Synergies between diabetes and hyperhomocysteinaemia: New insights to predict and prevent adverse cardiovascular effects

IF 5.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes, Obesity & Metabolism Pub Date : 2024-10-21 DOI:10.1111/dom.15947

Xue Fan PhD, Yuhe Liu MSc, Xueyu Chen MSc, Yuehao Xu PhD, Wenqian Wu BSc, Fengchang Li MSc, Gang Liu BSc, Xiaoli Chen BSc, Caiping Zhang PhD, Yong Zhou PhD

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Abstract

Aim

To explore the association of hyperhomocysteinaemia (HHcy) and diabetes synergies with cardiovascular events in the adult population of northern China.

Methods

Data were collected from the Asymptomatic Polyvascular Abnomalities Community study for 2010 to 2019. Serum homocysteine (Hcy) levels were determined by enzyme-linked immunosorbent assay. The participants were categorized into four groups based on their Hcy levels and diabetes status: non-diabetes/non-HHcy, non-diabetes/HHcy, diabetes/non-HHcy and diabetes/HHcy. The composite endpoint consisted of the occurrence of first-ever stroke, myocardial infraction (MI) or all-cause mortality. Cox regression analyses were performed to evaluate the associations of diabetes and HHcy with cardiovascular disease (CVD) events.

Results

In total, 5278 participants were eligible (average age 55.1 years, 60% male). Over a follow-up of 9.1 years, 618 events were identified, 202 stroke, 52 MI and 406 all-cause deaths. Compared with the non-diabetes/non-HHcy group, hazard ratios with 95% confidence intervals in the diabetes/HHcy group for stroke, MI, major adverse cardiovascular event (MACE), all-cause death and composite endpoint were 1.85 (1.12-3.04), 1.33 (0.42-4.23), 1.78 (1.13-2.80), 2.24 (1.56-3.23) and 1.97 (1.47-2.65), respectively. Significant interactions between HHcy and diabetes status were found for stroke, MI and MACE (P for interaction = .002, .027 and .044, respectively). In addition, the association of diabetes/HHcy with stroke was modified by age (< 60 and ≥ 60 years; P for interaction = .016).

Conclusions

The findings highlight the synergistic impact of diabetes and HHcy on CVD. Joint assessments of diabetes and Hcy levels should be emphasized for risk stratification and primary prevention of CVD.

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糖尿病与高同型半胱氨酸血症之间的协同作用：预测和预防心血管不良影响的新见解。

目的：探讨中国北方成年人群中高同型半胱氨酸血症（HHcy）和糖尿病协同作用与心血管事件的关系：方法：从无症状多血管异常社区研究（Asymptomatic Polyvascular Abnomalities Community Study）中收集2010年至2019年的数据。采用酶联免疫吸附法测定血清同型半胱氨酸（Hcy）水平。根据参与者的 Hcy 水平和糖尿病状况将其分为四组：非糖尿病/非 Hcy 组、非糖尿病/Hcy 组、糖尿病/非 Hcy 组和糖尿病/Hcy 组。复合终点包括首次中风、心肌梗死或全因死亡率。对糖尿病和HHcy与心血管疾病（CVD）事件的关系进行了Cox回归分析：共有 5278 名参与者符合条件（平均年龄 55.1 岁，60% 为男性）。在 9.1 年的随访中，共发现 618 例心血管疾病，其中中风 202 例，心肌梗死 52 例，全因死亡 406 例。与非糖尿病/非 HHcy 组相比，糖尿病/HHcy 组中风、心肌梗死、主要不良心血管事件 (MACE)、全因死亡和综合终点的危险比（95% 置信区间）分别为 1.85 (1.12-3.04)、1.33 (0.42-4.23)、1.78 (1.13-2.80)、2.24 (1.56-3.23) 和 1.97 (1.47-2.65)。在中风、心肌梗死和 MACE 方面，HHcy 与糖尿病状态之间存在显著的交互作用（交互作用的 P 分别为 0.002、0.027 和 0.044）。此外，糖尿病/HHcy 与中风的关系还受年龄的影响（结论：糖尿病/HHcy 与中风的关系受年龄的影响：研究结果凸显了糖尿病和 HHcy 对心血管疾病的协同影响。在心血管疾病的风险分层和一级预防中，应重视对糖尿病和 Hcy 水平的联合评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes, Obesity & Metabolism 医学-内分泌学与代谢

CiteScore

10.90

自引率

6.90%

发文量

319

审稿时长

3-8 weeks

期刊介绍： Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.