Liu Mengyuan, Fan Fangfang, Liu Bo, Jia Jia, Jiang Yimeng, Sun Pengfei, He Danmei, Liu Jiahui, Li Yuxi, Huo Yong, Li Jianping, Zhang Yan
Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.
Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, People's Republic of China.
Diabetes Metab Syndr Obes. 2020 Sep 28;13:3383-3393. doi: 10.2147/DMSO.S267122. eCollection 2020.
Hyperhomocysteinemia is an independent risk factor for cardio- and cerebrovascular diseases. However, the relationship between plasma homocysteine (Hcy) concentration and peripheral arterial disease (PAD) has not been completely characterized. The aim of the present study was to determine the relationship between plasma Hcy concentration and new-onset PAD and to assess the effects of combinations of Hcy and traditional cardiovascular risk factors.
We conducted a prospective community-based cohort study of 3119 Chinese participants who did not have PAD at baseline, with a median follow-up period of 2.30 years. We used multivariate logistic regression models to evaluate the relationship between high Hcy (≥10µmol/L) and new-onset PAD. The effects of combinations of high Hcy and traditional cardiovascular risk factors were assessed using logistic regression analysis.
After adjustment for 14 covariates, high Hcy concentration was significantly associated with new-onset PAD (odds ratio [OR]=2.08, 95% confidence interval [CI]: 1.08-4.03, =0.030). Smokers with high Hcy concentration were substantially more likely to have new-onset PAD than non-smokers with normal Hcy concentration (OR=4.44, 95% CI: 1.77-11.12, =0.001). The effect of diabetes on PAD became significant when present in combination with high Hcy concentration (OR=3.67, 95% CI: 1.25-10.80, =0.018). Participants with both elevated Hcy levels and older age had the highest risk of new-onset PAD (OR=4.28, 95% CI: 1.83-10.01, <0.001). With regard to the joint effect of Hcy and hypertension, dyslipidemia or sex, there was also a trend towards increased risk across four different groups ( for trend=0.026, 0.035, 0.016, respectively).
High plasma Hcy concentration independently predicts the incidence of PAD. Furthermore, there is a joint effect of high Hcy concentration and traditional cardiovascular risk factors such as smoking, diabetes and aging on the incidence of PAD.
高同型半胱氨酸血症是心脑血管疾病的独立危险因素。然而，血浆同型半胱氨酸（Hcy）浓度与外周动脉疾病（PAD）之间的关系尚未完全明确。本研究旨在确定血浆Hcy浓度与新发PAD之间的关系，并评估Hcy与传统心血管危险因素联合作用的影响。
我们对3119名基线时无PAD的中国参与者进行了一项基于社区的前瞻性队列研究，中位随访期为2.30年。我们使用多变量逻辑回归模型评估高Hcy（≥10µmol/L）与新发PAD之间的关系。使用逻辑回归分析评估高Hcy与传统心血管危险因素联合作用的影响。
在对14个协变量进行调整后，高Hcy浓度与新发PAD显著相关（比值比[OR]=2.08，95%置信区间[CI]：1.08 - 4.03，P = 0.030）。高Hcy浓度的吸烟者比Hcy浓度正常的非吸烟者发生新发PAD的可能性显著更高（OR = 4.44，95% CI：1.77 - 11.12，P = 0.001）。糖尿病与高Hcy浓度同时存在时对PAD的影响变得显著（OR = 3.67，95% CI：1.25 - 10.80，P = 0.018）。Hcy水平升高且年龄较大的参与者发生新发PAD的风险最高（OR = 4.28，95% CI：1.83 - 10.01，P < 0.001）。关于Hcy与高血压、血脂异常或性别之间的联合作用，在四个不同组中也存在风险增加的趋势（趋势P值分别为0.026、0.035、0.016）。
高血浆Hcy浓度可独立预测PAD的发生率。此外，高Hcy浓度与吸烟、糖尿病和衰老等传统心血管危险因素对PAD的发生率存在联合作用。
