{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:59:05Z","timestamp":1792814345823,"version":"4.5.0"},"reference-count":47,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Social determinants of health (SDHs) have been increasingly recognised as upstream drivers of preventable health disparities. However, it is unclear what the role of SDHs is in the whole progression of prediabetes. We aimed to delineate the impact of SDHs on the progression from prediabetes to subsequent cardio\u2013renal\u2013metabolic disease (CRMD), cardio\u2013renal\u2013metabolic multimorbidity (CRMM) and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>37 098 participants with prediabetes and free of any CRMD (i.e., type 2 diabetes, cardiovascular disease and chronic kidney disease [CKD]) at baseline from the UK Biobank were included. A combined SDH score was assessed by a sum of 17 items including financial, education, healthcare, neighbourhood, and social domains, and was categorised into favourable, medium, and unfavourable groups by tertile. Outcomes included first CRMD, CRMM (the coexistence of at least two CRMDs) and death during follow\u2010up. Five transition paths were considered, and multistate models were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with the favourable SDH group, the unfavourable SDH group consistently showed elevated risks for different transition stages, except for the CRMM\u2010to\u2010death transition. Lifestyle partially mediated the associations, while the mediation proportions at each stage explained less than 20%. Among disease\u2010specific associations, unfavourable SDHs disproportionally increased the risks of three CRMDs, with the highest risk observed for the CKD\u2010to\u2010death transition (hazard ratio\u2009=\u20092.22, 95% confidence interval: 1.16\u20134.26).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Unfavourable SDHs were associated with increased risks of progression from prediabetes. Resource allocation and lifestyle promotion should be prioritised for those with unfavourable SDHs to mitigate disparities in progression to CRMM and death in diabetes care, especially in the early disease stage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70067","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:11:39Z","timestamp":1756282299000},"page":"6605-6614","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Social determinants of health and progression to cardio\u2013renal\u2013metabolic multimorbidity and mortality in people with prediabetes: A prospective cohort study"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2473-9487","authenticated-orcid":false,"given":"Rong","family":"Hua","sequence":"first","affiliation":[{"name":"School of Pharmacy, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2968-1762","authenticated-orcid":false,"given":"Aimin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics The Chinese University of Hong Kong, Prince of Wales Hospital  Hong Kong SAR China"},{"name":"Hong Kong Institute of Diabetes and Obesity The Chinese University of Hong Kong, Prince of Wales Hospital  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9349-6599","authenticated-orcid":false,"given":"Le","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy Xi'an Jiaotong University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4147-3387","authenticated-orcid":false,"given":"Elaine","family":"Chow","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics The Chinese University of Hong Kong, Prince of Wales Hospital  Hong Kong SAR China"},{"name":"Hong Kong Institute of Diabetes and Obesity The Chinese University of Hong Kong, Prince of Wales Hospital  Hong Kong SAR China"},{"name":"Phase 1 Clinical Trial Centre The Chinese University of Hong Kong, Prince of Wales Hospital  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjing","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy Xi'an Jiaotong University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9874-8938","authenticated-orcid":false,"given":"Yin Ting","family":"Cheung","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc22\u20102376"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125\u2010024\u201006315\u20100"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2022.100599"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000001186"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(24)00757\u20108"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2023.3241"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000504558"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000001184"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2213\u20108587(19)30093\u20102"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc21\u20101046"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.2337\/dci20\u20100053"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.120.048026"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyr029"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc13\u20100570"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.2436"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2666\u20107568(24)00116\u20108"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125\u2010022\u201005761\u2010y"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfac302"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001779"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040297"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc23\u2010S002"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2024.103138"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933\u2010024\u201002347\u20103"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933\u2010023\u201001937\u2010x"},{"key":"e_1_2_10_26_1","unstructured":"Biobank TU.Data providers and dates of data availability.https:\/\/biobank.ndph.ox.ac.uk\/showcase\/exinfo.cgi?src=Data_providers_and_dates. Accessed 1 May 2025"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n604"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2018.1717"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.18396"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.109.192703"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy695"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.1267"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.2712"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmpb.2010.01.001"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2024.101108"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2024.156031"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab413"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1515\/ijb-2017-0006"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1159\/000510696"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1161\/circresaha.121.319811"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2017.12.016"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00038\u2010016\u20100822\u2010z"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.14791"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.15171\/ijhpm.2018.53"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581\u2010024\u201000820\u20106"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2017.52"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2014.07.002"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwx246"}],"container-title":["Diabetes, Obesity and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/pdf\/10.1111\/dom.70067","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/full-xml\/10.1111\/dom.70067","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/pdf\/10.1111\/dom.70067","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T06:24:06Z","timestamp":1771309446000},"score":1,"resource":{"primary":{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/10.1111\/dom.70067"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,27]]},"references-count":47,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/dom.70067"],"URL":"https:\/\/doi.org\/10.1111\/dom.70067","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/DOM.70067\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70067\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70067\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70067\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70067\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70067\/v2\/decision1","asserted-by":"object"}]},"ISSN":["1462-8902","1463-1326"],"issn-type":[{"value":"1462-8902","type":"print"},{"value":"1463-1326","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,27]]},"assertion":[{"value":"2025-06-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}