Zhang Hui, Li Yi, Hao Meng, Jiang Xiaoyan, Wang Jiucun, Jin Li, Bao Zhijun, Wang Xiaofeng
State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, People's Republic of China.
Institute for Six-sector Economy, Fudan University, Shanghai, People's Republic of China.
Br J Nutr. 2022 Apr 14;127(7):993-999. doi: 10.1017/S0007114521001690. Epub 2021 May 24.
Few studies have been conducted to investigate the association of kidney function decline with the trajectories of homocysteine (Hcy) over time, using repeated measurements. We aimed to investigate the association of kidney function with changes in plasma Hcy levels over time. Data were collected from the Rugao Longevity and Ageing Study. In detail, plasma Hcy and creatinine levels were measured in both waves (waves 2, 3 and 4) during the 3·5-year follow-up (n 1135). Wave 2 was regarded as the baseline survey. The estimated glomerular filtration rate (eGFR) was calculated based on creatinine. Subjects were categorised into four groups according to quartiles of eGFR at baseline. Linear mixed-effect models were used to investigate the association of eGFR with subsequent plasma Hcy levels. The mean eGFR at baseline was 90·84 (sd 11·42) ml/min per 1·73 m2. The mean plasma Hcy level was 14·09 (sd 6·82) at baseline and increased to 16·28 (sd 8·27) and 17·36 (sd 10·39) μmol/l during follow-ups. In the crude model, the interaction between time and eGFR at baseline was significant (β = -0·02, 95 % CI -0·02, -0·01, P = 0·002). After adjusting for confounding factors, a significant relationship remained (β = -0·02, 95 % CI -0·02, -0·01, P = 0·003), suggesting that kidney function decline at baseline was associated with a faster increase in Hcy levels. Kidney function decline is associated with a more pronounced increase in plasma Hcy levels. Further studies with longer follow-up periods and larger sample sizes are needed to validate our findings.
很少有研究使用重复测量来调查肾功能下降与同型半胱氨酸（Hcy）随时间变化轨迹之间的关联。我们旨在研究肾功能与血浆Hcy水平随时间变化之间的关联。数据来自如皋长寿与衰老研究。具体而言，在3.5年的随访期间（n = 1135）的两次随访（第2、3和4次随访）中测量了血浆Hcy和肌酐水平。第2次随访被视为基线调查。根据肌酐计算估计肾小球滤过率（eGFR）。根据基线时eGFR的四分位数将受试者分为四组。使用线性混合效应模型来研究eGFR与随后血浆Hcy水平之间的关联。基线时的平均eGFR为每1.73 m² 90.84（标准差11.42）ml/min。基线时的平均血浆Hcy水平为14.09（标准差6.82），随访期间增加到16.28（标准差8.27）和17.36（标准差10.39）μmol/L。在粗模型中，时间与基线时eGFR之间的交互作用显著（β = -0.02，95%CI -0.02，-0.01，P = 0.002）。在调整混杂因素后，显著关系仍然存在（β = -0.02，95%CI -0.02，-0.01，P = 0.003），表明基线时的肾功能下降与Hcy水平更快升高有关。肾功能下降与血浆Hcy水平更明显的升高有关。需要进一步进行更长随访期和更大样本量的研究来验证我们的发现。
