Abstract
A prospective community-based cohort study was conducted to investigate the effects of obesity on hyperhomocysteinemia (HHcy) in community residents from Shanghai, China, with a median follow-up period of 2.98 years. The exposures were high body mass index (BMI) (BMI ≥ 28.0 kg/m2) and high waist circumference (WC) (WC ≥ 85.0 cm for female and WC ≥ 90.0 for male) at baseline investigation, and the outcome was the incident of HHcy after the follow-up. A restricted cubic spline (RCS) was performed to assess the possible nonlinear relationship of BMI and WC with HHcy. A Cox proportional hazard regression model was used to evaluate the association between BMI and WC measured obesity and the risk of HHcy (Hcy level > 15 µmol/L). No significant non-linearity was found between BMI and WC with HHcy. Cox regression model showed that underweight measured by BMI was negatively associated with the risk of HHcy after controlling for confounder variables (adjusted HR = 0.64, 95% CI = 0.42 to 0.99). While abdominal obesity was positively associated with the risk of HHcy for those without CVD-related comorbidities (adjusted HR = 1.26, 95% CI = 1.05 to 1.51). Our results suggested that individuals could maintain a relatively low BMI and normal WC to lower the risk of HHcy.
Highlights
Homocysteine (Hcy), an intermediate product in the normal biosynthesis of the amino acids methionine and cysteine, has proven to have adverse effects on cardiovascular endothelium and could cause cardiovascular problems [1]
We examined the possible non-linear relationship of body mass index (BMI) and waist circumference (WC) with HHcy in all subjects, male and female subjects when controlling for age, gender, education level, alcohol drinking, smoking, tea drinking, exercise, retirement status, Cardiovascular disease (CVD)-related comorbidities, and baseline blood creatine level
After dividing BMI and WC into different groups according to the standards, we found that there was a significant difference in the mean serum Hcy level between underweight, overweight, obesity groups and the normal weight group (p < 0.001), and a significant difference in mean Hcy level between WC-measured abdominal obesity group and normal WC group (t = 2.44, p = 0.015)
Summary
Homocysteine (Hcy), an intermediate product in the normal biosynthesis of the amino acids methionine and cysteine, has proven to have adverse effects on cardiovascular endothelium and could cause cardiovascular problems [1]. Cardiovascular disease (CVD), including coronary artery diseases, stroke, and heart attacks, is the leading cause of death in China. The annual number of deaths due to CVD increased from 2.51 million in 1990 to. In 2016, there were nearly 94 million cases of cardiovascular disease, while the number is still rising in recent years [2]. Hcy has been identified as an important determinant of CVD, and recognized as an independent risk factor for stroke, heart attack and atherosclerosis; recent studies even demonstrated that. Hcy is associated with cancer, Alzheimer’s disease, Parkinson’s disease and autism [3,4].
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