Status of hyperhomocysteinemia in China: results from the China Stroke High-risk Population Screening Program, 2018

Abstract

A nationwide survey was conducted from October 2018 to September 2019 to assess the prevalence of hyperhomocysteinemia (Hhcy) and its influencing factors in China. A standardized questionnaire was used to collect information. Hhcy was defined as the level of serum homocysteine (HCY) \ge15.0 µmol/L. The H-type hypertension (HHYP) was defined as hypertension with an elevated serum HCY (\ge15.0 µmol/L). Finally, 110 551 residents \ge40 years of age from 31 provinces in the mainland of China were included. Overall, the median serum HCY level was 10.9 µmol/L (interquartile range 7.9–15.1). A total of 28 633 participants (25.9%) were defined as Hhcy. The Hhcy prevalence ranged from 7.9% in Shanghai to 56.8% in Tianjin. The data showed that serum HCY levels were associated with age, male gender, cigarette smoking, hypertension, diabetes, ethnicity, endurance in exercise (inverse), and fruit and vegetable intake (inverse). In addition, 15 486 participants were defined as HHYP, and the rate was 14.0%. HHYP was an independent predictor of stroke with an adjusted odds ratio of 1.752 (95% CI 1.338–2.105). The geographical distribution pattern of the Hhcy epidemic reflects dynamic differences, and national strategies should be carried out to further improve the care of patients with Hhcy across China.

Keywords

homocysteine / hyperhomocysteinemia / H-type hypertension / Chinese

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Acknowledgements

We express our gratitude to all the China Stroke Data Center Platform Hospitals that made this work possible. This study was supported by grants from the Special Plan of the Ministry of Science and Technology of the People’s Republic of China (No. Z135080000022), CAMS Innovation Fund for Medical Science (Nos. 2017-I2M-1-016 and 2019-I2M-2-006), Natural Science Foundation of Tianjin (No. 19JCYBJC26600), China Postdoctoral Science Foundation (Nos. 2019M660921 and 2020T130436), and Science Foundation for Post Doctorate Research of the Beijing (Nos. 2017-ZZ-123 and 2020-ZZ-005). The funding organizations had no role in the study’s design and concept; the collection, management, analysis, and interpretation of the data; or the preparation, review, or approval of the manuscript.

Compliance with ethics guidelines

Wenjun Tu, Feng Yan, Baohua Chao, Xunming Ji, and Longde Wang declare no conflict of interest. The Ethics Committee of Capital Medical University Xuanwu Hospital approved the trial protocol according to the Declaration of Helsinki (1964). Written Informed consent was obtained from all participants before entering the study.

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