Prevalence of hyperhomocysteinemia in China: a systematic review and meta-analysis.

Boyi Yang,Yanxun Wang,Yinuo Wang,Quanmei Zheng,Xueyuan Zhi,Guifan Sun,Shujun Fan

doi:10.3390/nu7010074

Boyi Yang, Yanxun Wang + Show 5 more

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https://doi.org/10.3390/nu7010074

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Abstract

Hyperhomocysteinemia (HHcy, total homocysteine concentrations > 15 μmol/L) has been associated with increased risk of many diseases. A systematic review was performed to summarize the prevalence of HHcy in China. We searched multiple international and Chinese scientific databases for relevant literature, and further manually screened reference lists and corresponded with original authors. Pooled prevalence of HHcy was calculated using random effects model. Subgroup analysis, meta-regression and sensitivity analysis were also performed. A total of 36 studies consisting 60,754 subjects (57.3% male; age range, 3–97 years) were finally included. The overall pooled prevalence of HHcy was 27.5%. Geographically, the prevalence was high in north areas, intermediate in central areas, and low in south areas, and was higher in inland versus coastal areas. The prevalence increased with age and was significantly higher in men than in women. Rural residents had a slightly higher HHcy prevalence than urban residents, and the studies conducted during 2006 to 2012 presented a higher HHcy prevalence than those during 1990 to 2005. In summary, the prevalence of HHcy in China is high, particularly in northern populations, the inlanders, males, and the elderly. Homocysteine-lowering strategies are necessary to reduce this highly preventable disorder.

Highlights

Hyperhomocysteinemia (HHcy), a pathological condition characterized by elevated total homocysteine concentrations in blood, is a well established risk factor for neural tube defects (NTDs), and it has been associated with many non-communicable diseases (NCDs), including cardiovascular and cerebrovascular diseases, type 2 diabetes, and cancers [1,2,3,4,5]
HHcy, hyperhomocysteinemia; No, number; CI, confidence interval; FPIA, fluorescence polarization immunoassay; ECA, enzymatic cycling assay; HPLC, high-performance liquid chromatography. This meta-analysis based on 60,754 subjects derived from 36 studies covering 19 provinces and municipalities in China, enabling us to assess reliable prevalence estimates of HHcy at the national level. This is the first meta-analysis of prevalence of HHcy in China, and the results showed that the overall estimate of HHcy prevalence was 27.5%
Our study shows that the prevalence of HHcy in China is high, in northern populations, the inlanders, males, and the elderly

Summary

Introduction

Hyperhomocysteinemia (HHcy), a pathological condition characterized by elevated total homocysteine (tHcy) concentrations (usually defined as tHcy concentrations > 15 μmol/L) in blood, is a well established risk factor for neural tube defects (NTDs), and it has been associated with many non-communicable diseases (NCDs), including cardiovascular and cerebrovascular diseases, type 2 diabetes, and cancers [1,2,3,4,5]. In the past two decades, numerous studies have been conducted in developed countries to explore tHcy status and its determinants. The results of these studies suggest that HHcy could be caused by many factors such as genetic variations, environmental exposures, lifestyle habits, disease states, hormonal factors, and several drugs [6,7,8], and the prevalence of HHcy varied widely with geography, age, sex, and ethnicity. Ethnical, social, and dietary diversity in China, the risk factors for HHcy vary among different populations [12,13,14]. Northern rural areas still have the highest prevalence of NTDs in the world [17]

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