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Predication of increased plasma homocysteine level on the prognosis of Chinese patients with first-onset

YAN Jiangtao, SHAO Jiaomei, WANG Daowen, YUE Zhengliang, HUI Rutai

《医学前沿（英文）》 2008年第2卷第4期页码 352-355 doi: 10.1007/s11684-008-0067-1

摘要： Epidemiological studies show that increased plasma total homocysteine (tHcy) level was an independent risk factor of cardiovascular diseases. This study was aimed to investigate the relationship between tHcy level and prognosis of first-onset stroke in Chinese people. One hundred ninety six patients with first-onset ischemic stroke and ninety-five patients with first-onset hemorrhagic stroke were enrolled in this study. The patients were divided into two groups in terms of tHcy level (< 18 ?mol/L and ≥ 18 ?mol/L). The plasma tHcy level was detected by a high performance liquid chromatography method with fluorescence detection. All the patients underwent a 5-year follow-up. Survival analysis shows that the probability of death or new vascular events in the ischemic stroke patients with high tHcy level (≥ 18 ?mol/L) was significantly higher than that in the counterparts with lower tHcy level (< 18 ?mol/L) (50.9% and 28.7%, respectively, = 0.004). The relative risk of death or new vascular events was 2.363 (95% CI, 1.209 to 4.617, = 0.012) in ischemic stroke patients with high tHcy levels(≥ 18 ?mol/L) compared to those with a lower tHcy level (< 18 ?mol/L). The increased tHcy level was significantly associated with the risk of death or new vascular events (, 2.492, 95% CI, 1.148 to 5.407, = 0.021) in patients with ischemic stroke in the exclusion of the influence of other risk factors such as gender, age, body mass index, plasma cholesterol level, the history of hypertension, diabetes or smoking. However, in the patients with hemorrhagic stroke, there was no significant difference in the probability of death or new vascular events between patients with a high tHcy level and those with a lower tHcy level (33.3% and 28.2%, respectively, = 0.546). Increased tHcy level was an independent risk factor for a worse outcome in patients with first-onset ischemic stroke, but not in hemorrhagic stroke patients.

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Status of hyperhomocysteinemia in China: results from the China Stroke High-risk Population Screening Program, 2018

《医学前沿（英文）》 2021年第15卷第6期页码 903-912 doi: 10.1007/s11684-021-0871-4

摘要： A nationwide survey was conducted from October 2018 to September 2019 to assess the prevalence of hyperhomocysteinemia (Hhcy) and its influencing factors in China. A standardized questionnaire was used to collect information. Hhcy was defined as the level of serum homocysteine (HCY)

≥

15.0 µmol/L. The H-type hypertension (HHYP) was defined as hypertension with an elevated serum HCY (

≥

15.0 µmol/L). Finally, 110 551 residents

≥

40 years of age from 31 provinces in the mainland of China were included. Overall, the median serum HCY level was 10.9 µmol/L (interquartile range 7.9–15.1). A total of 28 633 participants (25.9%) were defined as Hhcy. The Hhcy prevalence ranged from 7.9% in Shanghai to 56.8% in Tianjin. The data showed that serum HCY levels were associated with age, male gender, cigarette smoking, hypertension, diabetes, ethnicity, endurance in exercise (inverse), and fruit and vegetable intake (inverse). In addition, 15 486 participants were defined as HHYP, and the rate was 14.0%. HHYP was an independent predictor of stroke with an adjusted odds ratio of 1.752 (95% CI 1.338–2.105). The geographical distribution pattern of the Hhcy epidemic reflects dynamic differences, and national strategies should be carried out to further improve the care of patients with Hhcy across China.

关键词： homocysteine hyperhomocysteinemia H-type hypertension Chinese