Endocrinol Metab.  2022 Apr;37(2):333-343. 10.3803/EnM.2021.1202.

Association between Elevated Plasma Homocysteine and Low Skeletal Muscle Mass in Asymptomatic Adults

• Choi JH
• Seo JW
• Lee MY
• Lee YT
• Yoon KJ
• Park CH

• KMID: 2529225
• DOI: http://doi.org/10.3803/EnM.2021.1202

Abstract

Background
Homocysteine has been drawing attention with a closed linkage with skeletal muscle. However, the association of hyperhomocysteinemia with decreased skeletal muscle mass remains unclear. We aimed to investigate the association of hyperhomocysteinemia with low skeletal muscle mass (LMM) in asymptomatic adults.
Methods
This was a cross-sectional study of 114,583 community-dwelling adults without cancer, stroke, or cardiovascular diseases who underwent measurements of plasma homocysteine and body composition analysis from 2012 to 2018. Hyperhomocysteinemia was defined as >15 μmol/L. Skeletal muscle mass index (SMI) was calculated based on appendicular muscle mass (kg)/height (m)². Participants were classified into three groups based on SMI: “normal,” “mildly low,” and “severely low.”
Results
The prevalence of hyperhomocysteinemia was the highest in subjects with severely LMM (12.9%), followed by those with mildly LMM (9.8%), and those with normal muscle mass (8.5%) (P for trend <0.001). In a multivariable logistic regression model, hyperhomocysteinemia was significantly associated with having a mildly LMM (odds ratio [OR], 1.305; 95% confidence interval [CI], 1.224 to 1.392) and severely LMM (OR, 1.958; 95% CI, 1.667 to 2.286), respectively. One unit increment of log-transformed homocysteine was associated with 1.360 and 2.169 times higher risk of having mildly LMM and severely LMM, respectively.
Conclusion
We demonstrated that elevated homocysteine has an independent association with LMM in asymptomatic adults, supporting that hyperhomocysteinemia itself can be a risk for decline in skeletal musculature.

Keyword

Homocysteine; Sarcopenia; Muscle; skeletal

Figure

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  Fig. 1 Comparison of adjusted mean of ln (homocysteine) between the group classified by skeletal muscle mass. Adjusted for age, sex, center, systolic blood pressure, laboratory factor (low-density lipoprotein cholesterol, glycosylated hemoglobin [%], C-reactive protein, creatinine), health behavior factors (smoking status, heavy drinking, regular physical activity). Ln, natural log transformed; LMM, low skeletal muscle mass. aP=0.009; bP<0.001.

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