Association between serum total homocysteine and arterial stiffness in adults: a community-based study

Both increased arterial stiffness and higher total homocysteine (tHcy) are associated with an elevated risk for cardiovascular disease. However, the relationship between tHcy and arterial stiffness is still inconclusive. The authors aimed to test the relationship of tHcy with carotid-femoral pulse wave velocity (cfPWV) and examine the possible effect modifiers in adults. A study was conducted from July to September 2016 in Jiangsu Province, China. A total of 16644 participants were enrolled in the final analysis. Increased arterial stiffness is defined as a cfPWV 10m/s. Overall, there was a positive association between tHcy and cfPWV levels (per 5-mol/L tHcy increase: =0.10; 95% confidence interval [CI], 0.08-0.13) and increased arterial stiffness (per 5-mol/L tHcy increase: odds ratio, 1.11; 95% CI, 1.07-1.14). Compared with participants with tHcy <10mol/L, the significantly higher cfPWV levels were observed in those with tHcy 15mol/L (=0.37; 95% CI, 0.28-0.47). Accordingly, a higher prevalence of increased arterial stiffness was found in patients with tHcy10 to <15mol/L (odds ratio, 1.18; 95% CI, 1.05-1.33) and tHcy 15mol/L (odds ratio, 1.50; 95% CI, 1.32-1.71) as compared with participants with tHcy <10mol/L. Furthermore, the stronger positive association was found in participants who were older (60years, P for interaction=.008), had low body mass index (<25kg/m(2), P for interaction=.026), high systolic blood pressure levels (145mmHg [median], P for interaction=.048), or diabetes mellitus (P for interaction=.045). The present study demonstrated that serum tHcy concentrations were positively associated with cfPWV and the prevalence of increased arterial stiffness. These results suggest that the cardiovascular effects of tHcy may partly be mediated through arterial stiffness.