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Epidemiology
Original research
Prevalence and risk factors for hyperhomocysteinemia: a population-based cross-sectional study from Hunan, China
  1. Yide Yang1,
  2. Yuan Zeng1,
  3. Shuqian Yuan1,
  4. Ming Xie1,
  5. Yanhui Dong2,
  6. Jian Li3,
  7. Quanyuan He1,
  8. Xiangli Ye1,
  9. Yuan Lv1,
  10. Carl-Friedrich Hocher4,
  11. Bernhard K Kraemer4,
  12. Xiuqin Hong1,
  13. Berthold Hocher3,4,5,6
  1. 1Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, Hunan, China
  2. 2Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, Beijing, China
  3. 3Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, Hunan, China
  4. 4Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
  5. 5Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan Province, China
  6. 6Institute of Medical Diagnostics, IMD Berlin, Berlin, Germany
  1. Correspondence to Berthold Hocher; berthold.hocher{at}medma.uni-heidelberg.de; Professor Xiuqin Hong; hldhld{at}126.com

Abstract

Objectives Hyperhomocysteinemia is an independent risk factor for cardiovascular diseases. We aimed to investigate the prevalence and risk factors for hyperhomocysteinemia, especially modifiable lifestyle factors, such as smoking behaviour and dietary factors.

Design Population-based cross-sectional study.

Setting Hunan Province, China

Participants A total of 4012 participants completed the study, between July 2013 and March 2014. The median age is 55 (interquartile range: 45–63) years, with 1644 males (41%) and 2368 females (59%).

Main outcome measures Homocysteine level were measured by the microplate enzyme immunoassay method. Hyperthomocysteinemia was defined as ≥15 µmol/L. Questionnaire was used to investigate potential risk factors of hyperhomocysteinemia. Crude odd ratio (OR) or adjusted OR with 95% CI were determined by using univariable or multivariable logistic regression models.

Results The prevalence of hyperhomocysteinemia is 35.4% (45.4% vs 28.5% for men, women, respectively). One-year increase in age is significantly associated with 2% higher risk of hyperhomocysteinemia (OR=1.02, 95% CI: 1.01 to 1.03). One unit increase of BMI is associated with 5% higher risk of hyperhomocysteinemia (OR=1.05, 95% CI: 1.03 to 1.07). Compared with the non-smoker, smoking participants have a 24% higher risk of hyperhomocysteinemia (OR=1.24, 95% CI: 1.006 to 1.53), while the risk for those quitting smoking are not significantly different (OR=1.14, 95% CI: 0.85 to 1.54). compared with those consuming fruit and vegetable at least once every day, those consuming less than once every day had a significantly higher risk of hyperhomocysteinemia (OR=1.29, 95% CI:1.11 to 1.50). In addition, we found there were significant sex interaction with education level or alcohol drinking on the risk of hyperhomocysteinemia (pinteraction <0.05).

Conclusions Higher BMI and older age are potential risk factors for hyperhomocysteinemia. Current smoking but not quitting smoking is associated with higher risk of hyperhomocysteinemia. Fruit and vegetable consumption may have protective effect against hyperhomocysteinemia. Alcohol consumption or education level might interact to influence the risk of hyperhomocysteinemia.

  • epidemiology
  • adult cardiology
  • risk management

Data availability statement

Data are available upon reasonable request.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2020-048575

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • Contributors XH, YL and YY conducted and supervised the survey, and provided the original data. YY, BH and XH conceived and designed the study; YY, XY, YZ, FL, CZ and YD analysed the data; XH, JL, QH and YL contributed reagents/materials/analysis tools; YY, C-FH, BKK and BH wrote the paper. YY, BH, YZ and FL made the revisions. All authors (YY, YZ, FL, CZ, YD, JL, QH, XY, YL, C-FH, BKK, XH and BH) contributed and approved the final version of the manuscript. Prof. Berthold Hocher is the author responsible for the overall content as the guarantor.

    • Funding This work was supported by the National Natural Science Foundation of China (81903336, YY), the National Natural Science Foundation of China (81773530, XH), the Hunan Provincial Natural Science Foundation of China (2019JJ50376, YY), Scientific Research Project of Hunan Provincial Health Commission (202112031516, YY), a Project Supported by Scientific Research Fund of Hunan Provincial Education Department (18C0072, YY), Key Project of Hunan Provincial science and technology innovation (2020SK1015-3, YL) and a Project Supported by Scientific Research Fund of Hunan Provincial Education Department (18A028, XY). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.