Elevated homocysteine levels and risk of cardiovascular and all-cause mortality: a meta-analysis of prospective studies

作     者：Hui-yong PENG Chang-feng MAN Juan XU Yu FAN 

作者机构：Cancer Institute the Affiliated People's Hospital Jiangsu University 

出 版 物：《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》 (浙江大学学报（英文版）B辑（生物医学与生物技术）)

年 卷 期：2015年第16卷第1期

页      面：78-86页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Homocysteine Coronary heart disease Cardiovascular mortality All-cause mortality Meta-analysis 

摘      要：Objective： To investigate whether elevated homocysteine levels were a predictor of subsequent coronary heart disease （CHD） mortality, cardiovascular mortality or all-cause mortality in the general population by a meta- analysis. Methods： In a systematic search conducted in the databases of PubMed and Embase prior to October 2013, we identified relevant prospective observational studies evaluating the association between baseline homocysteine levels and CHD mortality, cardiovascular or all-cause mortality in the general population. Pooled adjust risk ratio （RR） and corresponding 95% confidence interval （CI） were calculated separately for categorical risk estimates and con- tinuous risk estimates. Results： Twelve studies with 23 623 subjects were included in the meta-analysis. Comparing the highest to lowest homocysteine level categories, CHD mortality increased by 66% （RR 1.66; 95% CI 1.12-2.47; P=-0.012）, cardiovascular mortality increased by 68% （RR 1.68; 95% CI 1.04-2.70; P=0.033）, and all-cause mortality increased by 93% （RR 1.93; 95% CI 1.54-2.43; P〈0.001）. Moreover, for each 5 pmol/L homocysteine increment, the pooled RR was 1.52 （95% CI 1.26-1.84; ,〈0.001） for CHD mortality, 1.32 （95% CI 1.08-1.61; P=0.006） for cardio- vascular mortality, and 1.27 （95% CI 1.03-1.55; P=-0.023） for all-cause mortality. Conclusions： Elevated homocysteine levels are an independent predictor for subsequent cardiovascular mortality or all-cause mortality, and the risks were more pronounced among elderly persons.