The association between plasma homocysteine level and coronary artery calcium in Korean men

Abstract

Purpose: Osteogenic differentiation in vascular smooth muscle cells by oxidative stress and inflammation is an important role on development of Coronary Artery Calcification. Homocysteine is known to be an independent risk factor for atherosclerosis via endothelial dysfunction and smooth muscle cell proliferation. The present study was performed to evaluate the association between homocysteine and Coronary Artery Calcification. Methods: Coronary Artery Calcium Score (CACS) and plasma homocysteine level were investigated in a total of 21,235 men (42±6.5 years) who participated in the Health Study between 2010 and 2011. Individuals were divided into 4 groups according to homocysteine quartiles, and classified into two groups according to the presence/absence of Coronary Artery Calcium (CAC), CAC (-) group with CACS=0 and CAC (+) group with CACS >0. Results: The prevalence of presence of CAC among total individuals was 13.5%. Among those with diabetes (n=1,345), hypertension (n=3,196), or metabolic syndrome (n=4,581), the prevalence of the presence of CAC was 31.3%, 23.2%, or 19.7%, respectively. According to homocysteine quartiles, the prevalence of CAC (+) group was 12.1%, 12.6%, 13.9%, and 15.3% in the lowest, 2nd, 3rd, and highest homocysteine quartiles, respectively. The CAC (+) group had unfavorable cardiometabolic and lipid profiles. In a multivariate regression analysis after adjusting for variables with a univariate relationship (p<0.20), the highest quartile group of homocysteine had higher odds ratios (ORs) for the presence of CAC compared with that of the lowest quartile group (OR[95% confidence interval (CI)], 1.286[1.079, 1.534]), and increasing quartiles of homocysteine was also associated with the presence of CAC (p for trend=0.002). Moreover, plasma homocysteine level had a significant relationship with the presence of CAC and increasing CACS, respectively (OR[95% CI] 1.391[1.131, 1.710]: standardized β=0.041, p<0.001, respectively). Conclusions: This study indicates an independent relationship between plasma homocysteine level and Coronary Artery Calcification, suggesting that homocysteine could be a useful marker for coronary artery calcification. Conflict of interest: No potential conflicts of interest relevant to this study were reported.