The Non-high-density Lipoprotein Cholesterol (Non-HDL-C) to High-density Lipoprotein Cholesterol (HDL-C) Ratio (NHHR) and Its Association With Occurrence of Diabetic Nephropathy in Patients With Diabetes Mellitus

The study will include adult participants recruited from outpatient clinics and inpatient departments. Participants will be classified into the following groups:

• Diabetes Mellitus without Diabetic Nephropathy (DM group) :

Patients with diabetes mellitus who have no evidence of diabetic nephropathy will be defined by a normal urinary albumin-to-creatinine ratio (UACR) and preserved renal function.

• Diabetic Nephropathy group (DN group) :

Patients with diabetes mellitus and diabetic nephropathy will be defined by the presence of elevated UACR and/or impaired renal function as assessed by estimated glomerular filtration rate (eGFR).

Subgroup Analysis :

Within the diabetic nephropathy group, further subgroup analyses will be performed to assess differences in NHHR according to:

Type of diabetes (Type 1 vs. Type 2 diabetes mellitus) Stages of chronic kidney disease (CKD) are classified based on KDIGO definitions of CKD based on estimated GFR and albuminuria.

Type of the study: Comparative cross-sectional study

Inclusion criteria

• Adults aged ≥18 years
• Diagnosed cases of diabetes mellitus (Type 1 or Type 2), with or without diabetic nephropathy
• Willingness to participate and provide informed consent

Exclusion criteria

• Known non-diabetic causes of chronic kidney disease
• Acute kidney injury
• Chronic inflammatory or autoimmune diseases
• Current use of medications known to significantly alter lipid metabolism (other than standard lipid-lowering therapy, if applicable)
• End-stage renal disease patients on dialysis