Fang Jinqiong, Tan Jiange, Chen Xingxing, Hua Kaiyu, Ding Yiyan, Wu Yajun, Tan Lijun, Hua Qihong, Shao Siyuan, Liu Tian, Hua Ying
Department of Personnel, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang Province, China.
Business Administration, Sino-British International College, University of Shanghai for Science and Technology, Shanghai, China.
Medicine (Baltimore). 2025 Aug 8;104(32):e43771. doi: 10.1097/MD.0000000000043771.
This study investigates the relationship between homocysteine (Hcy) levels and decreased intrinsic capacity (DIC) in older adults over 60 years of age, against the backdrop of rising cognitive decline in aging populations. Elevated Hcy, linked to various diseases, may serve as a biomarker for DIC. A cross-sectional study was conducted on 1311 community-dwelling older adults aged 60-91 years in Hangzhou, China, from March 2023 to June 2023. The primary exposure was Hcy level, with DIC as the outcome, assessed via the World Health Organization Intrinsic Capacity Composite Assessment scale. Covariates included gender, age, education, blood pressure, body mass index, and C-reactive protein. Data were analyzed using logistic regression models. Higher Hcy levels were significantly associated with increased DIC risk (OR = 1.03, 95% CI: 1.00-1.07, P = .0439). A non-linear relationship was observed, with a threshold effect at 14.6 μmol/L. Below this, each 1 μmol/L increase in Hcy corresponded to an 8% rise in DIC risk (95% CI: 1.02-1.15, P = .0137). In the very elderly, a stronger association was noted below 11.8 μmol/L (OR = 1.35, 95% CI: 1.143-1.61, P = .0005). Elevated Hcy levels are positively associated with the risk of DIC, especially among middle-aged and older adults, and exhibit a non-linear threshold effect. These findings suggest the potential of Hcy as a biomarker for DIC, advocating for age-specific management strategies. Further research should explore underlying mechanisms and validate these results across diverse populations.
本研究在老年人口认知能力下降趋势加剧的背景下，调查了60岁以上老年人中同型半胱氨酸（Hcy）水平与内在能力下降（DIC）之间的关系。与多种疾病相关的Hcy水平升高，可能是DIC的一个生物标志物。2023年3月至2023年6月，在中国杭州对1311名年龄在60 - 91岁的社区居住老年人进行了一项横断面研究。主要暴露因素为Hcy水平，以DIC为结局，通过世界卫生组织内在能力综合评估量表进行评估。协变量包括性别、年龄、教育程度、血压、体重指数和C反应蛋白。使用逻辑回归模型对数据进行分析。较高的Hcy水平与DIC风险增加显著相关（OR = 1.03，95% CI：1.00 - 1.07，P = 0.0439）。观察到一种非线性关系，在14.6 μmol/L时存在阈值效应。低于此值，Hcy每升高1 μmol/L，DIC风险相应增加8%（95% CI：1.02 - 1.15，P = 0.0137）。在高龄老年人中，在11.8 μmol/L以下观察到更强的关联（OR = 1.35，95% CI：1.143 - 1.61，P = 0.0005）。Hcy水平升高与DIC风险呈正相关，尤其是在中老年人中，并呈现非线性阈值效应。这些发现提示Hcy作为DIC生物标志物的潜力，倡导针对特定年龄的管理策略。进一步的研究应探索潜在机制，并在不同人群中验证这些结果。
