The association between homocysteine levels and cardiovascular disease risk among middle-aged and elderly adults in Taiwan

Abstract

Background Our study aimed to determine the association between homocysteine levels and cardiovascular disease (CVD) risk in middle-aged and elderly adults in a community in northern Taiwan. Methods Participants in our study included adults aged 50 to 85 years old during community health examinations in 2019. A total of 396 people were enrolled, the ethnicity of all participants is Chinese. We divided participants according to tertiles of ln[homocysteine] level (low, middle and high groups). The CVD risk was calculated by the Framingham cardiovascular risk score (FRS). An FRS ≥ 20% indicated high CVD risk. Pearson correlation coefficients were calculated between homocysteine level and other cardio-metabolic risk factors while adjusting for age. Multivariate logistic regression analysis was used to determine the association of high and middle ln[homocysteine] groups with high CVD risk after adjusting age, sex, uric acid, creatinine, and body mass index (BMI). The Youden index and receiver operating characteristic (ROC) curves were performed to determine the optimized cut-off value. Results There were 396 people enrolled for analysis; 41.4% of participants were male, and the average age was 64.79 (± 8.76). In our study, we showed a positive correlation of homocysteine with FRS. In the logistic regression models, higher ln[homocysteine] levels was associated with higher CVD risk with a odds ratio (OR) of 2.499 and 95% confidence interval (CI) of 1.214 to 5.142 in the high homocysteine level group compared with the low homocysteine group after adjusting for traditional CVD risk factors. The area under the ROC curve was 0.667, and a ln[homocysteine] cut-off value of 2.495 µmol/L was determined. Conclusions Middle-aged and elderly people with increased homocysteine levels were associated with higher FRSs in this Taiwan community. Furthermore, homocysteine was an independent risk factor for high CVD risk in this study.

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“…Conventional risk factors of CVDs such as dyslipidemia, hypertension, smoking, or diabetes mellitus do not fully clarify all CVD events and deaths. Several studies summarized that elevated plasma Hcy denotes an independent risk factor for CVDs other than conventional risk factors and can be applied as a biomarker to predict CVD onset in individuals [77][78][79].…”

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“…Homocysteine (Hcy) is a sulfhydryl amino acid situated at a branch point of methionine metabolism that is metabolized via two interrelated processes of remethylation and transsulfuration [ 1 ]. Numerous studies have found that elevated serum Hcy is a nontraditional independent risk factor for cardiovascular disease (CVD) [ 2 , 3 ]. Elevated serum Hcy is a common finding in patients with chronic kidney disease (CKD) [ 4 ], which is attributed to reduced renal clearance of circulating Hcy and impaired Hcy metabolism [ 5 ].…”

Histone Methylation Related Therapeutic Challenge in Cardiovascular Diseases

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