Zhang Panpan, Xie Xia, Zhang Yurong
Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Front Neurol. 2023 Jun 29;14:1184141. doi: 10.3389/fneur.2023.1184141. eCollection 2023.
Homocysteine (Hcy) is a predictor for stroke. B vitamins are required for the metabolism of Hcy. We designed a study to investigate the associations of plasma Hcy and B vitamins with the prevalence of stroke in adults.
A total of 8,371 adults were included in the National Health and Examination Survey (NHANES) between 2003-2006 in the United States. Multivariate regression analysis and smooth curve fitting were conducted to evaluate the associations of stroke prevalence with Hcy, folate, vitamin B6, and B12. A segmented regression model was used to analyze the threshold effects. Sample weights were calculated to ensure the results' generalizability.
The mean age of all participants was 46.43 years (51.8% women), and the prevalence of stroke was 2.72%. A nonlinear and positive association was found between plasma Hcy levels and the prevalence of stroke. Furthermore, L-shaped associations were found between plasma vitamin B6 and folate levels and stroke, with the turning point at 65.2 nmol/L for vitamin B6 and 26 nmol/L for folate, respectively. Vitamin B12 revealed a U-shaped relationship with stroke, with the turning points at 492.98 pmol/L for vitamin B12.
Non-linear associations of plasma Hcy and B vitamins levels with stroke prevalence were found in American adults. These associations may have an implication that higher plasma Hcy levels should be reduced, and plasma vitamin B6, vitamin B12 and folate levels should be moderately improved in stroke prevention. Future studies are needed to verify the causality of these associations and elucidate the underlying mechanisms.
同型半胱氨酸（Hcy）是中风的一个预测指标。B族维生素是Hcy代谢所必需的。我们设计了一项研究来调查成人血浆Hcy和B族维生素与中风患病率之间的关联。
2003年至2006年期间，共有8371名美国成年人纳入了国家健康与检查调查（NHANES）。进行多变量回归分析和平滑曲线拟合，以评估中风患病率与Hcy、叶酸、维生素B6和B12之间的关联。采用分段回归模型分析阈值效应。计算样本权重以确保结果具有普遍性。
所有参与者的平均年龄为46.43岁（女性占51.8%），中风患病率为2.72%。发现血浆Hcy水平与中风患病率之间存在非线性正相关。此外，还发现血浆维生素B6和叶酸水平与中风呈L形关联，维生素B6的转折点为65.2 nmol/L，叶酸的转折点为26 nmol/L。维生素B12与中风呈U形关系，维生素B12的转折点为492.98 pmol/L。
在美国成年人中发现血浆Hcy和B族维生素水平与中风患病率之间存在非线性关联。这些关联可能意味着在预防中风方面，应降低较高的血浆Hcy水平，并适度提高血浆维生素B6、维生素B12和叶酸水平。需要进一步的研究来验证这些关联的因果关系并阐明其潜在机制。
