Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland).
Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China (mainland).
Med Sci Monit. 2022 Jan 11;28:e934100. doi: 10.12659/MSM.934100.
BACKGROUND Hyperhomocysteinemia (HHcy) and metabolic syndrome (MS) are established cardiovascular risk factors of stroke and are frequently associated with hypertension. However, studies on the association between HHcy combined with MS and stroke risk in hypertensive patients were absent. MATERIAL AND METHODS In 14 059 selected participants with elevated blood pressure, we assessed the prevalence of the MS and stroke. We defined HHcy as plasma total homocysteine >15 μmol/L. MS was defined according to the Chinese Diabetes Society (CDS) criterion. Multivariable analysis was used to examine the association of HHcy or (and) MS with stroke risk in different models. RESULTS The prevalence rates of HHcy and MS were 49.96% and 42.21%, respectively. Patients with stroke had higher plasma total homocysteine levels and a higher prevalence of MS (P<0.001). Multivariable analyses indicated that HHcy and MS are independently associated with higher prevalence of stroke (adjusted-odds ratio (OR): 1.36, 95% CI 1.17 to 1.58, P<0.001; adjusted-OR: 1.68, 95% CI 1.44 to 1.96, P<0.001, respectively). Those with combined HHcy and MS had higher odds of stroke than those with isolated HHcy or MS (adjusted-OR: 1.78, 95% CI 1.47 to 2.15, P<0.001; adjusted-OR: 1.39, 95% CI 1.13 to 1.70, P=0.002, respectively). CONCLUSIONS HHcy combined with MS was associated with higher prevalence of stroke in Chinese adults with elevated blood pressure.
高同型半胱氨酸血症（HHcy）和代谢综合征（MS）是中风的既定心血管危险因素，常与高血压有关。然而，关于高血压患者中 HHcy 合并 MS 与中风风险之间的关联的研究尚缺乏。
在 14059 名高血压患者中，我们评估了 MS 和中风的患病率。我们将血浆总同型半胱氨酸 >15μmol/L 定义为 HHcy。MS 根据中国糖尿病学会（CDS）标准定义。多变量分析用于在不同模型中检查 HHcy 或（和）MS 与中风风险的关联。
HHcy 和 MS 的患病率分别为 49.96%和 42.21%。患有中风的患者具有更高的血浆总同型半胱氨酸水平和更高的 MS 患病率（P<0.001）。多变量分析表明 HHcy 和 MS 与中风的高患病率独立相关（校正优势比（OR）：1.36，95%置信区间 1.17 至 1.58，P<0.001；校正 OR：1.68，95%置信区间 1.44 至 1.96，P<0.001）。与单独 HHcy 或 MS 相比，同时存在 HHcy 和 MS 的患者中风的几率更高（校正 OR：1.78，95%置信区间 1.47 至 2.15，P<0.001；校正 OR：1.39，95%置信区间 1.13 至 1.70，P=0.002）。
在中国高血压成年人中，HHcy 合并 MS 与中风的高患病率相关。
