Association Between GGT/HDL-C Ratio and Diabetic Kidney Disease in Patients with Type-2 Diabetes Mellitus

Purpose: The ratio of gamma-glutamyl transferase (GGT) to high-density lipoprotein cholesterol (HDL-C) (GHR) represents a novel non-insulin-based biomarker for evaluating the risk of NAFLD and T2DM. However, its correlation with diabetic kidney disease (DKD) remains unexplored. This study aims to explore the association between GHR and DKD in patients with T2DM. Patients and Methods: In this cross-sectional study, 2798 patients diagnosed as T2DM admitted to the hospital from 2018 to 2023 were assessed. The analysis was conducted through restricted cubic spline (RCS) and logistic regression methodologies, complemented by additional stratified and interaction analyses. Results: As the quartiles of GHR increase, there is a notable increase in the prevalence of DKD, with the rates of 43.2%, 47.2%, 52.1%, and 57.4%, respectively. Logistic regression analysis showed a positive association between GHR and DKD (OR=1.17, 95% CI: 1.05-1.30), which was consistently observed across all subgroups through stratified analysis. RCS analysis identified an inverted L-shaped association, with an inflection point at 84.5. Additionally, AUC for GHR (AUC = 0.637, 95% CI: 0.616-0.657) was significantly higher compared to those of GGT and HDL alone. Conclusion: GHR exhibits a positive association with the risk of DKD, underscoring its potential utility as a cost-effective biomarker for stratifying the risk of DKD.