Association of Neutrophil/High-Density Lipoprotein Cholesterol Ratio with Metabolic Dysfunction-Associated Steatotic Liver Disease in Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study and Predictive Model Construction.

Objective: The neutrophil/high-density lipoprotein cholesterol ratio (NHR) has been identified as a combined indicator of inflammatory cells and lipid metabolism. The objective of this study was to investigate the relationship between the NHR and metabolic dysfunction-associated steatotic liver disease (MASLD) in patients with type 2 diabetes mellitus (T2DM).

Methods: This cross-sectional study selected patients with T2DM who were admitted to the Department of Endocrinology at the First Hospital of Zhangjiakou City. Liver ultrasound was performed on all patients to determine the presence or absence of MASLD, and NHR values were calculated. The patients were grouped according to the median NHR, and a difference analysis was performed to compare the differences in clinical information between groups.Logistic regression was used to assess independent influences of MASLD, and subgroup analyses were performed. The final stage of this project involved construction of a novel predictive model for MASLD, derived from the screened influential factors, alongside an evaluation of its predictive value using the receiver operating characteristic.

Results: A total of 621 patients with T2DM were included in this study according to the inclusion and exclusion criteria. Logistic regression analyses showed a significant negative correlation between NHR and MASLD, and this correlation was particularly significant in men and in patients not using GLP-1A. In addition, restricted cubic spline curve (RCS) plots showed a nonlinear correlation between NHR and MASLD. The area under the curve (AUC) of the novel prediction model constructed on the basis of NHR reached 0.78 (95% CI 0.75-0.82), which can be used to predict the onset of MASLD, and is effective in clinical applications.

Conclusion: NHR is significantly correlated with MASLD, and NHR has the potential to be an early detection and intervention indicator for screening T2DM patients for MASLD.