The correlation between plasma homocysteine level and lower extremity atherosclerotic disease in elderly patients of Chinese Han nationality with primary hypertension / 中华老年医学杂志

ABSTRACT

Objective To investigate the correlation between plasma homocysteine(Hcy)level and lower extremity atherosclerotic disease(LEAD)in elderly patients of Chinese Han nationality with primary hypertension.Methods A total of 144 elderly Chinese Han outpatients with primary hypertension aged 60-90 years (92 cases in men,52 in women)were randomly recruited in our department from January 2015 to January 2017.The diagnosis of LEAD was confirmed in this study by ankle brachial index(ABI)≤0.90(ABI normal value=1.00-1.40).The patients were divided into three different plasma Hcy level groupslow-(＜ 10 μmol/L),middle-(10-29 μmol/L),and high-Hcy level group(≥30 μmol/L).The differences in Hcy,ABI,toe branchial index,high density lipoprotein,apolipoprotein-A1,and baPWV were compared between three different Hcy level groups.Pearson correlation was established between the influencing factors and serum level of Hcy.Moreover,binary logistic regression model was used to determine the independent risk factors for LEAD among elderly Chinese Han patients with primary hypertension.Results The values of apolipoprotein A-1,high density lipoprotein cholesterol,ankle brachial index,and toe brachial index were higher in the low Hcy group than in the middle-and high Hcy-group(P＜0.05).The ankle brachial index was higher in the middle Hcy group than in the high Hcy group(P＜0.05).The brachial-ankle pulse wave velocity was higher in the high Hcy group than in the middle and low Hcy group (P ＜ 0.05).No statistically significant difference was found in age,gender,body mass index,mean arterial pressure,triglyceride,low density lipoprotein cholesterol,blood urea nitrogen,serum creatinine,blood uric acid,and plasma hypersensitivity C-reactive protein among the three groups(all P＞0.05).Pearson correlation analysis showed that the level of serum Hcy was positively correlated with brachial-ankle pulse wave velocity (r=0.637,P =0.000),while it was negatively correlated with ankle brachial index,toe branchial index,high density lipoprotein cholesterol,and apolipoprotein A-1 (r =-0.743,-0.257,-0.240,-0.449,all P＜0.05).Binary Logistic regression model showed that gender,Hcy,and low density lipoprotein cholesterol level were independent risk factors for LEAD in elderly Chinese Han patients with primary hypertension.Conclusions Plasma Hcy level is an independent risk factor for LEAD in elderly Chinese Han patients with primary hypertension,and it is positively correlated with this disease.