{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T13:27:08Z","timestamp":1793626028697,"version":"4.5.1"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Endocrino Diabet &amp;amp; Metabol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>CKD is a major complication of T2DM and a leading cause of end\u2010stage kidney disease. Because urinary albumin\u2010to\u2010creatinine ratio (UACR) and eGFR have recognized limitations, additional biomarkers may help characterize kidney dysfunction. HCY is frequently elevated in CKD and may reflect pathways of renal injury. We evaluated the association of HCY with kidney dysfunction and its cross\u2010sectional discrimination of CKD status in Vietnamese adults with T2DM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A descriptive cross\u2010sectional study was conducted among adult outpatients with T2DM recruited at UMC HCMC (Campus 2) from December 2023 to December 2025 using convenience sampling. CKD was defined as eGFR &lt;\u200960\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      and\/or UACR &gt;\u200930\u2009mg\/g. HCY and other laboratory parameters were measured using standardized protocols; eGFR was calculated using the 2021 CKD\u2010EPI creatinine\u2010cystatin C equation. Correlation, logistic regression, and ROC analyses were performed. Albuminuria alone was examined in a sensitivity analysis, and AUCs were compared using DeLong's test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 201 participants, 164 (81.6%) met the study\u2010defined CKD criteria. HCY was higher in participants with CKD and increased across worsening eGFR and albuminuria categories. HCY correlated more strongly with creatinine and cystatin C (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.67 for both) and eGFR (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.59) than with UACR (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.26). Higher HCY remained associated with CKD after adjustment for age and HbA1c (adjusted OR\u2009=\u20091.27, 95% CI 1.14\u20131.42). The HCY\u2010only AUC was 0.79; the Youden\u2010derived threshold was 11.35\u2009\u03bcmol\/L (sensitivity 0.76; specificity 0.78). For albuminuria alone, the association persisted (OR\u2009=\u20091.08, 95% CI 1.03\u20131.14), but discrimination was modest (AUC\u2009=\u20090.63). The multivariable AUC was 0.812 and did not differ significantly from the HCY\u2010only AUC (DeLong\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.325).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher HCY was associated with CKD and kidney dysfunction, with a stronger relationship to filtration markers than to albuminuria. These cross\u2010sectional findings do not establish screening or prognostic utility. The 11.35\u2009\u03bcmol\/L threshold is exploratory and requires external validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/edm2.70339","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T11:26:53Z","timestamp":1789558013000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Serum Homocysteine and Chronic Kidney Disease Severity in Vietnamese Outpatients With Type 2 Diabetes: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6279-2277","authenticated-orcid":false,"given":"Loi Ngoc","family":"Ho","sequence":"first","affiliation":[{"name":"University Medical Center Ho Chi Minh City  Ho Chi Minh City Vietnam"},{"name":"University of Medicine and Pharmacy at Ho Chi Minh City  Ho Chi Minh City Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8133-8027","authenticated-orcid":false,"given":"Tien","family":"Van Tran","sequence":"additional","affiliation":[{"name":"University of Medicine and Pharmacy at Ho Chi Minh City  Ho Chi Minh City Vietnam"},{"name":"Hospital for Rehabilitation\u2014Professional Disease  Ho Chi Minh City Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7049-2601","authenticated-orcid":false,"given":"Tinh Trung Truong","family":"Tran","sequence":"additional","affiliation":[{"name":"University of Medicine and Pharmacy at Ho Chi Minh City  Ho Chi Minh City Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5597-0571","authenticated-orcid":false,"given":"Nhan Trong","family":"Le","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Hong Bang International University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7962-1639","authenticated-orcid":false,"given":"Loc Huu","family":"Quach","sequence":"additional","affiliation":[{"name":"University Medical Center Ho Chi Minh City  Ho Chi Minh City Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8129-4156","authenticated-orcid":false,"given":"Khanh Minh","family":"Thanh","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Van Lang University  Ho Chi Minh City Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1342-4841","authenticated-orcid":false,"given":"Hien Ngoc","family":"Tran","sequence":"additional","affiliation":[{"name":"University of Medicine and Pharmacy at Ho Chi Minh City  Ho Chi Minh City Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7285-4221","authenticated-orcid":false,"given":"Hang Khanh","family":"Hoang","sequence":"additional","affiliation":[{"name":"Buon Ma Thuot Medical University  Buon Ma Thuot Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9760-440X","authenticated-orcid":false,"given":"Ha Hai","family":"Tran","sequence":"additional","affiliation":[{"name":"University of Medicine and Pharmacy at Ho Chi Minh City  Ho Chi Minh City Vietnam"},{"name":"Tra Vinh University  Vinh Long Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0485-1665","authenticated-orcid":false,"given":"Tuan Quoc","family":"Le","sequence":"additional","affiliation":[{"name":"University of Medicine and Pharmacy at Ho Chi Minh City  Ho Chi Minh City Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"issue":"7","key":"e_1_2_11_2_1","first-page":"11174","article-title":"Association Between Plasma Homocysteine and Progression of Early Nephropathy in Type 2 Diabetic Patients","volume":"8","author":"Wang H.","year":"2015","journal-title":"International Journal of Clinical and Experimental Medicine"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20040867"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1096\/fj.15-272443"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000444900"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu15010184"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1515\/pteridines-2020-0025"},{"key":"e_1_2_11_8_1","article-title":"Association Between Serum Homocysteine Levels and Severity of Diabetic Kidney Disease in 489 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