Plasma Homocysteine and Cardiovascular Organ Damage in a Population with a High Prevalence of Risk Factors
(2020) In The Journal of clinical endocrinology and metabolism 105(8).- Abstract
PURPOSE: It is unclear whether plasma homocysteine (Hcy) has a direct noxious impact on the cardiovascular (CV) system or whether its association with cardiovascular events (CVEs) is mediated by established risk factors. To explore the role of Hcy in CV impairment, the study evaluated cross-sectional relationships between plasma Hcy and indices of CV organ damage together with the associations of these indices with the history of CVEs. METHODS: In 269 patients with a high prevalence of diabetes, dyslipidemia, and hypertension, the carotid intima-media thickness, ankle-brachial index (ABI), reactive hyperemic index, carotid-femoral pulse wave velocity (cfPWV), left ventricular (LV) mass, and cardiac index were measured. RESULTS: 132... (More)
PURPOSE: It is unclear whether plasma homocysteine (Hcy) has a direct noxious impact on the cardiovascular (CV) system or whether its association with cardiovascular events (CVEs) is mediated by established risk factors. To explore the role of Hcy in CV impairment, the study evaluated cross-sectional relationships between plasma Hcy and indices of CV organ damage together with the associations of these indices with the history of CVEs. METHODS: In 269 patients with a high prevalence of diabetes, dyslipidemia, and hypertension, the carotid intima-media thickness, ankle-brachial index (ABI), reactive hyperemic index, carotid-femoral pulse wave velocity (cfPWV), left ventricular (LV) mass, and cardiac index were measured. RESULTS: 132 patients had carotid plaque, 31 ABI < 0.90, 126 endothelial dysfunction, 66 increased cfPWV, 125 LV hypertrophy (LVH), 153 decreased cardiac index, and 115 a history of CVEs. Plasma Hcy levels were related to LV mass and ABI, after adjustment for covariates and creatinine. Significantly higher Hcy levels were found in patients with LVH (8.5 [4.4] vs 7.6 [2.8] μmol/L; adjusted P = .001) and ABI < 0.9 (10.4 [3.8] vs 7.9 [3.4] μmol/L; adjusted P = .001) than in those with LV mass and ABI within limits. Hcy levels were comparable between patients with and without carotid plaques, increased arterial stiffness, impaired endothelial, and LV pump function. Within markers of CV organ damage, only LVH was associated with a history of CVEs. CONCLUSION: This study demonstrated an independent association between Hcy and LV mass as well as between LVH and a history of CVEs and suggests that LVH may represent 1 of the pathophysiologic links between Hcy and CV risk.
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- author
- Kozakova, Michaela ; Morizzo, Carmela ; Penno, Giuseppe ; Shore, Angela C. ; Nilsson, Jan LU and Palombo, Carlo
- organization
- publishing date
- 2020
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- arterial stiffness, cardiovascular events, homocysteine, left ventricular hypertrophy
- in
- The Journal of clinical endocrinology and metabolism
- volume
- 105
- issue
- 8
- article number
- dgaa289
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85086420423
- pmid:32453833
- ISSN
- 1945-7197
- DOI
- 10.1210/clinem/dgaa289
- language
- English
- LU publication?
- yes
- id
- 96006495-166b-4a64-ab8b-3e9fd74bb887
- date added to LUP
- 2020-07-02 08:43:49
- date last changed
- 2024-05-29 15:53:36
@article{96006495-166b-4a64-ab8b-3e9fd74bb887,
abstract = {{<p>PURPOSE: It is unclear whether plasma homocysteine (Hcy) has a direct noxious impact on the cardiovascular (CV) system or whether its association with cardiovascular events (CVEs) is mediated by established risk factors. To explore the role of Hcy in CV impairment, the study evaluated cross-sectional relationships between plasma Hcy and indices of CV organ damage together with the associations of these indices with the history of CVEs. METHODS: In 269 patients with a high prevalence of diabetes, dyslipidemia, and hypertension, the carotid intima-media thickness, ankle-brachial index (ABI), reactive hyperemic index, carotid-femoral pulse wave velocity (cfPWV), left ventricular (LV) mass, and cardiac index were measured. RESULTS: 132 patients had carotid plaque, 31 ABI < 0.90, 126 endothelial dysfunction, 66 increased cfPWV, 125 LV hypertrophy (LVH), 153 decreased cardiac index, and 115 a history of CVEs. Plasma Hcy levels were related to LV mass and ABI, after adjustment for covariates and creatinine. Significantly higher Hcy levels were found in patients with LVH (8.5 [4.4] vs 7.6 [2.8] μmol/L; adjusted P = .001) and ABI < 0.9 (10.4 [3.8] vs 7.9 [3.4] μmol/L; adjusted P = .001) than in those with LV mass and ABI within limits. Hcy levels were comparable between patients with and without carotid plaques, increased arterial stiffness, impaired endothelial, and LV pump function. Within markers of CV organ damage, only LVH was associated with a history of CVEs. CONCLUSION: This study demonstrated an independent association between Hcy and LV mass as well as between LVH and a history of CVEs and suggests that LVH may represent 1 of the pathophysiologic links between Hcy and CV risk.</p>}},
author = {{Kozakova, Michaela and Morizzo, Carmela and Penno, Giuseppe and Shore, Angela C. and Nilsson, Jan and Palombo, Carlo}},
issn = {{1945-7197}},
keywords = {{arterial stiffness; cardiovascular events; homocysteine; left ventricular hypertrophy}},
language = {{eng}},
number = {{8}},
publisher = {{Oxford University Press}},
series = {{The Journal of clinical endocrinology and metabolism}},
title = {{Plasma Homocysteine and Cardiovascular Organ Damage in a Population with a High Prevalence of Risk Factors}},
url = {{http://dx.doi.org/10.1210/clinem/dgaa289}},
doi = {{10.1210/clinem/dgaa289}},
volume = {{105}},
year = {{2020}},
}