Nutr Res Pract.  2024 Aug;18(4):511-522. 10.4162/nrp.2024.18.4.511.

Homocysteine levels are associated with diabetes mellitus in Chinese with H-type hypertension

• Fu D
• Gong W
• Bao X
• Yang B
• Wang F
• Qiao Y
• Wu Y
• Chen G
• Sun W
• Xiao Q
• Zou W
• Fang N

• KMID: 2558489
• DOI: http://doi.org/10.4162/nrp.2024.18.4.511

Abstract

BACKGROUND/OBJECTIVES
The study examined the association between homocysteine and diabetes mellitus in patients with H-type hypertension and assessed the possible effect modifiers.
SUBJECTS/METHODS
This cross-sectional study included 1,255 eligible participants in the ‘H-type Hypertension Management and Stroke Prevention Strategic International Science and Technology Innovation Cooperation Project’ among rural Chinese people with H-type hypertension. A multivariate logistic regression model was used to evaluate the relationship between homocysteine and diabetes mellitus.
RESULTS
The mean level of total homocysteine (tHcy) in the diabetes mellitus population was 19.37 μmol/L, which was significantly higher than the non-diabetic patients (18.18 μmol/L). When tHcy was analyzed as a continuous variable, the odds ratio (OR) of diabetes was 1.17 (95% confidence interval [CI], 1.01–1.35; per interquartile range). When tHcy was stratified according to the quintile, the ORs for diabetes were 2.86 (95% CI, 1.22–6.69) in the highest quintile (tHcy ≥ 20.60 μmol/L) compared to the reference group (tHcy < 12.04 μmol/L). When tHcy was grouped by 15 μmol/L and 20 μmol/L, patients with tHcy ≥ 20 μmol/L had a significantly (P = 0.037) higher risk of diabetes (OR, 2.03; 95% CI, 1.04–3.96) than in those with tHcy < 15 μmol/L. Subgroup analysis showed that the tHcy-diabetes association was unaffected by other variables.
CONCLUSION
In this study of rural Chinese people with H-type hypertension, the tHcy levels showed a positive association with diabetes mellitus. This independent association is unaffected by other potential risk factors.

Keyword

Homocysteine; diabetes mellitus; odds ratio; Chinese people; hypertension

Figure

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  Fig. 1 Flowchart of the study.tHcy, total homocysteine.

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  Fig. 2 Smoothing curves derived from generalized linear models illustrating the association between the tHcy levels (as a continuous variable) and diabetes mellitus, with an adjustment for age, sex, body mass index, systolic blood pressure, diastolic blood pressure, pulse, smoking status, alcohol drinking status, weekly fruit intake, stroke, coronary heart disease, dyslipidemia, glucose, cholesterol, triglycerides, high-density lipoprotein and low-density lipoprotein.tHcy, total homocysteine.

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  Fig. 3 Subgroup analyses on the association between the total homocysteine levels and ORs of diabetes Mellitus with an adjustment for age, sex, BMI, systolic blood pressure, diastolic blood pressure, pulse, smoking status, alcohol drinking status, weekly fruit intake, stroke, coronary heart disease, dyslipidemia, glucose, cholesterol, triglycerides, high-density lipoprotein, and low-density lipoprotein.OR, odds ratio; CI, confidence interval; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure.

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