Reference intervals of homocysteine in apparently healthy Chinese Han ethnic adults

Tingwei Si,Wenqian Zhang,Daoqin Liu,Yuping Wang,Qiwen Wu,Xia Fu

doi:10.1515/labmed-2021-0135

Abstract

Abstract Objectives The aim of this study was to establish reference intervals (RIs) of homocysteine (Hcy) in healthy Chinese Han ethnic adults according to the Clinical and Laboratory Standard Institute (CLSI) CA28-A3. Methods After filtering, serum Hcy values in 20,810 healthy subjects from a middle area of China (Wuhu, Anhui province) were measured. The non-parametrical percentile method was used to establish RIs and the 90% confidence intervals of lower and upper limits were calculated. The relationship between Hcy and age was analyzed by using Spearman’s approach. Besides, the risk of HHcy in males and females was examined by logistic regression analysis. Results The RIs of Hcy were 9.10–20.20 μmol/L for males, 6.10–15.90 μmol/L for females and 8.00–19.80 μmol/L for total subjects from 20 to 90 years old. The serum Hcy level was significantly correlated with age both in males (r=0.2159, p<0.0001) and females (r=0.2955, p<0.0001). In males, the prevalence and the risk of HHcy were higher than females of all ages (p<0.001). Conclusions Through the analysis of a large dataset from healthy population, it showed that the variations in different age- and sex-related RIs of Hcy were significant. It suggested that establishing more specific age- and sex-related RIs for Hcy in China is necessary.

Highlights

Homocysteine (Hcy) is a sulfur-containing amino acid that cannot be obtained from the diet, the main function of Hcy in the human body is acting as an important intermediate metabolite in the metabolism of methionine and cysteine [1, 2]
HHcy is associated with a large category of diseases that are characterized by variable presentation affecting many organs, it is worthy to pay more attention to monitoring the changes of serum Hcy levels in patients, which is positively significant for the therapy and prognosis of diseases in clinical
MannWhitney U test showed the significant difference between males and females in different age-groups (p

Summary

Introduction

Homocysteine (Hcy) is a sulfur-containing amino acid that cannot be obtained from the diet, the main function of Hcy in the human body is acting as an important intermediate metabolite in the metabolism of methionine and cysteine [1, 2]. The concentration of Hcy in plasma could be affected by many factors, such as vitamin B12, vitamin B6, folate, and the mutations involved in the Hcy metabolic pathway [3,4,5]. It has been shown that sex differences could affect Hcy levels, with higher concentration in males than females [6]. Hyperhomocysteinemia (HHcy) refers to a condition caused by abnormally elevated levels of Hcy in plasma. Enzyme defects related to Hcy metabolism are considered to be the most universal causes of HHcy, including Cystathionine beta-synthase (CBS) deficiency, Methylenetetrahydrofolate reductase (METHFR) deficiency and Methionine synthase (MS) deficiency, etc [7,8,9]. HHcy is associated with a large category of diseases that are characterized by variable presentation affecting many organs, it is worthy to pay more attention to monitoring the changes of serum Hcy levels in patients, which is positively significant for the therapy and prognosis of diseases in clinical

Objectives

Methods

Results

Conclusion