Our analysis indicates that even in non-obese populations, the association between TG/HDL-c and CKD remains significant (OR = 1.1660, 95% CI: 1.0810–1.2577), which supports that lipid toxicity may function independently of obesity; (3) Endothelial dysfunction and vascular injury: dyslipidemia triggers inflammatory cytokine production and adipokine imbalance (increased leptin, decreased adiponectin), which leads to endothelial dysfunction and vascular injury (72). Here, ADIPOQ is linked to obesity due to melanocortin 4 receptor deficiency.