Changyi Wang1, Liyuan Han2, Qunhong Wu3, Renjie Zhuo2, Kui Liu4, Jinshun Zhao2, Lina Zhang2, Yanhua Hao3, Rui Fan2, Yanfen Liu2, Runhua Li2, Zhongwei Chen1, Tao Zhang1, Sihan Chen1, Jianping Ma1, Shengyuan Liu1, Xiaolin Peng1, Shiwei Duan2. 1. a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China . 2. b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China . 3. c Department of Social Medicine , School of Public Health, Harbin Medical University , Harbin , Heilongjiang Province , People's Republic of China , and. 4. d Department of Science Research and Information Management , Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou , China.
Abstract
BACKGROUND: To assess the association between total plasma homocysteine (tHcy) and ischemic stroke (IS) in hypertensive subjects in a matched case-control study. METHODS: This is a 1:2 matched and population-based case-control study, all of the participants were recruited from the 60 communities in Shenzhen, China. Demographic and socioeconomic characteristics, medical records, lifestyle risk factors and other clinical characteristics were obtained from all of the subjects. The association between tHcy and incidence of IS was analyzed by using conditional logistic regression models. RESULTS: The median values of plasma tHcy were significantly higher in IS subjects than in non-IS subjects, especially in women. After adjusted for the confounding factors in Model 2, compared with the lowest quartile of tHcy, the odds ratios (ORs) and 95% CIs of the highest quartile of tHcy for IS were 0.83 (0.36-1.90) in men, 4.51 (1.29-15.7) in women and 1.31 (0.70-2.47) in the total subjects; the ORs and 95% CIs for IS per 5 μmol/L increase in homocysteine were 1.11 (0.99-1.22), 1.25 (1.03-1.58) and 1.15 (1.01-1.28) in men, women and total subjects, respectively. We observed significant associations in crude model, Model 1 and Model 2 in women for the comparison of tHcy ≥ 15 μmol/L versus < 15 μmol/L. Interaction analysis showed that the association of tHcy with IS was significant in women (p-interaction = 0.04). CONCLUSION: This matched case-control study indicates that tHcy may increase the susceptibility to IS in essential hypertension subjects, especially in women. Further large prospective cohort studies are needed to confirm our findings.
BACKGROUND: To assess the association between total plasma homocysteine (tHcy) and ischemic stroke (IS) in hypertensive subjects in a matched case-control study. METHODS: This is a 1:2 matched and population-based case-control study, all of the participants were recruited from the 60 communities in Shenzhen, China. Demographic and socioeconomic characteristics, medical records, lifestyle risk factors and other clinical characteristics were obtained from all of the subjects. The association between tHcy and incidence of IS was analyzed by using conditional logistic regression models. RESULTS: The median values of plasma tHcy were significantly higher in IS subjects than in non-IS subjects, especially in women. After adjusted for the confounding factors in Model 2, compared with the lowest quartile of tHcy, the odds ratios (ORs) and 95% CIs of the highest quartile of tHcy for IS were 0.83 (0.36-1.90) in men, 4.51 (1.29-15.7) in women and 1.31 (0.70-2.47) in the total subjects; the ORs and 95% CIs for IS per 5 μmol/L increase in homocysteine were 1.11 (0.99-1.22), 1.25 (1.03-1.58) and 1.15 (1.01-1.28) in men, women and total subjects, respectively. We observed significant associations in crude model, Model 1 and Model 2 in women for the comparison of tHcy ≥ 15 μmol/L versus < 15 μmol/L. Interaction analysis showed that the association of tHcy with IS was significant in women (p-interaction = 0.04). CONCLUSION: This matched case-control study indicates that tHcy may increase the susceptibility to IS in essential hypertension subjects, especially in women. Further large prospective cohort studies are needed to confirm our findings.
Entities:
Keywords:
Association study, case-control study, essential hypertension, homocysteine, ischemic stroke