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The following is a summary of “Potential predictive role of Non-HDL to HDL Cholesterol Ratio (NHHR) in MASLD: focus on obese and type 2 diabetic populations,” published in the February 2025 issue of the BMC Gastroenterology by Ma et al.

This cross-sectional study aimed to investigate the association between the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) and metabolic dysfunction-associated steatotic liver disease (MASLD), with a particular focus on individuals with obesity and type 2 diabetes. A total of 3,784 participants aged 20 years and older were analyzed using data from the National Health and Nutrition Examination Survey (NHANES) 2017–2018. 

The prevalence of MASLD was assessed through multivariable logistic regression models, which provided ORs and 95% CIs to quantify the strength of the association between NHHR and MASLD. A smooth curve fitting approach was employed to explore potential nonlinear relationships between NHHR and MASLD prevalence. Additionally, subgroup analyses were conducted based on age, sex, body mass index, and T2D status to assess the robustness of the findings, with interaction tests performed to determine whether the associations varied across different population strata. The results demonstrated a consistently positive association between NHHR and MASLD across all analytical models. In the fully adjusted model, compared to individuals in the lowest NHHR group, those in the middle and highest NHHR groups exhibited significantly higher odds of MASLD (OR = 1.51, 95% CI = 1.25–1.83, p < 0.001; OR = 1.97, 95% CI = 1.62–2.41, p < 0.001, respectively). 

This association remained significant across all subgroups, confirming the robustness of the relationship between NHHR and MASLD. The study’s findings indicate that NHHR may serve as a valuable predictive marker for MASLD screening, particularly in populations at higher risk due to obesity or T2D. Given the significant and linear nature of this relationship across diverse demographic and metabolic profiles, NHHR could potentially be incorporated into routine clinical assessments to identify individuals at risk for MASLD, enabling earlier intervention and management strategies. However, as a cross-sectional analysis, the study is limited in establishing causality, necessitating further prospective and mechanistic research to validate these findings and explore the underlying pathophysiological mechanisms linking NHHR with MASLD progression.

Source: bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-025-03659-8