The Association Between Homocysteine Levels and Cardiovascular Disease Risk Among Middle-Aged and Elderly Adults in Taiwan
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.MethodsParticipants in our study included adults aged 50 to 85 years old during community health examinations on 2019. A total of 396 people were enrolled. We divided participants according to tertiles of 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. High CVD risk in the middle and high homocysteine groups was compared with that in the low homocysteine group by multivariate logistic regression with adjustments for age, sex, smoking, hypertension (HTN), diabetes mellitus (DM), body mass index (BMI) and hyperlipidemia. The Youden index and receiver operating characteristic (ROC) curves were performed to determine the optimized cut-off value.ResultsThere were 396 people enrolled for analysis; 41.4% of participants were male, and the average age was 63.72 (±8.76). In our study, we showed a positive correlation of homocysteine with FRS. In the logistic regression models, the prevalence of high CVD risk was increased as homocysteine increased. The odds ratio (OR) and 95% confidence interval for high CVD risk was 2.851 (1.402 to 5.801) in the high homocysteine level group compared with the low homocysteine group after adjusting for traditional CVD risk factors (P=0.004). The area under the ROC curve was 0.67, and a homocysteine cut-off value of 12.15 µmol/L was determined.ConclusionsMiddle-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.