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Open Access

No association between elevated homocysteine levels and carotid atherosclerosis in a rural population in China

Yang Li, Li Wang, Wei Zhang, Yalan Fang, Xiaoyuan Niu
DOI: 10.1136/svn-2016-000037 Published 19 December 2016
Yang Li
Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
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Li Wang
Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
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Wei Zhang
Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
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Yalan Fang
Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
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Xiaoyuan Niu
Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
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Article Figures & Data

Tables

  • Table 1

    Sex and age distribution of the targeted population and participants, and participation rates

    NPer centResponse rate (%)
    Targeted population9286100.0–
    Female483052.0–
    Age
     55–64499753.8–
     65–74256727.6–
     75+172218.6–
    Participants2291100.024.7
    Female127555.726.4
    Age
     55–64130256.826.1
     65–7469330.227.0
     75+29613.017.2
  • Table 2

    Research overview of study participants

    N=2291Men
    N=1016
    Women
    N=1275
    Age (year)64.6±7.465.4±7.864.0±7.0
    Homocysteine (µmol/L)24.7±18.029.3±20.821.0±14.5
    Folic acid (nmol/L)11.2±13.010.6±14.711.6±11.5
    Atherosclerosis1747 (76.3%)854 (84.1%)893 (70.0%)
    Thickening of IMT only633 (27.6%)265 (26.1%)368 (28.9%)
    Plaque formation only982 (42.9%)514 (50.6%)468 (36.7%)
    Stenosis or occlusion132 (5.8%)75 (7.4%)57 (4.5%)
    • IMT, intima media thickness.

  • Table 3

    Comparison of demographic characteristics in participants with or without carotid atherosclerosis

    Carotid atherosclerosis
    No N=544Yes N=1747p Value
    Age (year)61.9±6.065.4±7.50.000
    BMI (kg/m2)24.4±3.523.7±3.30.000
    SBP (mm Hg)136.9±18.6140.3±20.80.000
    DBP (mm Hg)83.6±10.783.3±11.30.602
    Total cholesterol (mmol/L)4.3±1.24.4±1.10.538
    Triglycerides (mmol/L)1.6±1.11.5±1.10.004
    HDL-C (mmol/L)1.2±0.41.2±0.40.110
    LDL-C (mmol/L)2.5±0.92.5±0.80.109
    Uric acid (µmol/L)241.3±71.3253.8±74.00.001
    Homocysteine (µmol/L)22.4±16.025.4±18.60.000
    FBG (mmol/L)5.2±1.25.4±1.50.000
    Hypertension (%)213 (39.2%)683 (39.1%)0.980
    Diabetes mellitus (%)32 (5.9%)142 (8.1%)0.084
    Dyslipidaemia (%)66 (12.1%)131 (7.5%)0.001
    Family history of stroke (%)44 (8.1%)117 (6.7%)0.268
    Current smoker (%)164 (30.1%)810 (46.4%)0.000
    Drink (%)34 (6.3%)167 (9.6%)0.017
    Education—junior high school (%)110 (20.2%)336 (19.2%)0.611
    Sex (male, %)162 (29.8%)854 (48.9%)0.000
    • BMI, body mass index; DBP, diastolic blood pressure; FBG, fasting blood glucose; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; SBP, systolic blood pressure.

  • Table 4

    Comparison of demographic characteristics in participants with or without carotid plaque(s)

    Carotid plaque(s)
    No N=1177Yes N=1114p Value
    Age (year)62.8±6.566.5±7.80.000
    BMI (kg/m2)24.1±3.423.6±3.40.000
    SBP (mmHg)137.7±19.6141.3±21.00.000
    DBP (mmHg)83.3±11.083.4±11.30.877
    Total cholesterol (mmol/L)4.3±1.14.4±1.10.012
    Triglycerides (mmol/L)1.6±1.11.4±1.00.004
    HDL-C (mmol/L)1.2±0.41.2±0.40.176
    LDL-C (mmol/L)2.4±0.82.6±0.90.000
    Uric acid(µmol/L)243.5±70.7258.6±75.80.000
    Homocysteine (µmol/L)23.2±17.226.2±18.70.000
    FBG (mmol/L)5.3±1.45.4±1.50.183
    Hypertension (%)449 (38.1%)447 (40.1%)0.177
    Diabetes mellitus (%)71 (6.0%)103 (9.2%)0.002
    Dyslipidaemia (%)116 (9.9%)81 (7.3%)0.016
    Family history of stroke (%)93 (7.9%)68 (6.1%)0.055
    Current smoker (%)417 (35.4%)557 (50.0%)0.000
    Drink (%)91 (7.7%)110 (9.9%)0.041
    Education—junior high school (%)249 (21.2%)197 (17.7%)0.020
    Sex (male, %)427 (36.3%)589 (52.9%)0.000
    • BMI, body mass index; DBP, diastolic blood pressure; FBG, fasting blood glucose; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; SBP, systolic blood pressure.

  • Table 5

    Baseline characteristics and laboratory profiles by quartile of Hcy level

    First quartile N=573Second quartile N=578Third quartile N=566Fourth quartile N=574p Value
    Age (year)62.9±6.664.2±7.265.3±7.365.9±7.90.000
    BMI (kg/m2)23.7±3.623.8±3.223.9±3.524.0±3.30.477
    SBP (mm Hg)138.4±20.4138.8±20.9140.2±20.5140.5±19.60.219
    Triglycerides (mmol/L)1.4±1.11.5±1.01.6±1.21.5±1.00.004
    HDL-C (mmol/L)1.1±0.41.2±0.41.2±0.41.2±0.40.000
    LDL-C (mmol/L)2.3±0.92.6±0.92.6±0.92.6±0.80.000
    Uric acid (µmol/L)211.5±72.5253.4±66.5265.4±66.8273.2±72.50.000
    FBG (mmol/L)5.4±1.55.4±1.85.4±1.35.3±1.30.186
    Current smoker (%)196 (34.2%)221 (38.2%)245 (43.3%)312 (54.4)0.000
    Drink (%)39 (6.8%)52 (9.0%)52 (9.2%)57 (9.9%)0.273
    Dyslipidaemia (%)53 (9.3%)41 (7.1%)50 (8.8%)53 (9.2%)0.511
    Education—junior high school (%)116 (20.2%)114 (19.7%)98 (17.3%)118 (20.6%)0.502
    Sex (male, %)177 (30.9%)220 (38.1%)261 (46.1)358 (62.4)0.000
    Atherosclerosis (%)403 (70.3%)442 (76.5%)442 (78.1%)460 (80.1%)0.001
    Plaque(s) (%)233 (40.7%)265 (45.8%)299 (52.8%)317 (55.2%)0.000
    • Continuous variables are shown as mean±SD. Quantitative variables between groups were compared by t-test, approximate t-test or variance analysis, whereas classification of variable rate was compared by χ2 test.

    • BMI, body mass index; DBP, diastolic blood pressure; FBG, fasting blood glucose; Hcy, homocysteine; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; SBP, systolic blood pressure.

  • Table 6

    ORs (95% CIs) for the presence of carotid atherosclerosis by quartile of Hcy level

    OR (95% CI)
    Hcy quartileCrudeModel 2Model 3
    First quartile1.001.001.00
    Second quartile1.371 (1.054 to 1.783)1.296 (0.992 to 1.692)1.253 (0.957 to 1.640)
    p=0.019p=0.057p=0.101
    Third quartile1.504 (1.150 to 1.966)1.334 (1.014 to 1.755)1.219 (0.922 to 1.612)
    p=0.003p=0.040p=0.164
    Fourth quartile1.702 (1.296 to 2.235)1.465 (1.107 to 1.938)1.156 (0.859 to 1.555)
    p=0.000p=0.007p=0.339
    • Reference group: first quartile. Model 2: adjusted for age, model 3: adjusted for age and gender.

    • Hcy, homocysteine.

  • Table 7

    ORs (95% CIs) for the presence of carotid plaque(s) by quartile of Hcy level

    OR (95% CI)
    Hcy quartileCrudeModel 4Model 5Model 6
    First quartile1.001.001.001.00
    Second quartile1.235 (0.978 to 1.560)1.162 (0.915 to 1.475)1.117 (0.877 to 1.422)–
    p=0.076p=0.218p=0.369–
    Third quartile1.634 (1.292 to 2.066)1.454 (1.142 to 1.852)1.335 (1.044 to 1.709)1.246 (0.967 to 1.606)
    p=0.000p=0.002p=0.022p=0.089
    Fourth quartile1.800 (1.424 to 2.275)1.580 (1.241 to 2.011)1.324 (1.040 to 1.730)1.259 (0.963 to 1.646)
    p=0.000p=0.000p=0.023p=0.093
    • Reference group: first quartile. Model 4: adjusted for age, model 5: adjusted for age and gender, model 6: adjusted for age, gender, current smoker, FBG, LDL and SBP.

    • FBG, fasting blood glucose; Hcy, homocysteine; LDL, low-density lipoprotein; SBP, systolic blood pressure.

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No association between elevated homocysteine levels and carotid atherosclerosis in a rural population in China
Yang Li, Li Wang, Wei Zhang, Yalan Fang, Xiaoyuan Niu
Stroke and Vascular Neurology Dec 2016, 1 (4) 154-160; DOI: 10.1136/svn-2016-000037

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No association between elevated homocysteine levels and carotid atherosclerosis in a rural population in China
Yang Li, Li Wang, Wei Zhang, Yalan Fang, Xiaoyuan Niu
Stroke and Vascular Neurology Dec 2016, 1 (4) 154-160; DOI: 10.1136/svn-2016-000037
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No association between elevated homocysteine levels and carotid atherosclerosis in a rural population in China
Yang Li, Li Wang, Wei Zhang, Yalan Fang, Xiaoyuan Niu
Stroke and Vascular Neurology Dec 2016, 1 (4) 154-160; DOI: 10.1136/svn-2016-000037
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