Prevalence of Hyperhomocysteinemia in China: A Systematic Review and Meta-Analysis

Abstract

Hyperhomocysteinemia (HHcy, total homocysteine concentrations > 15 μmol/L) has been associated with increased risk of many diseases. A systematic review was performed to summarize the prevalence of HHcy in China. We searched multiple international and Chinese scientific databases for relevant literature, and further manually screened reference lists and corresponded with original authors. Pooled prevalence of HHcy was calculated using random effects model. Subgroup analysis, meta-regression and sensitivity analysis were also performed. A total of 36 studies consisting 60,754 subjects (57.3% male; age range, 3–97 years) were finally included. The overall pooled prevalence of HHcy was 27.5%. Geographically, the prevalence was high in north areas, intermediate in central areas, and low in south areas, and was higher in inland versus coastal areas. The prevalence increased with age and was significantly higher in men than in women. Rural residents had a slightly higher HHcy prevalence than urban residents, and the studies conducted during 2006 to 2012 presented a higher HHcy prevalence than those during 1990 to 2005. In summary, the prevalence of HHcy in China is high, particularly in northern populations, the inlanders, males, and the elderly. Homocysteine-lowering strategies are necessary to reduce this highly preventable disorder.

Acute Myocardial Infarction in a Young Man with Hyperhomocysteinemia and Pulmonary Tuberculosis

“…In China, the prevalence of HHcy is high, reaching 27.5%, which is similar to the incidence reported in Brazil and Lebanon, but higher than the incidence reported in Switzerland, Costa Rica, and Korea, and lower than the incidence reported in Iran, Algeria, and coastal West Africa (15). Geographically, the prevalence was high in northern areas, intermediate in central areas, and low in southern areas, and was higher inland than in coastal areas (15). Within each region, men had higher plasma homocysteine concentrations than women.…”

“…Additionally, a nested case-control study as part of the Japan Collaborative Cohort (JACC) Study confirmed that high serum homocysteine levels were associated with increased mortality from ischemic stroke, CAD and total cardiovascular disease among Japanese individuals (14). In China, the prevalence of HHcy is high, reaching 27.5%, which is similar to the incidence reported in Brazil and Lebanon, but higher than the incidence reported in Switzerland, Costa Rica, and Korea, and lower than the incidence reported in Iran, Algeria, and coastal West Africa (15). Geographically, the prevalence was high in northern areas, intermediate in central areas, and low in southern areas, and was higher inland than in coastal areas (15).…”

The health-related quality of life of ankylosing spondylitis patients assessed by SF-36: a systematic review and meta-analysis

“…(at least more than 35) [24,25]; (4) studies used case-control, longitudinal cohort, or cross-sectional design; (5) only the most recent and large sample size study was included for duplicated publications. Studies were excluded if they did not meet the above criteria.…”

Folic acid therapy reduces serum uric acid in hypertensive patients: a substudy of the China Stroke Primary Prevention Trial (CSPPT)

“…In China, the prevalence of hyperuricemia is w13% (31), and the prevalence of tHcy concentrations $15 mmol/L is 27-30% (32,33), without the mandatory folic acid fortification of foods. In China, the estimated number of adults with hyperuricemia is 170 million, and the number of adults with tHcy concentrations $15 mmol/L is 350 million.…”