Biochemical and Hematological Correlates of Elevated Homocysteine in National Surveys and a Longitudinal Study of Urban Adults

Nutrients

JoseA. Canas¹  HindA. Beydoun²  AlanB. Zonderman³  Sharmin Hossain³  MicheleK. Evans³  PeterH. MacIver³  MayA. Beydoun³ 

[1] Department of Pediatrics, Johns Hopkins Medical Institutions, Saint Petersburg, FL 33701, USA;Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA 22060, USA;Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD 21224, USA;

关键词: homocysteine;    hematological indices;    biochemical indices;    inflammation;    predictive models;    aging;   

DOI  :  10.3390/nu12040950

来源: DOAJ

【 摘 要 】

Elevated blood homocysteine (Hcy) among middle-aged adults can increase age-related disease risk, possibly through other biochemical and hematological markers. We selected markers for hyperhomocysteinemia among middle-aged adults, studied time-dependent Hcy-marker associations and computed highly predictive indices of hyperhomocysteinemia, with cross-sectional and longitudinal validations. We used data from the National Health and Nutrition Examination Survey (NHANES III, phase 2, n_max = 4000), the NHANES 1999–2006 (n_max = 10,151) and pooled NHANES (cross-sectional validation). Longitudinal validation consisted of mixed-effects linear regression models (Hcy predicting markers’ annual rates of change), applied to the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS, n = 227–244 participants, k = 2.4 repeats/participant, Age_base: 30–65 years) data. Machine learning detected nine independent markers for Hcy > 14 µmol/L (NHANES III, phase 2): older age; lower folate and B-12 status; higher serum levels of creatinine, uric acid, alkaline phosphatase, and cotinine; mean cell hemoglobin and red cell distribution widths (RDW); results replicated in the 1999–2006 NHANES [AUC = 0.60–0.80]. Indices combining binary markers increased elevated Hcy odds by 6.9–7.5-fold. In HANDLS, first-visit Hcy predicted annual increase in creatinine, RDW and alkaline phosphatase, with third-visit index (2013–2018) directly predicting Hcy (2004–2009). We provide evidence of the internal and external validity of indices composed of several biomarkers that are strongly associated with elevated Hcy.

【 授权许可】

Unknown