diabetes Mellitus. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21176275"},{"key":"ref_23","first-page":"633","article-title":"Data Resource Profile: A Protocol of China National Diabetic Chronic Complications Study","volume":"35","author":"Hou","year":"2022","journal-title":"Biomed. Environ. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1016\/j.jdiacomp.2016.03.020","article-title":"Prevalence of chronic kidney disease and associated factors in Chinese individuals with type 2 diabetes: Cross-sectional study","volume":"30","author":"Guo","year":"2016","journal-title":"J. Diabetes Complicat."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2000","DOI":"10.2337\/dc20-2715","article-title":"Chronic Kidney Disease Testing Among Primary Care Patients with Type 2 Diabetes Across 24 U.S. Health Care Organizations","volume":"44","author":"Stempniewicz","year":"2021","journal-title":"Diabetes Care"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1001\/jama.2019.14745","article-title":"Chronic Kidney Disease Diagnosis and Management: A Review","volume":"322","author":"Chen","year":"2019","journal-title":"JAMA-J. Am. Med. Assoc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A new equation to estimate glomerular filtration rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Liu, X., Zhang, Y., Luo, D., Chen, B., Lai, C., He, C., and Li, S. (2025). Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and cardiometabolic multimorbidity among middle-aged and older adults in China. BMC Public Health, 25.","DOI":"10.1186\/s12889-025-21757-w"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1038\/s41569-022-00829-z","article-title":"Hypertension in China: Epidemiology and treatment initiatives","volume":"20","author":"Wang","year":"2023","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/S2213-8587(21)00047-4","article-title":"Clinical management and treatment of obesity in China","volume":"9","author":"Zeng","year":"2021","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Wang, X., Tian, B., Zhang, S., Zhang, J., Yang, W., Li, J., Wang, W., Wang, Y., and Zhang, W. (2023). Diabetes knowledge predicts HbA1c levels of people with type 2 diabetes mellitus in rural China: A ten-month follow-up study. Sci. Rep., 13.","DOI":"10.1038\/s41598-023-45312-y"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Li, H., Wu, Y., Bai, Z., Xu, X., Su, D., Chen, J., He, R., and Sun, J. (2023). The Association Between Family Health and Frailty with the Mediation Role of Health Literacy and Health Behavior Among Older Adults in China: Nationwide Cross-Sectional Study. JMIR Public Health Surveill., 9.","DOI":"10.2196\/44486"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Chen, X., Du, X., Lu, F., Zhang, J., Xu, C., Liang, M., Chen, L., and Zhong, J. (2025). The Association Between the Triglyceride-Glucose Index, Its Combination with the Body Roundness Index, and Chronic Kidney Disease in Patients with Type 2 Diabetes in Eastern China: A Preliminary Study. Nutrients, 17.","DOI":"10.3390\/nu17030492"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Yu, B., Li, M., Yu, Z., Zheng, T., Feng, X., Gao, A., Zhang, H., and Gao, R. (2024). The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) as a predictor of all-cause and cardiovascular mortality in US adults with diabetes or prediabetes: NHANES 1999\u20132018. BMC Med., 22.","DOI":"10.1186\/s12916-024-03536-3"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Tsoupras, A., Lordan, R., and Zabetakis, I. (2018). Inflammation, not Cholesterol, Is a Cause of Chronic Disease. Nutrients, 10.","DOI":"10.3390\/nu10050604"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1038\/ki.2012.186","article-title":"Abrogation of lectin-like oxidized LDL receptor-1 attenuates acute myocardial ischemia-induced renal dysfunction by modulating systemic and local inflammation","volume":"82","author":"Lu","year":"2012","journal-title":"Kidney Int."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Xu, Z., Yang, S., and Cui, L. (2024). Understanding the heterogeneity and dysfunction of HDL in chronic kidney disease: Insights from recent reviews. BMC Nephrol., 25.","DOI":"10.1186\/s12882-024-03808-3"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"S165","DOI":"10.2337\/dcS15-3006","article-title":"SGLT2 Inhibitors and the Diabetic Kidney","volume":"39","author":"Fioretto","year":"2016","journal-title":"Diabetes Care"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Huang, J.K., and Lee, H.C. (2022). Emerging Evidence of Pathological Roles of Very-Low-Density Lipoprotein (VLDL). Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23084300"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Ma, K., Gao, W., Xu, H., Liang, W., and Ma, G. (2022). Role and Mechanism of the Renin-Angiotensin-Aldosterone System in the Onset and Development of Cardiorenal Syndrome. J. Renin-Angiotensin-Aldosterone Syst., 2022.","DOI":"10.1155\/2022\/3239057"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1038\/nm.3762","article-title":"Defective fatty acid oxidation in renal tubular epithelial cells has a key role in kidney fibrosis development","volume":"21","author":"Kang","year":"2015","journal-title":"Nat. Med."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Long, Z., Luo, Y., Yu, M., Wang, X., Zeng, L., and Yang, K. (2024). Targeting ferroptosis: A new therapeutic opportunity for kidney diseases. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1435139"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3493","DOI":"10.1113\/JP274492","article-title":"Transforming growth factor-beta signalling in renal fibrosis: From Smads to non-coding RNAs","volume":"596","author":"Tang","year":"2018","journal-title":"J. Physiol."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Liu, K., Cooper, M.E., Chai, Z., and Liu, F. (2025). High-Density Lipoprotein in Patients with Diabetic Kidney Disease: Friend or Foe?. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26041683"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1016\/j.ekir.2021.04.023","article-title":"Chronic Inflammation in Chronic Kidney Disease Progression: Role of Nrf2","volume":"6","author":"Stenvinkel","year":"2021","journal-title":"Kidney Int. Rep."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Hwang, S.W., Lee, T., Uh, Y., and Lee, J.Y. (2024). Urinary albumin creatinine ratio is associated with lipid profile. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-65037-w"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Li, Y., Liu, Y., Liu, S., Gao, M., Wang, W., Chen, K., Huang, L., and Liu, Y. (2023). Diabetic vascular diseases: Molecular mechanisms and therapeutic strategies. Signal Transduct. Target. Ther., 8.","DOI":"10.1038\/s41392-023-01400-z"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1038\/nrneph.2017.155","article-title":"Dyslipidaemia in nephrotic syndrome: Mechanisms and treatment","volume":"14","author":"Agrawal","year":"2018","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Zsom, L., Zsom, M., Salim, S.A., and Fulop, T. (2022). Estimated Glomerular Filtration Rate in Chronic Kidney Disease: A Critical Review of Estimate-Based Predictions of Individual Outcomes in Kidney Disease. Toxins, 14.","DOI":"10.3390\/toxins14020127"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1681\/ASN.2016060666","article-title":"Glomerular Hyperfiltration in Diabetes: Mechanisms, Clinical Significance, and Treatment","volume":"28","author":"Tonneijck","year":"2017","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Nankivell, B.J., Nankivell, L., Elder, G.J., and Gruenewald, S.M. (2020). How unmeasured muscle mass affects estimated GFR and diagnostic inaccuracy. Eclinicalmedicine, 29\u201330.","DOI":"10.1016\/j.eclinm.2020.100662"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Bowling, C.B., Olsen, M.K., Berkowitz, T., Smith, B., Floyd, B., Majette, N., Miles, A.L., Crowley, S.D., Wang, V., and Maciejewski, M.L. (2022). Reserve and resilience in CKD: Concept introduction and baseline results from the Physical REsilience Prediction in Advanced REnal Disease (PREPARED) study. BMC Nephrol., 23.","DOI":"10.1186\/s12882-022-03033-w"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1080\/10937404.2016.1243501","article-title":"The aging kidney and the nephrotoxic effects of mercury","volume":"20","author":"Bridges","year":"2017","journal-title":"J. Toxicol. Environ. Health-Part B-Crit. Rev."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Kellum, J.A., Romagnani, P., Ashuntantang, G., Ronco, C., Zarbock, A., and Anders, H.J. (2021). Acute kidney injury. Nat. Rev. Dis. Primers, 7.","DOI":"10.1038\/s41572-021-00284-z"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Gonzalez, P., Lozano, P., Ros, G., and Solano, F. (2023). Hyperglycemia and Oxidative Stress: An Integral, Updated and Critical Overview of Their Metabolic Interconnections. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24119352"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Wang, N., and Zhang, C. (2024). Oxidative Stress: A Culprit in the Progression of Diabetic Kidney Disease. Antioxidants, 13.","DOI":"10.3390\/antiox13040455"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Denimal, D. (2023). Antioxidant and Anti-Inflammatory Functions of High-Density Lipoprotein in Type 1 and Type 2 Diabetes. Antioxidants, 13.","DOI":"10.3390\/antiox13010057"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"7059","DOI":"10.12659\/MSM.916121","article-title":"Alcohol Consumption Can be a \u201cDouble-Edged Sword\u201d for Chronic Kidney Disease Patients","volume":"25","author":"Fan","year":"2019","journal-title":"Med. Sci. Monit."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Pan, J., Li, C., Zhang, J., Sun, Z., Yu, X., Wan, Q., Ruan, Z., Wang, W., and Li, Y. (2024). Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and diabetic kidney disease in patients with diabetes in the United States: A cross-sectional study. Lipids Health Dis., 23.","DOI":"10.1186\/s12944-024-02308-5"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Zhang, L., Fan, D., Zhu, T., Geng, L., Gan, L., Ou, S., and Yin, D. (2024). The ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol is associated with diabetic kidney disease: A cross-sectional study. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0311620"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Huang, D., and He, Y. (2025). Association between non-high-density lipoprotein cholesterol-to-high-density lipoprotein cholesterol ratio and macroalbuminuria: Evidence from NHANES 1999\u20132018. Front. Endocrinol., 16.","DOI":"10.3389\/fendo.2025.1503780"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Hong, H., He, Y., Gong, Z., Feng, J., and Qu, Y. (2024). The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and kidney stones: A cross-sectional study. Lipids Health Dis., 23.","DOI":"10.1186\/s12944-024-02089-x"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Du, Y.Z., Dong, Q.X., Hu, H.J., Guo, B., Li, Y.H., Zhang, J., Li, F.C., and Guo, J. (2024). A cross-sectional analysis of the relationship between the non-high density to high density lipoprotein cholesterol ratio (NHHR) and kidney stone risk in American adults. 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