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Jing Z, Wang G, Li Z, Wu S, Qiu X, Huang R. Association of blood pressure variability with target organ damage in older patients with essential hypertension. Chronic Dis Transl Med 2023; 9:320-328. [PMID: 37915384 PMCID: PMC10617365 DOI: 10.1002/cdt3.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 04/26/2023] [Accepted: 05/11/2023] [Indexed: 11/03/2023] Open
Abstract
Background Although multiple measures of blood pressure variability (BPV) have been proposed, whether they are better than mean blood pressure in predicting target organs is unclear. We aimed to determine the relationship between short term BPV and target organ injury. Methods This study was a retrospective study, and 635 inpatients in the Department of Cardiology from 2015 to 2020 were selected. We divided participants into four groups on the basis of the quartiles of BPV. One-way analysis of variance was used to compare the differences between the groups, and linear regression was used to analyze the relationship between BPV and target organ damage. Results The average age of 635 patients was 74.36 ± 6.50 years old. Among them, 354 of 627 patients had diminished renal function (56.5%), 221of 604 patients had associated left ventricular hypertrophy (36.6%), and 227 of 231 patients had carotid plaque formation (98.3%). The baseline data indicated significant differences in fasting glucose, total cholesterol, low-density lipoprotein, creatinine, glomerular filtration rate, sex, calcium channel blocker use, and the rate of diminished renal function. Multiple linear regression analysis showed that BPV was negatively correlated with renal injury (creatinine: r = 0.306, p < 0.01; estimated glomerular filtration rate: r = 0.058, p < 0.01), and BPV is positively correlated with cardiac injury (r = 0.083, p < 0.01). Elevated BPV was not found to be associated with vascular injury. Conclusion Renal function decreases with increasing BPV and left ventricular mass increases with increasing BPV.
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Affiliation(s)
- Zhiquan Jing
- Department of Cardiology, Beijing Friendship HospitalCapital Medical UniversityBeijingChina
| | - Gang Wang
- Department of Cardiology, Beijing Friendship HospitalCapital Medical UniversityBeijingChina
| | - Zeya Li
- Department of Cardiology, Beijing Friendship HospitalCapital Medical UniversityBeijingChina
| | - Shanshan Wu
- Department of Clinical Epidemiology and EBM, Beijing Friendship HospitalCapital Medical UniversityBeijingChina
| | - Xiang Qiu
- Department of CardiologyBeijing Fangshan First HospitalBeijingChina
| | - Rongchong Huang
- Department of Cardiology, Beijing Friendship HospitalCapital Medical UniversityBeijingChina
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Soluble epoxide hydrolase and TRPC3 channels jointly contribute to homocysteine-induced cardiac hypertrophy: Interrelation and regulation by C/EBPβ. Biochim Biophys Acta Mol Basis Dis 2023; 1869:166643. [PMID: 36669577 DOI: 10.1016/j.bbadis.2023.166643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Studies in certain cardiac hypertrophy models suggested the individual role of soluble epoxide hydrolase (sEH) and canonical transient receptor potential 3 (TRPC3) channels, however, whether they jointly mediate hypertrophic process remains unexplored. Hyperhomocysteinemia promotes cardiac hypertrophy while the involvement of sEH and TRPC3 channels remains unknown. This study aimed to explore the role of, and interrelation between sEH and TRPC3 channels in homocysteine-induced cardiac hypertrophy. METHODS Rats were fed methionine-enriched diet to induce hyperhomocysteinemia. H9c2 cells and neonatal rat cardiomyocytes were incubated with homocysteine. Cardiac hypertrophy was evaluated by echocardiography, histological examination, immunofluorescence imaging, and expressions of hypertrophic markers. Epoxyeicosatrienoic acids (EETs) were determined by ELISA. TRPC3 current was recorded by patch-clamp. Gene promotor activity was measured using dual-luciferase reporter assay. RESULTS Inhibition of sEH by 1-trifluoromethoxyphenyl-3-(1-propionylpiperidin-4-yl) urea (TPPU) reduced ventricular mass, lowered the expression of hypertrophic markers, decreased interstitial collagen deposition, and improved cardiac function in hyperhomocysteinemic rats, associated with restoration of EETs levels in myocardium. TPPU or knockdown of sEH suppressed TRPC3 transcription and translation as well as TRPC3 current that were enhanced by homocysteine. Exogenous 11,12-EET inhibited homocysteine-induced TRPC3 expression and cellular hypertrophy. Silencing C/EBPβ attenuated, while overexpressing C/EBPβ promoted homocysteine-induced hypertrophy and expressions of sEH and TRPC3, resulting respectively from inhibition or activation of sEH and TRPC3 gene promoters. CONCLUSIONS sEH and TRPC3 channels jointly contribute to homocysteine-induced cardiac hypertrophy. Homocysteine transcriptionally activates sEH and TRPC3 genes through a common regulatory element C/EBPβ. sEH activation leads to an upregulation of TRPC3 channels via a 11,12-EET-dependent manner.
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Luo JT, Zeng CM, Zhao YM, Zeng ZY. The relationship between homocysteine and cardiopulmonary exercise testing in patients with acute coronary syndrome after percutaneous coronary intervention. BMC Cardiovasc Disord 2023; 23:3. [PMID: 36609219 PMCID: PMC9817365 DOI: 10.1186/s12872-022-02976-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 11/24/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE The purpose of this study was to investigate the relationship between homocysteine (Hcy) levels and cardiopulmonary exercise testing (CPET) in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). We also explored the relationship between Hcy levels and cardiac ultrasonography. METHODS This study comprised 261 patients with ACS who underwent coronary angiography and PCI at Yulin First Hospital from January 2020 to June 2021. All subjects completed basic data collection, laboratory examination, CPET and cardiac ultrasonography. The CPET includes the peak oxygen uptake (peak VO2), anaerobic threshold (AT), metabolic equivalents (METs), exercise load (load), oxygen pulse (O2 pulse), end-tidal CO2 partial pressure (PETCO2), ventilatory equivalents for carbon dioxide (VE/VCO2) and Oxygen uptake efficiency (OUES). Cardiac ultrasonography was used to evaluate the left ventricular end diastolic diameter (LVEDD), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT) and left ventricular ejection fraction (LVEF). A serum Hcy level ≥ 15 µmol/L was defined as hyperhomocysteinemia (HHcy). The patients were divided into the Hcy < 15 µmol/L group (n = 189) and the Hcy ≥ 15 µmol/L group (n = 72). RESULTS The average age of the participating patients was 58.9 ± 10.1 years. The majority of participants were male (86.6%). The CPET indices of METs, load, VO2/kg, and PETCO2 were significantly decreased in the Hcy ≥ 15 µmol/L group compared with the Hcy < 15 µmol/L group. Additionally, the CPET index of the VE/VCO2 slope and the cardiac ultrasonography indices of IVST and LVPWT were significantly increased in the Hcy ≥ 15 µmol/L group compared with the Hcy < 15 µmol/L group. These differences were statistically significant (P < 0.05). Correlation analysis showed that Hcy levels were negatively correlated with METs, VO2/kg and PETCO2 and positively correlated with the VE/VCO2 slope (P < 0.05). Partial correlation analysis showed that Hcy levels were negatively correlated with METs and VO2/kg in the AT state. The correlation coefficients were - 0.172 and - 0.172, respectively (P < 0.05). Hcy levels were negatively correlated with METs, VO2/kg and PETCO2 in the peak state. The correlation coefficients were - 0.177, -0.153 and - 0.129, respectively (P < 0.05). After further adjustment for confounders, multiple linear regression analysis showed that Hcy levels were negatively correlated with METs and VO2/kg in the AT state and peak state. The standardized regression coefficients were - 0.035, -0.122, -0.048 and - 0.128, respectively (P < 0.05). Correlation analysis showed that Hcy levels were positively correlated with the IVST and LVPWT (P < 0.05), but after adjusting for confounding factors, partial correlation analysis showed that there was no correlation between them. CONCLUSION A high Hcy level is associated with lower METs and VO2/kg and worse cardiopulmonary function in patients with ACS after PCI.
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Affiliation(s)
- Jun-Ting Luo
- grid.412594.f0000 0004 1757 2961Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi China ,grid.256607.00000 0004 1798 2653Department of Cardiology, The Sixth Affiliated Hospital, Guangxi Medical University, Yulin, Guangxi China
| | - Chun-Mei Zeng
- grid.256607.00000 0004 1798 2653Department of Cardiology, The Sixth Affiliated Hospital, Guangxi Medical University, Yulin, Guangxi China
| | - Yan-Mei Zhao
- grid.256607.00000 0004 1798 2653Department of Cardiology, The Sixth Affiliated Hospital, Guangxi Medical University, Yulin, Guangxi China
| | - Zhi-Yu Zeng
- grid.412594.f0000 0004 1757 2961Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi China ,Guangxi Key Laboratory of Precision Medicine in Cardio-Cerebrovascular Diseases Control and Prevention and Guangxi Clinical Research Center for Cardio-Cerebrovascular Diseases, Nanning, Guangxi China
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Ji D, Zhang B, He B. The Diagnostic Value of the Deepest S Wave in 12-Lead Electrocardiogram to Elderly Patients with Essential Hypertension and Left Ventricular Hypertrophy. Clin Interv Aging 2022; 17:1663-1672. [PMID: 36444336 PMCID: PMC9700434 DOI: 10.2147/cia.s380814] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/11/2022] [Indexed: 09/29/2023] Open
Abstract
OBJECTIVE This study aims to explore the diagnostic value of the deepest S wave (SD) in elderly patients with essential hypertension and left ventricular hypertrophy (LVH). METHODS A retrospective study was conducted in elderly patients with essential hypertension from October 2020 to December 2021. The 12-lead electrocardiogram (ECG) examination was carried out at the time of admission. Echocardiography was performed to estimate left ventricular mass (LVM) and the left ventricular muscle mass index (LVMI) was adjusted by the body surface area (BSA). The Receiver Operating Characteristic (ROC) curve for diagnosing hypertension with LVH was drawn, the cut-off value was determined according to the Youden index, and the area under the curve (AUC) was calculated. The diagnostic values of SD, SD+Sv4, ravl+Sv3, and Sv1+Rv5 were compared. RESULTS The results of SD, SD+Sv4, RavL+Sv3, and Sv1+Rv5 in the Study group were 2.03 (1.56-2.57) mV, 3.09 (2.38-3.98) mV, 2.19 (1.46-2.78) mV, and 3.38 (2.67-4.19) mV respectively, which were all higher than those in the Control group [0.93 (0.68-1.23) mV, 1.37 (1.32-2.18) mV, 1.03 (0.68-1.46) mV, and 2.28 (1.67-2.67) mV], P<0.001. Compared with the ROC curved by SD+Sv4, RavL+Sv3, and Sv1+Rv5, the AUC of the ROC curved by SD was [0.887, 95% CI (0.837-0.927)], and the cut-off value was 1.298 with the Sensitivity = 86.03 and Specificity = 86.59 in diagnosing essential hypertension with LVH. In female patients, the AUC of the ROC curved by SD was [0.891, 95% CI (0.841-0.934)], and the cut-off value was 1.304 with the Sensitivity of 89.32% and Specificity of 88.67%, which were all higher than those in male patients [AUC = 0.887, 95% CI (0.828-0.943); cut-off value = 1.288; Sensitivity = 82.12%, and Specificity = 84.22%]. CONCLUSION ECG can effectively diagnose elderly patients with essential hypertension and LVH and the diagnostic value of SD and SD+Sv4 are higher than the current Cornell criteria and Sokolow-Lyon criteria.
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Affiliation(s)
- Dapeng Ji
- Department of Cardiac Function, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University, Wuhan, People’s Republic of China
| | - Bo Zhang
- Department of Cardiac Function, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University, Wuhan, People’s Republic of China
| | - Bo He
- Department of Cardiac Function, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University, Wuhan, People’s Republic of China
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Shih YL, Shih CC, Chen JY. Elevated homocysteine level as an indicator for chronic kidney disease in community-dwelling middle-aged and elderly populations in Taiwan: A community-based cross-sectional study. Front Med (Lausanne) 2022; 9:964101. [PMID: 36004372 PMCID: PMC9393293 DOI: 10.3389/fmed.2022.964101] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background Hyperhomocysteinemia is an important factor for endothelial cell damage and a risk factor for cardiovascular diseases. Chronic kidney disease (CKD) is recognized as a leading burden in Taiwan’s healthcare system. This study aimed to investigate the association between homocysteine levels and CKD in middle-aged and elderly adults from a community in northern Taiwan. Methods A total of 396 middle-aged and elderly Taiwanese adults were enrolled and completed the health survey. We divided participants according to tertiles of homocysteine levels as first group (homocysteine level ≤ 11.1 μmol/L), second group (homocysteine level 11.2∼14.3 μmol/L), and third group (homocysteine level > 14.3 μmol/L). CKD was defined as estimated glomerular filtration rate (eGFR) < 60 (mL/min/1.73 m2) or urine albumin to creatinine ratio > 30 (mg/g). Pearson correlation was calculated between eGFR and other related risk factors after adjustment for age. The risk of CKD in the second and third groups compared to that in the first group was assessed by multivariate logistic regression after adjustment for age, sex, smoking, hypertension (HTN), diabetes mellitus (DM), body mass index (BMI), dyslipidemia, and uric acid. The Youden index and receiver operating characteristic (ROC) curve were calculated for the optimized cutoff value. Results Elevated plasma homocysteine levels were more likely to lower the eGFR and increase the prevalence of CKD. Pearson correlation showed a positive correlation between eGFR and high-density lipoprotein cholesterol, while a negative correlation was observed between homocysteine levels, waist circumference, systolic blood pressure, uric acid levels and BMI (all p < 0.05). In the logistic regression analysis, the prevalence of CKD increased, as well as the homocysteine level. The odds ratio of CKD under 95% confidence interval was 2.655 (1.284–5.490) for the third group compared with the first group after adjusting for age, sex, smoking, DM, HTN, dyslipidemia, uric acid, and BMI (p = 0.008). The area under the ROC curve was 0.662, and a cutoff value of 15.15 μmol/L for the homocysteine level was obtained for detecting subjects with CKD. Conclusion Our study findings revealed that elevated homocysteine levels were significantly associated with CKD and could be used as an indicator of CKD among the middle-aged and elderly populations in Taiwan.
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Affiliation(s)
- Yu-Lin Shih
- Department of Family Medicine, Chang-Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan
| | - Chin-Chuan Shih
- General Administrative Department, United Safety Medical Group, New Taipei City, Taiwan
| | - Jau-Yuan Chen
- Department of Family Medicine, Chang-Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
- *Correspondence: Jau-Yuan Chen,
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Li Z, Yang Y, Zheng L, Sun G, Guo X, Sun Y. It's Time to Add Electrocardiography and Echocardiography to CVD Risk Prediction Models: Results from a Prospective Cohort Study. Risk Manag Healthc Policy 2021; 14:4657-4671. [PMID: 34815727 PMCID: PMC8604639 DOI: 10.2147/rmhp.s337466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/31/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To develop and validate a new prediction model for the general population based on a large panel of both traditional and novel factors in cardiovascular disease (CVD). Design and Setting We used a prospective cohort in the Northeast China Rural Cardiovascular Health Study (NCRCHS). Participants A total of 11,956 participants aged ≥35 years were recruited between 2012 and 2013, using a multistage, randomly stratified, cluster-sampling scheme. In 2015 and 2017, the participants were invited to join the follow-up study for incident cardiovascular events. The loss to follow-up number was 351. At the study’s end, we obtained the CVD outcome events for 10,349 participants. Primary and Secondary Outcome Measures The prediction model was developed using demographic factors, blood biochemical indicators, electrocardiographic (ECG) characteristics, and echocardiography indicators collected at baseline (Model 1). Framingham-related variables, namely age, sex, smoking, total and high-density lipoprotein cholesterol and diabetes status were used to construct the traditional model (Model 2). Results For the observed population (n = 10,349), the median follow-up time was 4.66 years. The total incidence of CVD was 1.1%/year, including stroke (n = 342) and coronary heart disease (n = 175). The results of Model 1 indicated that in addition to the traditional risk factors, QT interval (p < 0.001), aortic root diameter (p < 0.001), and ventricular septal thickness (p < 0.001) were predictive factors for CVD. Decision curve analysis (DCA) showed that the net benefit with Model 1 was higher than that of Model 2. Conclusion QT interval from electrocardiography and aortic root diameter and ventricular septal thickness from echocardiography should be included in the CVD risk prediction models.
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Affiliation(s)
- Zhao Li
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Yiqing Yang
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Guozhe Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
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Homocysteine, hypertension, and risks of cardiovascular events and all-cause death in the Chinese elderly population: a prospective study. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2021; 18:796-808. [PMID: 34754291 PMCID: PMC8558741 DOI: 10.11909/j.issn.1671-5411.2021.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Increased homocysteine levels are associated with the risk of cardiovascular disease (CVD) and death. However, their prevention has not been effective in decreasing CVD risk. This study investigated the individual and combined associations of hyperhomocysteinemia and hypertension with incident CVD events and all-cause death in the Chinese elderly population without a history of CVD. METHODS This prospective study was conducted among 1,257 elderly participants (mean age: 69 years). A questionnaire survey, physical examinations, and laboratory tests were conducted to collect baseline data. Hyperhomocysteinemia was defined as homocysteine level ≥ 15 µmol/L. H-type hypertension was defined as concomitant hypertension and hyperhomocysteinemia. Multivariate Cox regression analysis was used to evaluate individual and combined associations of hyperhomocysteinemia and hypertension with the risks of incident CVD events and all-cause death. RESULTS Over a median of 4.84-year follow-up, hyperhomocysteinemia was independently associated with incident CVD events and all-cause death. The hazard ratios (HRs) were 1.45 (95% CI: 1.01−2.08) for incident CVD events and 1.55 (95% CI: 1.04−2.30) for all-cause death. After adjustment for confounding factors, H-type hypertension had the highest HRs for incident CVD events and all-cause death. The fully adjusted HRs were 2.44 for incident CVD events (95% CI: 1.28−4.65), 2.07 for stroke events (95% CI: 1.01−4.29), 8.33 for coronary events (95% CI: 1.10−63.11), and 2.31 for all-cause death (95% CI: 1.15−4.62). CONCLUSIONS Hyperhomocysteinemia was an independent risk factor, and when accompanied by hypertension, it contributed to incident CVD events and all-cause death in the Chinese elderly population without a history of CVD.
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Ren Z, Zhang J, Yu S, Zhao S, Tang J, Zheng Y, Meng W, Xu C, Zhang Y, Xu Y. Hypertension-Mediated Organ Damage Correlates With Serum Homocysteine Level in Community-Dwelling Elderly Chinese: The North Shanghai Study. Front Cardiovasc Med 2021; 8:662741. [PMID: 34041284 PMCID: PMC8141577 DOI: 10.3389/fcvm.2021.662741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/13/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Serum homocysteine (Hcy) level is associated with cardiocerebrovascular disease. However, the relationship between Hcy and hypertension-mediated organ damage (HMOD) in non-hospitalized residents has not been elucidated. We aimed to investigate the association of HMOD with Hcy in elderly Chinese. Methods: One thousand seven hundred and forty-four community-dwelling elderly Chinese (age ≥65 years) participated in the Northern Shanghai Study from Jun. 2014 to Aug. 2015. Hyperhomocysteinemia (HHcy) was defined as serum Hcy ≥15 mmol/L, and HMOD was estimated as arterial stiffness [carotid-femoral pulse wave velocity (CF-PWV) and ankle-brachial index (ABI)], cardiac impairment [left ventricular (LV) hypertrophy and LV diastolic dysfunction], and renal dysfunction [estimated glomerular filtration rate (eGFR) and urinary albumin/creatinine ratio]. Linear and logistic regression models were built to explore the associations of HMOD with Hcy. Results: Among 1,744 participants, 632 (36.2%) were diagnosed as HHcy. HHcy group had more men (61.2 vs. 35.3%), with higher age (73.7 ± 6.7 vs. 70.4 ± 5.3 years) and BMI (24.2 ± 3.4 vs. 23.7 ± 3.5 kg/m2). Linear regression analysis showed that serum Hcy level was positively associated CF-PWV and negatively associated with ABI and eGFR. By logistic regression, HHcy was significantly associated with abnormal CF-PWV [odds ratio (OR) = 1.53, 95% confidence interval (CI) 1.08–2.16] and ABI (OR = 1.55, 95% CI 1.17–2.04), and decreased eGFR (OR = 7.09, 95% CI 4.03–12.47) after adjustment for covariates. Moreover, similar associations of serum Hcy level with CF-PWV and eGFR were observed in subgroups by gender and hypertensive state. Conclusion: HMOD, particularly renal dysfunction and arterial stiffening, was significantly and independently associated with increased serum Hcy level in the elderly Chinese. Clinical Trial Registration: [ClinicalTrial.gov], identifier [NCT02368938].
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Affiliation(s)
- Zhongyuan Ren
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.,Soochow University Medical College, Suzhou Industrial Park (SIP), Suzhou, China
| | - Jun Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Shikai Yu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Song Zhao
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jiamin Tang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yixing Zheng
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Weilun Meng
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chong Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yi Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
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Shih CC, Shih YL, Chen JY. The association between homocysteine levels and cardiovascular disease risk among middle-aged and elderly adults in Taiwan. BMC Cardiovasc Disord 2021; 21:191. [PMID: 33879044 PMCID: PMC8056530 DOI: 10.1186/s12872-021-02000-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 04/09/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Our study aimed to determine the association between homocysteine levels and cardiovascular disease (CVD) risk in middle-aged and elderly adults in a community in northern Taiwan. METHODS Participants in our study included adults aged 50 to 85 years old during community health examinations in 2019. A total of 396 people were enrolled, the ethnicity of all participants is Chinese. We divided participants according to tertiles of ln[homocysteine] level (low, middle and high groups). The CVD risk was calculated by the Framingham cardiovascular risk score (FRS). An FRS ≥ 20% indicated high CVD risk. Pearson correlation coefficients were calculated between homocysteine level and other cardio-metabolic risk factors while adjusting for age. Multivariate logistic regression analysis was used to determine the association of high and middle ln[homocysteine] groups with high CVD risk after adjusting age, sex, uric acid, creatinine, and body mass index (BMI). The Youden index and receiver operating characteristic (ROC) curves were performed to determine the optimized cut-off value. RESULTS There were 396 people enrolled for analysis; 41.4% of participants were male, and the average age was 64.79 (± 8.76). In our study, we showed a positive correlation of homocysteine with FRS. In the logistic regression models, higher ln[homocysteine] levels was associated with higher CVD risk with a odds ratio (OR) of 2.499 and 95% confidence interval (CI) of 1.214 to 5.142 in the high homocysteine level group compared with the low homocysteine group after adjusting for traditional CVD risk factors. The area under the ROC curve was 0.667, and a ln[homocysteine] cut-off value of 2.495 µmol/L was determined. CONCLUSIONS Middle-aged and elderly people with increased homocysteine levels were associated with higher FRSs in this Taiwan community. Furthermore, homocysteine was an independent risk factor for high CVD risk in this study.
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Affiliation(s)
- Chin-Chuan Shih
- General Administrative Department, United Safety Medical Group, 2F, No.302, Zhongzheng Rd., Xinzhuang District, New Taipei City, 242, Taiwan (R.O.C.)
| | - Yu-Lin Shih
- Department of Family Medicine, Chang-Gung Memorial Hospital, Linkou Branch, No.5, Fuxing St., Guishan Dist, Taoyuan City, 333, Taiwan (R.O.C.)
| | - Jau-Yuan Chen
- Department of Family Medicine, Chang-Gung Memorial Hospital, Linkou Branch, No.5, Fuxing St., Guishan Dist, Taoyuan City, 333, Taiwan (R.O.C.).
- Chang Gung University College of Medicine, Taoyuan, No.259, Wenhua 1st Rd., Guishan Dist, Taoyuan City, 333, Taiwan (R.O.C.).
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Wu X, Lin J, Xue N, Teng J, Wang Y, Li Y, Xu X, Shen Z, Ding X, Fang Y. Relationship Between Gene Polymorphism of Methylenetetrahydrofolate Reductase C677T and Left Ventricular Hypertrophy in Chinese Patients with Chronic Kidney Disease. Lab Med 2021; 52:519-527. [PMID: 33693817 DOI: 10.1093/labmed/lmab004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the relationship between the gene polymorphism of methylenetetrahydrofolate reductase (MTHFR) C677T and left ventricular hypertrophy (LVH) in patients with chronic kidney disease (CKD). METHODS A total of 763 Chinese patients with CKD undergoing genetic testing were included in the study. The association between the gene polymorphism of MTHFR C677T and echocardiographic parameters was analyzed through univariate and multivariate analyses. RESULTS We found a remarkably positive association between MTHFR C677T gene polymorphism and LVH indexes, including interventricular septal thickness (F = 3.8; P = .022), left ventricular posterior wall thickness (F = 3.0; P = .052), left ventricular mass (F = 3.9; P = .022), and left ventricular mass index (F = 2.6; P = .075). After adjusting for the potential confounders linking the polymorphism,we found that the positive association between the polymorphism and LVH indexes still existed in patients with CKD in some multiple linear regression models (P <.05). CONCLUSION MTHFR C677T gene polymorphism may be a genetic susceptibility marker for the development of LVH in patients with CKD.
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Affiliation(s)
- Xie Wu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jing Lin
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ning Xue
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jie Teng
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yaqiong Wang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yang Li
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xunhui Xu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ziyan Shen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yi Fang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Medical Center of Kidney Disease, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Zhongshan Hospital, Fudan University, Shanghai, China
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11
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Cai W, Lang M, Jiang X, Yu Q, Zhou C, Zou W, Zhang X, Lei J. Correlation among high salt intake, blood pressure variability, and target organ damage in patients with essential hypertension: Study protocol clinical trial (SPIRIT compliant). Medicine (Baltimore) 2020; 99:e19548. [PMID: 32243371 PMCID: PMC7220693 DOI: 10.1097/md.0000000000019548] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 02/13/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Essential hypertension is a multifactorial disease, which is affected by genetic and environmental factors, and can cause diseases such as cerebrovascular disease, heart failure, coronary heart disease, and chronic renal failure. High salt intake is a risk factor for hypertension, stroke, and cardiovascular disease. Blood pressure variability (BPV) is a reliable independent predictor of cardiovascular events and death. At present, there are few studies about the correlation among high salt intake, BPV, and target organ damage (TOD) in patients with hypertension. OBJECTIVE The purpose of this study is to compare 24-hour urine sodium excretion, BPV, carotid intima-media thickness, left ventricular mass index, and serum creatinine or endogenous creatinine clearance rate. To clarify the relationship between high salt load and BPV and TOD in patients with hypertension.This study is a cross-sectional study. It will recruit 600 patients with essential hypertension in the outpatient and inpatient department of cardiovascular medicine of Chengdu Fifth People's Hospital. Researchers will obtain blood and urine samples with the patient's informed consent. In addition, we will measure patient's blood pressure and target organ-related information. TRIAL REGISTRY The study protocol was approved by the Chengdu Fifth People's Hospital. Written informed consent will be obtained from all the participants. The trial was registered in the Chinese Clinical trial registry, ChiCTR2000029243. This trial will provide for the correlation among high salt intake, BPV, and TOD in patients with essential hypertension.
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Affiliation(s)
- Wei Cai
- Department of Cardiology, The Affiliated Chengdu Fifth People's Hospital, North Sichuan Medical College
| | - MingJian Lang
- Department of Cardiology, Chengdu Fifth People's Hospital, Chengdu, Sichuan Province, China
| | - XiaoBo Jiang
- Department of Cardiology, Chengdu Fifth People's Hospital, Chengdu, Sichuan Province, China
| | - Qian Yu
- Department of Cardiology, Chengdu Fifth People's Hospital, Chengdu, Sichuan Province, China
| | - Congliang Zhou
- Department of Cardiology, Chengdu Fifth People's Hospital, Chengdu, Sichuan Province, China
| | - Wenshu Zou
- Department of Cardiology, Chengdu Fifth People's Hospital, Chengdu, Sichuan Province, China
| | - Xiaohua Zhang
- Department of Cardiology, Chengdu Fifth People's Hospital, Chengdu, Sichuan Province, China
| | - JianGuo Lei
- Department of Cardiology, The Affiliated Chengdu Fifth People's Hospital, North Sichuan Medical College
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