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The association of homocysteine level with the risk of diabetic nephropathy and diabetic retinopathy in NHANES

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Abstract

Aims

To examine the association of homocysteine (Hcy) with diabetic nephropathy (DN) and diabetic retinopathy (DR) in a representative United States population.

Methods

This was a cross-sectional study using data from participants in the National Health and Nutrition Examination Survey 2005–2006. Metrics including Hcy level, urinary albumin to creatinine ratio, estimated glomerular filtration rate, and retinopathy grading were collected. Multiple logistic regression models were employed to assess the association of Hcy with DN and DR.

Results

630 participants were included in this study. The Hcy level was significantly higher in those with DN and DR than those without DN and DR. Hcy was associated with an increased risk of DN (OR = 1.31, 95% CI 1.18–1.46; P < 0.001). In the fully adjusted model of DN (model II), compared to participants in quartiles 1 of Hcy, the adjusted ORs for participants in quartiles 2–4 were 1.49 (95% CI 0.52–4.26; P = 0.426), 3.81 (95% CI 1.35–10.73; P = 0.015), and 14.08 (95% CI 3.84–51.66; P = 0.001), respectively. Hcy was also associated with an increased risk of DR (OR = 2.260, 95% CI 1.212–4.216; P = 0.014), but this association was non-significant in the fully adjusted model of DR (model II).

Conclusions

In diabetic patients, Hcy was associated with increased risk of DN in a non-linear manner. In addition, Hcy was associated with the risk of DR, but the association was attenuated after adjusting for confounders. In the future, Hcy can potentially be used as an early screening indicator for diabetic microvascular complications.

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Funding

This study was supported by the Guangzhou Science and Technology Project (No. 201804010038), Natural Science Foundation Project of Guangdong Province (No. 2020A1515010276), the National Natural Science Foundation of China (82000901), the Science and Technology Program of Guangzhou, China (3030901006102), Joint Funds for the Innovation of Science and Technology, Fujian Province (No. 2018Y9087).

Author information

Author notes

  1. Huangdong Li, Chengyi Liu and Jingyu Zhang have contributed equally and should be considered as co-first authors.

Authors and Affiliations

  1. Ophthalmic Center, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, Guangdong, China

    Huangdong Li, Chengyi Liu, Jingyu Zhang, Ruiming Yang, Jiamian Liang & Zhiping Liu

  2. Conghua Maternity and Children Health Care Center, Conghua District, Xincheng West Road 76, Guangzhou, 510900, China

    Chengyi Liu

  3. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510623, China

    Wei Wang & Weijing Cheng

  4. Department of Ophthalmology, University of Colorado, Aurora, CO, 80045, USA

    Amy Michelle Huang

  5. Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350004, China

    Jian Guo

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  1. Huangdong Li
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Contributions

All authors have approved the final version of the manuscript. HL and ZL designed the study; JZ, YL, WC, RY, AH, JL, WW, participated in data collection, analysis and interpretation; HL, WC, WW, and ZL drafted the manuscript. This manuscript has not been submitted for publication in another journal. We had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding authors

Correspondence to Jian Guo or Zhiping Liu.

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Conflict of interest

The authors report no conflicts of financial or non-financial interest.

Ethical approval

In accordance with the principles of the Declaration of Helsinki, the National Health and Nutrition Examination Survey protocols were approved by the research ethics review board at the National Center for Health Statistics.

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All participants provided written informed consent.

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This article belongs to the Topical Collection "Diabetic Nephropathy", managed by Giuseppe Pugliese.

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Li, H., Liu, C., Zhang, J. et al. The association of homocysteine level with the risk of diabetic nephropathy and diabetic retinopathy in NHANES. Acta Diabetol 60, 907–916 (2023). https://doi.org/10.1007/s00592-023-02075-2

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  • DOI: https://doi.org/10.1007/s00592-023-02075-2

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