Ren Zhongyuan, Zhang Jun, Yu Shikai, Zhao Song, Tang Jiamin, Zheng Yixing, Meng Weilun, Xu Chong, Zhang Yi, Xu Yawei
Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Soochow University Medical College, Suzhou Industrial Park (SIP), Suzhou, China.
Front Cardiovasc Med. 2021 May 10;8:662741. doi: 10.3389/fcvm.2021.662741. eCollection 2021.
Serum homocysteine (Hcy) level is associated with cardiocerebrovascular disease. However, the relationship between Hcy and hypertension-mediated organ damage (HMOD) in non-hospitalized residents has not been elucidated. We aimed to investigate the association of HMOD with Hcy in elderly Chinese. One thousand seven hundred and forty-four community-dwelling elderly Chinese (age ≥65 years) participated in the Northern Shanghai Study from Jun. 2014 to Aug. 2015. Hyperhomocysteinemia (HHcy) was defined as serum Hcy ≥15 mmol/L, and HMOD was estimated as arterial stiffness [carotid-femoral pulse wave velocity (CF-PWV) and ankle-brachial index (ABI)], cardiac impairment [left ventricular (LV) hypertrophy and LV diastolic dysfunction], and renal dysfunction [estimated glomerular filtration rate (eGFR) and urinary albumin/creatinine ratio]. Linear and logistic regression models were built to explore the associations of HMOD with Hcy. Among 1,744 participants, 632 (36.2%) were diagnosed as HHcy. HHcy group had more men (61.2 vs. 35.3%), with higher age (73.7 ± 6.7 vs. 70.4 ± 5.3 years) and BMI (24.2 ± 3.4 vs. 23.7 ± 3.5 kg/m). Linear regression analysis showed that serum Hcy level was positively associated CF-PWV and negatively associated with ABI and eGFR. By logistic regression, HHcy was significantly associated with abnormal CF-PWV [odds ratio (OR) = 1.53, 95% confidence interval (CI) 1.08-2.16] and ABI (OR = 1.55, 95% CI 1.17-2.04), and decreased eGFR (OR = 7.09, 95% CI 4.03-12.47) after adjustment for covariates. Moreover, similar associations of serum Hcy level with CF-PWV and eGFR were observed in subgroups by gender and hypertensive state. HMOD, particularly renal dysfunction and arterial stiffening, was significantly and independently associated with increased serum Hcy level in the elderly Chinese. [ClinicalTrial.gov], identifier [NCT02368938].
血清同型半胱氨酸（Hcy）水平与心脑血管疾病相关。然而，非住院居民中Hcy与高血压介导的器官损害（HMOD）之间的关系尚未阐明。我们旨在研究中国老年人中HMOD与Hcy的关联。2014年6月至2015年8月，1744名居住在社区的中国老年（年龄≥65岁）人参与了上海北部研究。高同型半胱氨酸血症（HHcy）定义为血清Hcy≥15 mmol/L，HMOD评估指标为动脉僵硬度[颈股脉搏波速度（CF-PWV）和踝臂指数（ABI）]、心脏损害[左心室（LV）肥厚和LV舒张功能障碍]以及肾功能障碍[估计肾小球滤过率（eGFR）和尿白蛋白/肌酐比值]。建立线性和逻辑回归模型以探讨HMOD与Hcy的关联。在1744名参与者中，632人（36.2%）被诊断为HHcy。HHcy组男性更多（61.2%对35.3%），年龄更大（73.7±6.7岁对70.4±5.3岁），体重指数更高（24.2±3.4对23.7±3.5 kg/m²）。线性回归分析显示，血清Hcy水平与CF-PWV呈正相关，与ABI和eGFR呈负相关。通过逻辑回归分析，校正协变量后，HHcy与异常CF-PWV[比值比（OR）=1.53，95%置信区间（CI）1.08 - 2.16]和ABI（OR = 1.55，95% CI 1.17 - 2.04）以及eGFR降低（OR = 7.09，95% CI 4.03 - 12.47）显著相关。此外，在按性别和高血压状态划分的亚组中，也观察到血清Hcy水平与CF-PWV和eGFR有类似的关联。在中国老年人中，HMOD，尤其是肾功能障碍和动脉僵硬度，与血清Hcy水平升高显著且独立相关。[ClinicalTrial.gov]，标识符[NCT02368938]
