Hyperhomocysteinemia accompany with metabolic syndrome increase the risk of left ventricular hypertrophy in rural Chinese

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Abstract

Background

To investigate the influence of hyperhomocysteinemia (HHcy) and metabolic syndrome (MetS) on left ventricular hypertrophy (LVH) in residents in rural Northeast China.

Methods

We performed a cross-sectional baseline data analysis of 6837 subjects (mean age: 54 ± 10 years) recruited from a rural area of China. Anthropometric indicators were measured according to standard methods. MetS was defined by the modified ATP III criteria. HHcy was defined according to the WHO standard: an Hcy level > 15 μmol/L representing HHcy. Four groups were defined: non-HHcy & non-MetS, HHcy & non-MetS, MetS & non-HHcy and HHcy & MetS.

Results

The left ventricular mass index for height ^2.7 (LVMH ^2.7) in both sexes was significantly higher in the HHcy & MetS group than in the non-HHcy & non-MetS group (females: 51.23 ± 16.34 vs. 40.09 ± 10.55 g ^-2.7, P < 0.001; males: 48.67 ± 12.24 g ^-2.7 vs. 42.42 ± 11.38 g ^-2.7, P < 0.001). A similar result was observed in those groups when using the left ventricular mass index (LVMI) for body surface area to define LVH (females: 103.58 ± 31.92 g ^− 2 vs. 86.63 ± 20.47 g ^− 2, P < 0.001; males: 106.10 ± 24.69 g ^− 2 vs. 98.16 ± 23.29 g ^− 2, P < 0.001). The results of multiple regression analysis indicated that the HHcy & MetS group had a higher risk of LVH than the other three groups (OR: 1.628 for LVMI, P < 0.001, OR: 2.433 for LVMH ^2.7, P < 0.001). Moreover, subjects in the HHcy & non-MetS group [OR (95% CI): 1.297 (1.058, 1.591) for LVMI, P < 0.05; OR (95% CI): 1.248 (1.044, 1.492) for LVMH ^2.7, P < 0.05] also had a statistically greater risk of LVH than subjects in the non-HHcy & non-MetS group. The HHcy & non-MetS group was also found to be significantly and independently associated with LVH.

Conclusion

Hyperhomocysteinemia has an independent effect on LVH. The combined effect of MetS and hyperhomocysteinemia might increase the strength of the abovementioned effects.

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Most cited references 34

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Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings.

Richard Devereux, Daniel R. Alonso, Elizabeth M. Lutas … (1986)

To determine the accuracy of echocardiographic left ventricular (LV) dimension and mass measurements for detection and quantification of LV hypertrophy, results of blindly read antemortem echocardiograms were compared with LV mass measurements made at necropsy in 55 patients. LV mass was calculated using M-mode LV measurements by Penn and American Society of Echocardiography (ASE) conventions and cube function and volume correction formulas in 52 patients. Penn-cube LV mass correlated closely with necropsy LV mass (r = 0.92, p less than 0.001) and overestimated it by only 6%; sensitivity in 18 patients with LV hypertrophy (necropsy LV mass more than 215 g) was 100% (18 of 18 patients) and specificity was 86% (29 of 34 patients). ASE-cube LV mass correlated similarly to necropsy LV mass (r = 0.90, p less than 0.001), but systematically overestimated it (by a mean of 25%); the overestimation could be corrected by the equation: LV mass = 0.80 (ASE-cube LV mass) + 0.6 g. Use of ASE measurements in the volume correction formula systematically underestimated necropsy LV mass (by a mean of 30%). In a subset of 9 patients, 3 of whom had technically inadequate M-mode echocardiograms, 2-dimensional echocardiographic (echo) LV mass by 2 methods was also significantly related to necropsy LV mass (r = 0.68, p less than 0.05 and r = 0.82, p less than 0.01). Among other indexes of LV anatomy, only measurement of myocardial cross-sectional area was acceptably accurate for quantitation of LV mass (r = 0.80, p less than 0.001) or diagnosis of LV hypertrophy (sensitivity = 72%, specificity = 94%).(ABSTRACT TRUNCATED AT 250 WORDS)

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Joint effects of physical activity, body mass index, waist circumference and waist-to-hip ratio with the risk of cardiovascular disease among middle-aged Finnish men and women.

Noel Barengo, Jaakko Tuomilehto, Gang Hu … (2004)

To assess joint associations of physical activity and different indicators of obesity (body mass index, waist circumference, and waist-to-hip ratio) with the risk of cardiovascular disease (CVD). The study comprised 18,892 Finnish men and women aged 25-74 years without history of coronary heart disease, stroke, or heart failure at baseline. Physical activity, different indicators of obesity, education, smoking, blood pressure, total and high-density lipoprotein cholesterol and history of diabetes were measured at baseline. An incident CVD event was defined as the first stroke or coronary heart disease event or CVD death based on national hospital discharge and mortality register data. The median follow-up time was 9.8 years. Physical activity had a strong, independent, and inverse association with CVD risk in both genders. All obesity indicators had a significant direct association with CVD risk after adjustment for age, smoking, education and physical activity. Further adjustment for the obesity-related risk factors weakened the associations and they remained statistically significant in men only. Physical activity and the obesity indicators both predicted CVD risk in men, but in women the joint effect was inconsistent. Both regular physical activity and normal weight can reduce the risk of CVD. Physical inactivity seems to have an independent effect on CVD risk, whereas obesity increases the risk partly through the modification of other risk factors.

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Prevalence of Hyperhomocysteinemia in China: A Systematic Review and Meta-Analysis

Boyi Yang, Shujun Fan, Xueyuan Zhi … (2014)

Hyperhomocysteinemia (HHcy, total homocysteine concentrations > 15 μmol/L) has been associated with increased risk of many diseases. A systematic review was performed to summarize the prevalence of HHcy in China. We searched multiple international and Chinese scientific databases for relevant literature, and further manually screened reference lists and corresponded with original authors. Pooled prevalence of HHcy was calculated using random effects model. Subgroup analysis, meta-regression and sensitivity analysis were also performed. A total of 36 studies consisting 60,754 subjects (57.3% male; age range, 3–97 years) were finally included. The overall pooled prevalence of HHcy was 27.5%. Geographically, the prevalence was high in north areas, intermediate in central areas, and low in south areas, and was higher in inland versus coastal areas. The prevalence increased with age and was significantly higher in men than in women. Rural residents had a slightly higher HHcy prevalence than urban residents, and the studies conducted during 2006 to 2012 presented a higher HHcy prevalence than those during 1990 to 2005. In summary, the prevalence of HHcy in China is high, particularly in northern populations, the inlanders, males, and the elderly. Homocysteine-lowering strategies are necessary to reduce this highly preventable disorder.

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Author and article information

Contributors

Shasha Yu: 914989307@qq.com

Yintao Chen: chenyintao047717@163.com

Hongmei Yang: yanghongmei047717@126.com

Xiaofan Guo: guoxiaofan047717@126.com

Liqiang Zheng: zhengliqiang047717@126.com

Yingxian Sun:

ORCID: http://orcid.org/0000-0003-0592-2058

sunyingxian12@aliyun.com

Journal

Journal ID (nlm-ta): BMC Cardiovasc Disord

Journal ID (iso-abbrev): BMC Cardiovasc Disord

Title: BMC Cardiovascular Disorders

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2261

Publication date (Electronic): 3 February 2020

Publication date PMC-release: 3 February 2020

Publication date Collection: 2020

Volume: 20

Electronic Location Identifier: 44

Affiliations

[1 ]GRID grid.412636.4, Department of Cardiology, , The First Hospital of China Medical University, ; 155 Nanjing North Street, Heping District, Shenyang, 110001 China

[2 ]GRID grid.412467.2, ISNI 0000 0004 1806 3501, Department of Clinical Epidemiology, , Shengjing Hospital of China Medical University, ; Shenyang, 117004 China

Author information

Yingxian Sun http://orcid.org/0000-0003-0592-2058

Article

Publisher ID: 1350

DOI: 10.1186/s12872-020-01350-2

PMC ID: 6998833

PubMed ID: 32013876

SO-VID: 090d91ab-0d16-49b6-b2e1-a01a86cd5c3b

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 5 November 2019

Date accepted : 20 January 2020

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ScienceOpen disciplines: Cardiovascular Medicine

Keywords: hyperhomocysteinemia,metabolic syndrome,left ventricular hypertrophy,predictor,rural

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ScienceOpen disciplines: Cardiovascular Medicine

Keywords: hyperhomocysteinemia, metabolic syndrome, left ventricular hypertrophy, predictor, rural

Hyperhomocysteinemia accompany with metabolic syndrome increase the risk of left ventricular hypertrophy in rural Chinese

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Karger: Cardiovascular System

Most cited references 34

Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings.

Joint effects of physical activity, body mass index, waist circumference and waist-to-hip ratio with the risk of cardiovascular disease among middle-aged Finnish men and women.

Prevalence of Hyperhomocysteinemia in China: A Systematic Review and Meta-Analysis

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