Cobalamin Intake and Related Biomarkers: Examining Associations With Mortality Risk Among Adults With Type 2 Diabetes in NHANES

Wang, Shanjie; Wang, Ye; Wan, Xin; Guo, Junchen; Zhang, Yiying; Tian, Maoyi; Fang, Shaohong; Yu, Bo

doi:10.2337/dc21-1674

Cited by 36 publications

(29 citation statements)

References 39 publications

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“…Studies have demonstrated that elevated MMA levels in diabetes patients showed more severe peripheral neuropathy [ 60 , 61 ]. Similarly, our recent prospective cohort study in type 2 diabetes patients also found that MMA accumulation was positively associated with increased mortality risk [ 62 ]. Obesity and diabetes may play a critical biological role in the metabolic process of MMA in the setting of diseases.…”

Section: Circulating Mma In Clinical Diagnosismentioning

confidence: 71%

The Regulation and Characterization of Mitochondrial-Derived Methylmalonic Acid in Mitochondrial Dysfunction and Oxidative Stress: From Basic Research to Clinical Practice

Liu

Wang

Zhang

et al. 2022

Oxidative Medicine and Cellular Longevity

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Methylmalonic acid (MMA) can act as a diagnosis of hereditary methylmalonic acidemia and assess the status of vitamin B12. Moreover, as a new potential biomarker, it has been widely reported to be associated with the progression and prognosis of chronic diseases such as cardiovascular events, renal insufficiency, cognitive impairment, and cancer. MMA accumulation may cause oxidative stress and impair mitochondrial function, disrupt cellular energy metabolism, and trigger cell death. This review primarily focuses on the mechanisms and epidemiology or progression in the clinical study on MMA.

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Section: Circulating Mma In Clinical Diagnosismentioning

confidence: 71%

The Regulation and Characterization of Mitochondrial-Derived Methylmalonic Acid in Mitochondrial Dysfunction and Oxidative Stress: From Basic Research to Clinical Practice

Liu

Wang

Zhang

et al. 2022

Oxidative Medicine and Cellular Longevity

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“…Self-reported cardiovascular disease consisted of coronary heart disease, myocardial infarction, heart failure, and stroke. Duration of diabetes and diabetic peripheral complications (diabetic ulcer/sore, meroparesthesia, or retinopathy) were extracted from diabetic questionnaires [ 22 ]. Prescribed medications were recorded during the preceding 30 days.…”

Section: Methodsmentioning

confidence: 99%

“…Body mass index (BMI) was calculated as weight (in kilograms) divided by height (in meters) squared. Hypertension was defined by antihypertensive treatment, the average systolic blood pressure ≥ 140 mmHg or the diastolic blood pressure ≥ 90 mmHg at baseline [ 22 ]. Blood and urine samples were collected, processed, and transported to central laboratories following validated procedures.…”

Section: Methodsmentioning

confidence: 99%

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Association of Serum Homocysteine with Cardiovascular and All-Cause Mortality in Adults with Diabetes: A Prospective Cohort Study

Chen

et al. 2022

Oxidative Medicine and Cellular Longevity

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Background. Homocysteine (Hcy) was implicated in oxidative stress and diabetes biologically. However, the clinical evidence on the link between Hcy level and diabetes is limited and controversial. This study is aimed at investigating the association of serum Hcy with all-cause and cardiovascular mortality in diabetic patients. Methods. Serum Hcy was measured among 2,286 adults with type 2 diabetes in NHANES 1999-2006. Cox proportional hazard regression was used to estimate hazard ratios (HR) and 95% CIs for the association of Hcy with all-cause and cause-specific mortality. Results. Over a median follow-up of 11.0 (interquartile range, 8.9-13.4) years, 952 of the 2286 patients with diabetes died, covering 269 (28.3%) cardiovascular deaths and 144 (15.2%) cancer deaths. Restricted cubic spline showed the linear relationship between Hcy and all-cause mortality risk. After multivariate adjustment, higher serum Hcy levels were independently associated with increased risk of all-cause and cardiovascular mortality. Compared with participants in the bottom tertile of Hcy, the multivariate-adjusted HRs and 95% CI for participants in the top quartile were 2.33 (1.64-3.30) for all-cause mortality ( p trend < 0.001 ), 2.24 (1.22-4.10) for CVD mortality ( p trend = 0.017 ), and 2.05 (0.90-4.69) for cancer mortality ( p trend = 0.096 ). The association with total mortality was especially stronger among patients with albuminuria. Serum Hcy significantly improved reclassification for 10-year mortality in diabetic patients (net reclassification index = 0.253 and integrated discrimination improvement = 0.011 ). Conclusions. Serum Hcy was associated with risks of all-cause and cardiovascular mortality in diabetic adults. Our results suggested that Hcy was a promising biomarker in risk stratification among diabetic patients.

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“…Diabetes was defined if each condition was satisfied in the following items according to the recent American Diabetes Association (ADA) recommendation ( 19 ): (1) Previous diagnosis of type 2 diabetes by doctors (2) Fasting blood glucose levels greater than or equal to 7.0 mmol/L (126 mg/dL) (3) Postprandial 2 h plasma glucose levels greater than or equal to 11.1 mmol/L (200 mg/dL) after a standard 75-g oral glucose tolerance test (4) HbA1c levels were 6.5% (48 mmol/mol) or higher (5) The use of insulin or hypoglycemic drugs. Possible type 1 diabetes patients were defined as those aged <20 years who were only treated with insulin ( 20 ).…”

Section: Methodsmentioning

confidence: 99%

Identifying Distinct Risk Thresholds of Glycated Hemoglobin and Systolic Blood Pressure for Rapid Albuminuria Progression in Type 2 Diabetes From NHANES (1999–2018)

Xue

Chen

et al. 2022

Front. Med.

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BackgroundIt is widely recognized that glycated hemoglobin (HbA1c) and systolic blood pressure (SBP) are two key risk factors for albuminuria and renal function impairment in patients with type 2 diabetes mellitus (T2DM). Our study aimed to identify the specific numerical relationship of albumin/creatinine ratio (ACR) with HbA1c and SBP among a large population of adults with T2DM.MethodA total of 8,626 patients with T2DM were included in the data analysis from the National Health and Nutrition Examination Surveys (NHANES) (1999-2018). The multiple linear regressions were used to examine the associations of ACR with HbA1c and SBP. Generalized additive models with smooth functions were performed to identify the non-linear relations between variables and interactions were also tested.ResultsSignificantly threshold effects were observed between ACR and HbA1c or SBP after multivariable adjustment, with the risk threshold values HbA1c = 6.4% and SBP = 127 mmHg, respectively. Once above thresholds were exceeded, the lnACR increased dramatically with higher levels of HbA1c (β = 0.23, 95 CI%:0.14, 0.32, P < 0.001) and SBP (β = 0.03, 95 CI%:0.03, 0.04, P < 0.001). Subgroup analysis showed high protein diet was related to higher ACR. In addition, a higher risk of ACR progression was observed in central obesity participants with HbA1C ≥ 6.4% or hyperuricemia participants with SBP ≥ 127 mmHg among patients withT2DM.ConclusionWe identified thresholds of HbA1c and SBP to stratify patients with T2DM through rapid albuminuria progression. These might provide a clinical reference value for preventing and controlling diabetes kidney disease.

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Cobalamin Intake and Related Biomarkers: Examining Associations With Mortality Risk Among Adults With Type 2 Diabetes in NHANES

Cited by 36 publications

References 39 publications

The Regulation and Characterization of Mitochondrial-Derived Methylmalonic Acid in Mitochondrial Dysfunction and Oxidative Stress: From Basic Research to Clinical Practice

The Regulation and Characterization of Mitochondrial-Derived Methylmalonic Acid in Mitochondrial Dysfunction and Oxidative Stress: From Basic Research to Clinical Practice

Association of Serum Homocysteine with Cardiovascular and All-Cause Mortality in Adults with Diabetes: A Prospective Cohort Study

Identifying Distinct Risk Thresholds of Glycated Hemoglobin and Systolic Blood Pressure for Rapid Albuminuria Progression in Type 2 Diabetes From NHANES (1999–2018)

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