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Abstract: Objective: To investigate whether elevated homocysteine levels were a predictor of subsequent coronary heart disease (CHD) mortality, cardiovascular mortality or all-cause mortality in the general population by a meta-analysis. Methods: In a systematic search conducted in the databases of PubMed and Embase prior to October 2013, we identified relevant prospective observational studies evaluating the association between baseline homocysteine levels and CHD mortality, cardiovascular or all-cause mortality in the general population. Pooled adjust risk ratio (RR) and corresponding 95% confidence interval (CI) were calculated separately for categorical risk estimates and continuous risk estimates. Results: Twelve studies with 23623 subjects were included in the meta-analysis. Comparing the highest to lowest homocysteine level categories, CHD mortality increased by 66% (RR 1.66; 95% CI 1.12–2.47; P=0.012), cardiovascular mortality increased by 68% (RR 1.68; 95% CI 1.04–2.70; P=0.033), and all-cause mortality increased by 93% (RR 1.93; 95% CI 1.54–2.43; P<0.001). Moreover, for each 5 μmol/L homocysteine increment, the pooled RR was 1.52 (95% CI 1.26–1.84; P<0.001) for CHD mortality, 1.32 (95% CI 1.08–1.61; P=0.006) for cardiovascular mortality, and 1.27 (95% CI 1.03–1.55; P=0.023) for all-cause mortality. Conclusions: Elevated homocysteine levels are an independent predictor for subsequent cardiovascular mortality or all-cause mortality, and the risks were more pronounced among elderly persons.

血浆同型半胱氨酸水平升高与心血管疾病及各种死亡风险因子的meta分析

[1]Bautista, L.E., Arenas, I.A., Penuela, A., et al., 2002. Total plasma homocysteine level and risk of cardiovascular disease: a meta-analysis of prospective cohort studies. J. Clin. Epidemiol., 55(9):882-887.

[2]Begg, C.B., Mazumdar, M., 1994. Operating characteristics of a rank correlation test for publication bias. Biometrics, 50(4):1088-1101.

[3]Blacher, J., Benetos, A., Kirzin, J.M., et al., 2002. Relation of plasma total homocysteine to cardiovascular mortality in a French population. Am. J. Cardiol., 90(6):591-595.

[4]Bostom, A.G., Silbershatz, H., Rosenberg, I.H., et al., 1999. Nonfasting plasma total homocysteine levels and all-cause and cardiovascular disease mortality in elderly Framingham men and women. Arch. Intern. Med., 159(10):1077-1080.

[5]Celermajer, D.S., Sorensen, K., Ryalls, M., et al., 1993. Impaired endothelial function occurs in the systemic arteries of children with homozygous homocystinuria but not in their heterozygous parents. J. Am. Coll. Cardiol., 22(3):854-858.

[6]Colon Lopez, V., Haan, M.N., Aiello, A.E., et al., 2008. Fasting total homocysteine (THCY) concentration and mortality in older Mexican Americans. J. Nutr. Health. Aging, 12(10):685-689.

[7]Cui, R., Moriyama, Y., Koike, K.A., et al., 2008. Serum total homocysteine concentrations and risk of mortality from stroke and coronary heart disease in Japanese: the JACC study. Atherosclerosis, 198(2):412-418.

[8]Dangour, A.D., Breeze, E., Clarke, R., et al., 2008. Plasma homocysteine, but not folate or vitamin B-12, predicts mortality in older people in the United Kingdom. J. Nutr., 138(6):1121-1128.

[9]de Bree, A., Verschuren, W.M., Blom, H.J., et al., 2003. Coronary heart disease mortality, plasma homocysteine, and B-vitamins: a prospective study. Atherosclerosis, 166(2):369-377.

[10]Dionisio, N., Jardin, I., Salido, G.M., et al., 2010. Homocysteine, intracellular signaling and thrombotic disorders. Curr. Med. Chem., 17(27):3109-3119.

[11]Egger, M., Davey Smith, G., Schneider, M., et al., 1997. Bias in meta-analysis detected by a simple, graphical test. BMJ, 315(7109):629-634.

[12]Gonzalez, S., Huerta, J.M., Fernandez, S., et al., 2007. Homocysteine increases the risk of mortality in elderly individuals. Br. J. Nutr., 97(6):1138-1143.

[13]Higgins, J.P., Thompson, S.G., Deeks, J.J., et al., 2003. Measuring inconsistency in meta-analyses. BMJ, 327(7414):557-560.

[14]Ho, R.C., Cheung, M.W., Fu, E., et al., 2011. Is high homocysteine level a risk factor for cognitive decline in elderly? A systematic review, meta-analysis, and meta-regression. Am. J. Geriatr. Psychiatry, 19(7):607-617.

[15]Hoogeveen, E.K., Kostense, P.J., Jakobs, C., et al., 2000. Hyperhomocysteinemia increases risk of death, especially in type 2 diabetes: 5-year follow-up of the Hoorn study. Circulation, 101(13):1506-1511.

[16]Kark, J.D., Selhub, J., Adler, B., et al., 1999. Nonfasting plasma total homocysteine level and mortality in middle-aged and elderly men and women in Jerusalem. Ann. Intern. Med., 131(5):321-330.

[17]Naess, H., Nyland, H., Idicula, T., et al., 2013. C-reactive protein and homocysteine predict long-term mortality in young ischemic stroke patients. J. Stroke. Cerebrovasc. Dis., 22(8):e435-e440.

[18]Nygård, O., Vollset, S.E., Refsum, H., et al., 1995. Total plasma homocysteine and cardiovascular risk profile. The Hordaland homocysteine study. JAMA, 274(19):1526-1533.

[19]Nygård, O., Nordrehaug, J.E., Refsum, H., et al., 1997. Plasma homocysteine levels and mortality in patients with coronary artery disease. N. Engl. J. Med., 337(4):230-236.

[20]Rossi, G.P., Maiolino, G., Seccia, T.M., et al., 2006. Hyperhomocysteinemia predicts total and cardiovascular mortality in high-risk women. J. Hypertens., 24(5):851-859.

[21]Selhub, J., 2006. The many facets of hyperhomocysteinemia: studies from the Framingham cohorts. J. Nutr., 136(6S):1726S-1730S.

[22]Selhub, J., Jacques, P.F., Wilson, P.W., et al., 1993. Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. JAMA, 270(22):2693-2698.

[23]Stehouwer, C.D., Weijenberg, M.P., van den Berg, M., et al., 1998. Serum homocysteine and risk of coronary heart disease and cerebrovascular disease in elderly men: a 10-year follow-up. Arterioscler. Thromb. Vasc. Biol., 18(12):1895-1901.

[24]Stroup, D.F., Berlin, J.A., Morton, S.C., et al., 2000. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA, 283(15):2008-2012.

[25]Swart, K.M., van Schoor, N.M., Blom, H.J., et al., 2012. Homocysteine and the risk of nursing home admission and mortality in older persons. Eur. J. Clin. Nutr., 66(2):188-195.

[26]Vollset, S.E., Refsum, H., Tverdal, A., et al., 2001. Plasma total homocysteine and cardiovascular and noncardiovascular mortality: the hordaland homocysteine study. Am. J. Clin. Nutr., 74(1):130-136.

[27]Waśkiewicz, A., Sygnowska, E., Broda, G., 2012. Homocysteine concentration and the risk of death in the adult polish population. Kardiol. Pol., 70(9):897-902.

[28]Wells, G., Shea, B.O., Connell, D., et al., 2013. The Newcastle-Ottawa scale (NOS) for assessing the quality if nonrandomized studies in meta-analyses. Available from http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp [Accessed on Oct. 6, 2013].

[29]Wong, Y.Y., Almeida, O.P., Mccaul, K.A., et al., 2012. Homocysteine, frailty, and all-cause mortality in older men: the health in men study. J. Gerontol. A Biol. Sci. Med. Sci., 68(5):590-598.

[30]Yang, J., Hu, X., Zhang, Q., et al., 2012. Homocysteine level and risk of fracture: a meta-analysis and systematic review. Bone, 51(3):376-382.

[31]Zylberstein, D.E., Bengtsson, C., Bjorkelund, C., et al., 2004. Serum homocysteine in relation to mortality and morbidity from coronary heart disease: a 24-year follow-up of the population study of women in Gothenburg. Circulation, 109(5):601-606.