{
  "abstract": "Introduction Type 2 diabetes mellitus (T2DM) and metabolic dysfunction-associated steatotic liver disease (MASLD) frequently coexist in the same individual. Dyslipidemia plays a central role in the pathogenesis of MASLD. Remnant cholesterol (RC) is the cholesterol content carried in triglyceride-rich lipoproteins. We aimed to examine the association of RC, its discordance with low-density lipoprotein cholesterol (LDL-C) in terms of MASLD risk in patients with T2DM.Research design and methods A total of 26 302 T2DM patients who were hospitalized were cross-sectionally assessed. Logistic regression models were employed to assess the associations. We used three approaches to assess the effects of the discordance between RC and LDL-C on MASLD risk: clinical cut-off points, differences of >10 percentile points and residuals.Results The median age was 62.0 years, and 48.3% had MASLD. RC was more closely associated with MASLD than LDL-C. Furthermore, discordantly high RC was associated with higher MASLD risk than discordantly high LDL-C, regardless of which method of discordance analysis is used. For example, for the residual approach, in a regression model including LDL-C and RC residual, the latter, representing the portion of RC not explained by LDL-C, was more associated with MASLD risk than LDL-C (OR=1.26, 95% CI 1.22 to 1.30 for RC residual and OR=1.04, 95% CI 1.01 to 1.07 for LDL-C); in a regression model including RC and LDL-C residual, the latter representing the portion of LDL-C not explained by RC, RC was more associated with MASLD risk than LDL-C residual (OR=1.24, 95% CI 1.20 to 1.29 for RC and OR=1.09, 95% CI 1.06 to 1.12 for LDL-C residual).Conclusions Discordantly high RC was associated with higher MASLD risk than discordantly high LDL-C. Our findings suggest that RC may serve as a potential target for prevention and intervention for MASLD.",
  "authors": [
    {
      "affiliations": [
        "Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China",
        "Hubei Provincial Clinical Medical Research Center for Endocrinology and Metabolic Diseases, Wuhan, People's Republic of China"
      ],
      "name": "Ying Zhao"
    },
    {
      "affiliations": [
        "Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China",
        "Hubei Provincial Clinical Medical Research Center for Endocrinology and Metabolic Diseases, Wuhan, People's Republic of China"
      ],
      "name": "Zhaoyue Li"
    },
    {
      "affiliations": [
        "Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China",
        "Hubei Provincial Clinical Medical Research Center for Endocrinology and Metabolic Diseases, Wuhan, People's Republic of China"
      ],
      "name": "Tian Yu"
    },
    {
      "affiliations": [
        "Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China",
        "Hubei Provincial Clinical Medical Research Center for Endocrinology and Metabolic Diseases, Wuhan, People's Republic of China"
      ],
      "name": "Yan Yang"
    },
    {
      "affiliations": [
        "Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China",
        "Hubei Provincial Clinical Medical Research Center for Endocrinology and Metabolic Diseases, Wuhan, People's Republic of China"
      ],
      "name": "Tingting Du"
    }
  ],
  "title": "Discordant high remnant cholesterol with LDL-C increases the metabolic dysfunction-associated steatotic liver disease risk in patients with type 2 diabetes mellitus",
  "uid": "7c32eb6d-a62d-55d1-8aa3-5d0aefbe7d3e"
}