PMID- 36086712
OWN - NLM
STAT- MEDLINE
DCOM- 20220913
LR  - 20240331
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 101
IP  - 36
DP  - 2022 Sep 9
TI  - Association between homocysteinemia and mortality in CKD: A propensity-score 
      matched analysis using NHANES-National Death Index.
PG  - e30334
LID - 10.1097/MD.0000000000030334 [doi]
LID - e30334
AB  - Hyperhomocysteinemia (HHcy) is considered a risk factor for cardiovascular 
      disease (CVD), including chronic kidney disease (CKD). In this study, we 
      investigated the association between levels of serum homocysteine (Hcy) and 
      mortality, inferred from the presence of CKD. Our study included data of 9895 
      participants from the 1999 to 2016 National Health and Nutrition Examination 
      Surveys (NHANES). Multivariable-adjusted Cox proportional hazard models using 
      propensity-score, were used to examine dose-response associations between Hcy 
      level and mortality. A total of 9895 participants, 1025 (10.3%) participants were 
      diagnosed with CKD. In a multivariate Cox regression analysis including all 
      participants, Hcy level was significantly associated with all-cause mortality in 
      the nonCKD group, compared to the 1st quartile in the fully adjusted model (2nd 
      quartile: hazard ratio (HR) 1.75, 95% confidence interval (CI) 1.348-2.274, 
      P < .001; 3rd quartile: HR 2.22, 95% CI 1.726-2.855, P < .001; 4th quartile: HR 
      3.77, 95% CI 2.952-4.830, P < .001). However, this finding was not observed in 
      the CKD group. The observed pattern was similar after propensity score matching. 
      In the nonCKD group, overall mortality increased in proportion to Hcy 
      concentration (2nd quartile: HR 2.19, 95% CI 1.299-3.709, P = .003; 3rd quartile: 
      HR 2.60, 95% CI 1.570-4.332, P < .001; 4th quartile: HR 3.72, 95% CI 2.254-6.139, 
      P < .001). However, the risk of all-cause mortality according to the quartile of 
      Hcy level, did not increase in the CKD group. This study found a correlation 
      between the Hcy level and mortality rate only in the nonCKD group. These altered 
      risk factor patterns may be attributed to protein-energy wasting or chronic 
      inflammation status, that is accompanied by CKD.
CI  - Copyright (c) 2022 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Song, Je Hun
AU  - Song JH
AD  - Department of Internal Medicine, Ulsan University Hospital, University of Ulsan 
      College of Medicine, Ulsan, South Korea.
FAU - Huh, Hyuk
AU  - Huh H
AD  - Department of Internal Medicine, Pusan Paik Hospital, Inje University College of 
      Medicine, Busan, South Korea.
FAU - Bae, Eunjin
AU  - Bae E
AD  - Department of Internal Medicine, Gyeongsang National University Changwon 
      Hospital, Changwon, South Korea.
FAU - Lee, Jeonghwan
AU  - Lee J
AD  - Department of Internal Medicine, Seoul National University Boramae Medical 
      Center, Seoul, South Korea.
AD  - Department of Internal Medicine, Seoul National University College of Medicine, 
      Seoul, South Korea.
FAU - Lee, Jung Pyo
AU  - Lee JP
AD  - Department of Internal Medicine, Seoul National University Boramae Medical 
      Center, Seoul, South Korea.
AD  - Department of Internal Medicine, Seoul National University College of Medicine, 
      Seoul, South Korea.
FAU - Lee, Jong Soo
AU  - Lee JS
AD  - Department of Internal Medicine, Ulsan University Hospital, University of Ulsan 
      College of Medicine, Ulsan, South Korea.
FAU - Kim, Gwang Sil
AU  - Kim GS
AD  - Department of Internal Medicine, Sanggye Paik Hospital, Inje University College 
      of Medicine, Seoul, South Korea.
FAU - Yoo, Kyung Don
AU  - Yoo KD
AUID- ORCID: 0000-0001-6545-6517
AD  - Department of Internal Medicine, Ulsan University Hospital, University of Ulsan 
      College of Medicine, Ulsan, South Korea.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - Homocysteinemia
SB  - IM
MH  - Humans
MH  - *Hyperhomocysteinemia/complications/epidemiology
MH  - Nutrition Surveys
MH  - Propensity Score
MH  - *Renal Insufficiency, Chronic
PMC - PMC10980502
COIS- The authors have no funding and conflict of interests to declare.
EDAT- 2022/09/11 06:00
MHDA- 2022/09/14 06:00
PMCR- 2022/09/09
CRDT- 2022/09/10 01:08
PHST- 2022/09/10 01:08 [entrez]
PHST- 2022/09/11 06:00 [pubmed]
PHST- 2022/09/14 06:00 [medline]
PHST- 2022/09/09 00:00 [pmc-release]
AID - 00005792-202209090-00040 [pii]
AID - 10.1097/MD.0000000000030334 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2022 Sep 9;101(36):e30334. doi: 
      10.1097/MD.0000000000030334.