showed a trendP = 0.115
In fully adjusted models, the highest HGI quartile (Q4) demonstrated a significantly increased risk of DN (OR = 1.54, 95% CI: 1.03–2.30, P = 0.036), while the lowest HGI quartile (Q1) also showed a trend toward higher risk (OR = 1.40, 95% CI: 0.92–2.14, P = 0.115).