{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T19:17:09Z","timestamp":1780773429722,"version":"3.54.1"},"reference-count":48,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T00:00:00Z","timestamp":1729468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To explore the association of hyperhomocysteinaemia (HHcy) and diabetes synergies with cardiovascular events in the adult population of northern China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected from the Asymptomatic Polyvascular Abnomalities Community study for 2010 to 2019. Serum homocysteine (Hcy) levels were determined by enzyme\u2010linked immunosorbent assay. The participants were categorized into four groups based on their Hcy levels and diabetes status: non\u2010diabetes\/non\u2010HHcy, non\u2010diabetes\/HHcy, diabetes\/non\u2010HHcy and diabetes\/HHcy. The composite endpoint consisted of the occurrence of first\u2010ever stroke, myocardial infraction (MI) or all\u2010cause mortality. Cox regression analyses were performed to evaluate the associations of diabetes and HHcy with cardiovascular disease (CVD) events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 5278 participants were eligible (average age 55.1\u2009years, 60% male). Over a follow\u2010up of 9.1\u2009years, 618 events were identified, 202 stroke, 52 MI and 406 all\u2010cause deaths. Compared with the non\u2010diabetes\/non\u2010HHcy group, hazard ratios with 95% confidence intervals in the diabetes\/HHcy group for stroke, MI, major adverse cardiovascular event (MACE), all\u2010cause death and composite endpoint were 1.85 (1.12\u20103.04), 1.33 (0.42\u20104.23), 1.78 (1.13\u20102.80), 2.24 (1.56\u20103.23) and 1.97 (1.47\u20102.65), respectively. Significant interactions between HHcy and diabetes status were found for stroke, MI and MACE (\n                      <jats:italic>P<\/jats:italic>\n                      for interaction\u2009=\u2009.002, .027 and .044, respectively). In addition, the association of diabetes\/HHcy with stroke was modified by age (&lt;\u200960 and \u2265\u200960\u2009years;\n                      <jats:italic>P<\/jats:italic>\n                      for interaction\u2009=\u2009.016).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.15947","type":"journal-article","created":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T01:55:47Z","timestamp":1729562147000},"page":"5776-5785","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Synergies between diabetes and hyperhomocysteinaemia: New insights to predict and prevent adverse cardiovascular effects"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2446-8834","authenticated-orcid":false,"given":"Xue","family":"Fan","sequence":"first","affiliation":[{"name":"Department of Research Center for Cardiovascular and Cerebrovascular Disease, Clinical Research Institute, Shanghai General Hospital Shanghai Jiao Tong University School of Medicine  Shanghai 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