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Association between hyperhomocysteinaemia and the risk of all-cause and cause-specific mortality among adults in the USA

Published online by Cambridge University Press:  06 July 2022

Wenyan Zhao ,
Yan Lin ,
Huibo He ,
Honglei Ma ,
Wei Yang ,
Qian Hu ,
Xi Chen  and
Faliang Gao Open the ORCID record for Faliang Gao[Opens in a new window]
Wenyan Zhao
Affiliation:
Center for General Practice Medicine, Department of General Practice Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, People’s Republic of China
Yan Lin
Affiliation:
Center for General Practice Medicine, Department of General Practice Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, People’s Republic of China
Huibo He
Affiliation:
Center for General Practice Medicine, Department of General Practice Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, People’s Republic of China
Honglei Ma
Affiliation:
Center for General Practice Medicine, Department of General Practice Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, People’s Republic of China
Wei Yang
Affiliation:
Center for General Practice Medicine, Department of General Practice Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, People’s Republic of China
Qian Hu
Affiliation:
Center for General Practice Medicine, Department of General Practice Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, People’s Republic of China
Xi Chen*
Affiliation:
Center for General Practice Medicine, Department of General Practice Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, People’s Republic of China
Faliang Gao*
Affiliation:
Center for Rehabilitation Medicine, Department of Neurosurgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, People’s Republic of China Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou, People’s Republic of China
*
*Corresponding author: Dr F. Gao, email gaofaliang1985@126.com; X. Chen, email vipxichen2021@126.com
*Corresponding author: Dr F. Gao, email gaofaliang1985@126.com; X. Chen, email vipxichen2021@126.com
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Abstract

Hyperhomocysteinaemia (HHcy) is associated with all-cause mortality in some disease states. However, the correlation between HHcy and the risk of mortality in the general population has rarely been researched. We aimed to evaluate the association between HHcy and all-cause and cause-specific mortality among adults in the USA. This study analysed data from the National Health and Nutrition Examination Survey database (1999–2002 survey cycle). A multivariable Cox regression model was built to evaluate the correlation between HHcy and all-cause and cause-specific mortality. Smooth curve fitting was used to analyse their dose-dependent relationship. A total of 8442 adults aged 18–70 years were included in this study. After a median follow-up period of 14·7 years, 1007 (11·9 %) deaths occurred including 197 CVD-related deaths, 255 cancer-related deaths and fifty-eight respiratory disease deaths. The participants with HHcy had a 93 % increased risk of all-cause mortality (hazard ratio (HR) 1·93; 95 % CI (1·48, 2·51)), 160 % increased risk of CVD mortality (HR 2·60; 95 % CI (1·52, 4·45)) and 82 % increased risk of cancer mortality (HR 1·82; 95 % CI (1·03, 3·21)) compared with those without HHcy. For unmeasured confounding, E-value analysis proved to be robust. In conclusion, HHcy was associated with high risk of all-cause and cause-specific (CVD, cancer) mortality among adults aged below 70 years.

Keywords

HyperhomocysteinaemiaMortalityAdultsNational Health and Nutrition Examination Survey
Type
Research Article
Information
British Journal of Nutrition , Volume 129 , Issue 6 , 28 March 2023 , pp. 1046 - 1057
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Nutrition Society

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Footnotes

†

These authors contributed equally to this work and share correspondence.

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