Tehran University of Medical Sciences Acta Biochimica Iranica 0001-5261 2026 4 2026 06 22 89 97 EN Mohammed Fadhii Ajeel Alshammari Department of Clinical Biochemistry and Genetics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Fatemeh Sadat Hoseini Department of Clinical Biochemistry and Genetics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Hossein Mokhtari Amol Faculty of Paramedicine, Mazandaran University of Medical Sciences, Sari, Iran Hadis Musavi Department of Clinical Biochemistry and Genetics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Abbas Khonakdar-Tarsi Department of Clinical Biochemistry and Genetics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran 2026 06 04 2026 06 29 Objective: Diabetic nephropathy (DN) is a major complication of type 2 diabetes mellitus (T2DM). This study aims to evaluate the association of the uric acid-to-high-density lipoprotein cholesterol ratio (UHR) with biochemical parameters in patients with and without DN. Methods: In this comparative cross-sectional study, 120 patients with T2DM (60 with DN and 60 without DN) were enrolled. Clinical, biochemical, lipid, renal, inflammatory, and hematological parameters were measured. Correlations between UHR and glycemic indices were analyzed, and receiver operating characteristic (ROC) analysis was performed. Results: Patients with DN had higher triglyceride and creatinine levels, lower high-density lipoprotein cholesterol (HDL-C) levels, and borderline higher UHR (P=0.05) than those without DN. No significant differences were found for HbA1c, fasting blood glucose, postprandial glucose, mean plasma glucose, triglyceride-glucose index, or serum uric acid. UHR was not significantly correlated with any glycemic index (all P>0.05). ROC analysis showed poor discriminatory performance of UHR for DN (AUC=0.452, P=0.475). Conclusion: Although UHR was borderline elevated in patients with DN, it was not associated with glycemic indices and showed poor diagnostic performance. These findings suggest that UHR has limited utility as an independent biomarker of diabetic nephropathy in T2DM. https://abi.tums.ac.ir/index.php/abi/article/view/196 https://abi.tums.ac.ir/index.php/abi/article/download/196/142