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Distribution characteristics of circulating homocysteine and folate and related factors in agriculture, stock-raising and urban populations: a cross-sectional survey

  • Fengyu Pan (a1), Mulalibieke Heizhati (a1), Lin Wang (a1), Ling Zhou (a1), Jing Hong (a1), Delian Zhang (a1), Guijuan Chang (a1), Qin Luo (a1), Le Sun (a1), Na Yue (a1) and Nanfang Li (a1)...



To investigate homocysteine (Hcy) and folate levels, prevalence of hyperhomocysteinaemia (HHcy) and folate deficiency, which are affected by lifestyles in urban, agricultural and stock-raising populations.


This is a cross-sectional study.


Urban, agricultural and stock-raising regions in Emin, China.


Totally 1926 subjects – 885 (45·9 %) from urban, 861 (44·7 %) from agricultural and 180 (9·4 %) from stock-raising regions – were obtained using multistage stratified random sampling. Inclusion criteria encompassed inhabitants aged ≥15 years who resided at the current address for ≥6 months and agreed to participate in the study. Surveys on health behaviour questionnaires and physical examinations were conducted and blood samples collected.


The folate level of subjects from the stock-raising region was the lowest, followed by those from the agricultural region, and the highest in those from the urban region (3·48 v. 6·50 v. 7·12 ng/ml, P < 0·001), whereas mean Hcy showed no significant difference across regions. The OR for HHcy in stock-raising regions was 1·90 (95 % CI 1·11, 3·27) compared with the urban region after adjusting for all possible covariates. The OR for folate deficiency in stock-raising and agriculture regions was 11·51 (95 % CI 7·09, 18·67) and 1·91 (95 % CI 1·30, 2·82), respectively, compared with the urban region after adjusting for all possible covariates.


HHcy and folate deficiency are highly prevalent in stock-raisers, which is of important reference for HHcy control in Xinjiang, with a possibility of extension to others with approximate lifestyles.


Corresponding author

*Corresponding author: Email


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These authors equally contributed to this work.



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1.Zhou, M, Wang, H, Zhu, Jet al. (2016) Cause-specific mortality for 240 causes in China during 1990–2013: a systematic subnational analysis for the global burden of disease study 2013. Lancet 387, 251272.
2.Veeranna, V, Zalawadiya, SK, Niraj, Aet al. (2011) Homocysteine and reclassification of cardiovascular disease risk. J Am Coll Cardiol 58, 10251033.
3.Wang, Y, Li, X, Qin, Xet al. (2013) Prevalence of hyperhomocysteinaemia and its major determinants in rural Chinese hypertensive patients aged 45–75 years. Br J Nutr 109, 12841293.
4.Zhong, C, Xu, T, Xu, Tet al. (2016) Plasma homocysteine and prognosis of acute ischemic stroke: a gender-specific analysis from CATIS randomized clinical trial. Mol Neurobiol 54, 19.
5.Xu, C, Wu, Y, Liu, Get al. (2014) Relationship between homocysteine level and diabetic retinopathy: a systematic review and meta-analysis. Diagn Pathol 9, 167.
6.Hainsworth, AH, Yeo, NE, Weekman, EMet al. (2016) Homocysteine, hyperhomocysteinemia and vascular contributions to cognitive impairment and dementia (VCID). Biochim Biophys Acta 1862, 10081017.
7.Boyama, BA, Cepni, I, Imamoglu, Met al. (2016) Homocysteine in embryo culture media as a predictor of pregnancy outcome in assisted reproductive technology. Gynecol Endocrinol 32, 193195.
8.Ebara, S (2017) Nutritional role of folate. Congenit Anom 57, 138141.
9.Zappacosta, B, Mastroiacovo, P, Persichilli, Set al. (2013) Homocysteine lowering by folate-rich diet or, pharmacological supplementations in subjects with, moderate hyperhomocysteinemia. Nutrients 5, 15311543.
10.Anderson, CA, Jee, SH, Charleston, Jet al. (2010) Effects of folic acid supplementation on serum folate and plasma homocysteine concentrations in older adults: a dose-response trial. Am J Epidemiol 172, 932.
11.Refsum, H, Nurk, E, Smith, ADet al. (2006) The Hordaland Homocysteine Study: a community-based study of homocysteine, its determinants, and associations with disease. J Nutr 136, 17311740.
12.Jacques, PF, Selhub, J, Bostom, AGet al. (1999) The effect of folic acid fortification on plasma folate and total homocysteine concentrations. N Engl J Med 340, 14491454.
13.Hickling, S, Hung, J, Knuiman, Met al. (2005) Impact of voluntary folate fortification on plasma homocysteine and serum folate in Australia from 1995 to 2001: a population based cohort study. J Epidemiol Community Health 59, 371376.
14.Tucker, KL, Mahnken, B, Wilson, PWet al. (1996) Folic acid fortification of the food supply: potential benefits and risks for the elderly population. JAMA 276, 18791885.
16.Monteagudo, C, Scander, H, Nilsen, Bet al. (2017) Folate intake in a Swedish adult population: food sources and predictive factors. Food Nutr Res 61, 1328960.
17.Teixeira, JA, Steluti, J, Gorgulho, BMet al. (2020) Prudent dietary pattern influences homocysteine level more than folate, vitamin B12, and docosahexaenoic acid: a structural equation model approach. Eur J Nutr 59, 8191.
18.Calcaterra, V, Larizza, D, De Giuseppe, Ret al. (2019) Diet and lifestyle role in homocysteine metabolism in Turner’s syndrome. Med Princ Pract 28, 4855.
19.Kearney, PM, Whelton, M, Reynolds, Ket al. (2005) Global burden of hypertension: analysis of worldwide data. Lancet 365, 217223.
20.Yang, B, Fan, S, Zhi, Xet al. (2015) Prevalence of hyperhomocysteinemia in China: a systematic review and meta-analysis. Nutrients 7, 7490.
21.Zhou, L, Zhao, X, Heizhati, Met al. (2019) Trends in lipids and lipoproteins among adults in Northwestern Xinjiang, China, from 1998 through 2015. J Epidemiol 59, 257263.
22.Han, W, Hu, Y, Tang, Yet al. (2017) Relationship between urinary sodium with blood pressure and hypertension among a Kazakh community population in Xinjiang, China. J Hum Hypertens 31, 333340.
23.Guo, S, Pang, H, Guo, Het al. (2015) Ethnic differences in the prevalence of high homocysteine levels among low-income rural Kazakh and Uyghur adults in far western China and its implications for preventive public health. Int J Environ Res Public Health 12, 53735385.
24.Perloff, D, Grim, C, Flack, Jet al. (1993) Human blood pressure determination by sphygmomanometry. Circulation 88, 24602470.
25.World Health Organization (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser, 894.
26.Sacco, RL, Adams, R, Albers, Get al. (2006) Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention: the American Academy of Neurology affirms the value of this guideline. Circulation 113, e409449.
27.Zhao, S, Wang, Y, Mu, Yet al. (2014) Prevalence of dyslipidaemia in patients treated with lipid-lowering agents in China: results of the DYSlipidemia International Study (DYSIS). Atherosclerosis 235, 463469.
29.Lonn, E, Yusuf, S, Arnold, MJet al. (2006) Homocysteine lowering with folic acid and B vitamins in vascular disease. N Engl J Med 354, 15671577.
30.Moretti, R & Caruso, P (2019) The controversial role of homocysteine in neurology: from labs to clinical practice. Int J Mol Sci 20, 231.
31.Wang, X, Qin, X, Demirtas, Het al. (2007) Efficacy of folic acid supplementation in stroke prevention: a meta-analysis. Lancet 369, 18761882.
32.Qin, X & Huo, Y (2016) H-type hypertension, stroke and diabetes in China: opportunities for primary prevention. J Diabetes 8, 3840.
33.Li, Y, Huang, T, Zheng, Yet al. (2016) Folic acid supplementation and the risk of cardiovascular diseases: a meta-analysis of randomized controlled trials. J Am Heart Assoc 5, e003768.
34.Huo, Y, Li, J, Qin, Xet al. (2015) Efficacy of folic acid therapy in primary prevention of stroke among adults with hypertension in China: the CSPPT randomized clinical trial. JAMA 313, 13251335.
35.Qin, YY, Wang, P, Qin, JQet al. (2018) Prevalence of hyperhomocysteinemia during routine physical examination in Guangxi Province, China and related risk factors. J Clin Lab Anal 32.
36.Zhang, J, Liu, TT, Zhang, Wet al. (2016) Hyperhomocysteinemia is associated with vitamin B-12 deficiency: a cross-sectional study in a rural, elderly population of Shanxi China. J Nutr Health Aging 20, 594601.
37.González-Gross, M, Benser, J, Breidenassel, Cet al. (2012) Gender and age influence blood folate, vitamin B12, vitamin B6, and homocysteine levels in European adolescents: the Helena Study. Nutr Res 32, 817826.
38.Stefler, D & Bobak, M (2015) Does the consumption of fruits and vegetables differ between Eastern and Western European populations? Systematic review of cross-national studies. Arch Public Health 73, 29.
39.Goryakin, Y, Rocco, L, Suhrcke, Met al. (2015) Fruit and vegetable consumption in the former Soviet Union: the role of individual- and community-level factors. Public Health Nutr 18, 28252835.
40.WHO (2015) Global Health Observatory Data Repository. (accessed March 2016).


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Distribution characteristics of circulating homocysteine and folate and related factors in agriculture, stock-raising and urban populations: a cross-sectional survey

  • Fengyu Pan (a1), Mulalibieke Heizhati (a1), Lin Wang (a1), Ling Zhou (a1), Jing Hong (a1), Delian Zhang (a1), Guijuan Chang (a1), Qin Luo (a1), Le Sun (a1), Na Yue (a1) and Nanfang Li (a1)...


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