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Objective To explore the correlation between uric acid/high-density lipoprotein cholesterol ratio (UHR) and visceral fat area (VFA) in patients with type 2 diabetes mellitus (T2DM). Methods A total of 909 patients with T2DM treated in National Metabolic Management Center (MMC) of the Affiliated Hospital of Jiangsu University from May 2018 to July 2020 were enrolled in this study. The general clinical information and physical examination [including height, weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), neck circumference, waist circumference, hip circumference, VFA and subcutaneous fat area (SFA)] were collected. Body mass index (BMI), waist hip ratio (WHR) and VFA/SFA ratio (V/S) were calculated. And glucose metabolism indexes [fasting plasma glucose (FPG), fasting insulin (FINS), 2 hour postprandial plasma glucose (2hPG), 2 hour postprandial insulin (2hINS) and glycated hemoglobin A1c (HbAlc)], biochemical indexes [total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), --glutamyl transpeptidase (GGT), blood urea nitrogen (BUN) and serum creatinine (Scr)] and thyroid hormone [free triiodothyronine (FT3), free thyroxine (FT4), sensitivity thyrotropin stimulating hormone (sTSH)] were conducted on all subjects. Homeostasis model assessment of insulin resistance (HOMA-IR), homeostasis model assessment of β--cell function (HOMA-β) and UHR were calculated. Meanwhile, according to UHR, all patients were divided into tertiles, which included group Q1 (UHR≤21.10%, 303 cases), group Q2 (21.10%31.06%, 303 cases). Based on VFA, patients were divided into control group (VFA<100, 597 cases) and visceral obesity (VO) group (VFA≥100, 312 cases). The differences between groups were compared by one-way analysis of variance (ANOVA), Kruskal-Wallis nonparametric test and χ2 test. Spearman correlation analysis was used to analyze the correlation between UHR and various indicators, and multiple linear regression analysis was used to analyze the influencing factors of VFA in T2DM patients. Results Compared with group Q1, the proportions of males, smoking, drinking, the proportion of hyperlipidemia, FINS, HOMA-β, TG, GGT, Scr, BMI, neck circumference, waist circumference, hip circumference, WHR, VFA, SFA and V/S in groups Q2 and Q3 were all increased, while SBP, DBP, 2hINS, HOMA-IR, ALT, AST, FT3 only increased in group Q3. Age, TC, LDL-C only decreased in group Q3. Compared with group Q2, the proportion of males, hyperlipidemia, DBP, HOMA-IR, TG, ALT, γ-GT, BMI, waist circumference and VFA in group Q3 were increased, while age and LDL-C decreased (P<0.05). Spearman correlation analysis indicated that UHR was positively correlated with VFA and V/S(r=0.328, 0.205, both P<0.001. Multiple linear regression analysis indicated that UHR was independently correlated with VFA (β =0.241, 95%CI 0.097-0.384, P<0.01). Compared with control group, UHR in VO group was statistically significantly higher (P<0.01). Conclusion There is a positive correlation between UHR and VFA as well as V/S in patients with T2DM, and it has clinical value for early warning of VO in the T2DM. [ABSTRACT FROM AUTHOR]