Hyperhomocystinemia and the Prevalence of Symptomatic Atherosclerotic Vascular Disease in Taiwanese Chronic Hemodialysis Patients: A Retrospective Study

Figures & data

Table 1. Demographics and risk factors of chronic hemodialysis patients with and without symptomatic ASVD

	With ASVD (n = 48)		Without ASVD (n = 148)		t-test p
	Mean±SD	95%CI	Mean±SD	95%CI
Age (y)	67.7±9.6	65.0–70.4	64.0±10.3	62.4–65.9	0.03
Sex (n/% women)	22/46%		77/52%		0.50
tHcy (µmol/L)	31.9±9.9	29.1–34.7	28.7±9.4	27.2–30.2	0.04
Folate (ng/mL)	8.8±5.8	7.2–10.5	10.2±6.6	9.1–11.3	0.20
B-12 (pg/mL)	632.1±359.2	530.5–733.8	822.3±528.9	737.1–907.5	0.02
Hemoglobin (mg%)	9.9±1.4	9.5–10.3	9.8±1.5	9.6–10.0	0.69
Total cholesterol (mg/dL)	181.5±41.5	169.5–193.2	181.3±38.0	175.2–187.4	0.98
HDL cholesterol (mg/dL)	35.6±12.1	32.2–39.1	37.9±11.9	36.0–39.8	0.25
LDL cholesterol (mg/dL)	105.4±30.7	96.7–114.1	110.8±33.5	105.4–116.2	0.32
Triglyceride (mg/dL)	187.3 + 109.5	156.4–218.3	166.6 + 91.9	154.2–183.3	0.24
Glucose (mg/dL)	169.5±73.1	157.8–181.3	195.9±82.0	172.7–219.1	0.04
Diabetes (n/%)	27/56%		73/49%		0.57
Hypertension (n/%)	20/42%		55/35%		0.49
Current smoking (n/%)	5/10%		13/9%		0.39
Albumin (mg/dL)	3.7±0.3	3.6–3.8	3.8±0.4	3.7–3.8	0.17
Creatinine (mg/dL)	10.2±2.5	9.5–10.9	10.8±2.5	10.4–11.2	0.14
Dialysis duration (mo)	70.6±45.2	57.3–83.4	63.5±40.7	56.9–70.0	0.30
Adequacy of dialysis (Kt/V)	1.53±0.41	1.44–1.70	1.43±0.30	1.42–1.59	0.47
High-flux dialysis (n/%)	28/58%		94/61%		0.59

Abbreviation: ASVD: atherosclerotic vascular disease.

Figure 1A. The relationship between homocysteine and serum folate levels y = −4.830ln(x) + 39.422, r = −0.308 (P = 0.014) in chronic hemodialysis patients with ASVD.

Figure 1B. The relationship between homocysteine and vitamin B₁₂ levels y = −5.228ln(x) + 62.838, r = −0.303 (P = 0.016) in chronic hemodialysis patients with ASVD.

Figure 2A. The relationship between homocysteine and serum folate levels y = −5.819ln(x) + 41.522, r = −0.432 (P<0.001) in chronic hemodialysis patients without ASVD.

Figure 2B. The relationship between homocysteine and vitamin B₁₂ levels y = −0.856ln(x) + 34.963, r = −0.057 (P = 0.513) in chronic hemodialysis patients without ASVD.

Figure 3. The prevalence of ASVD by plasma homocysteine level after controlling for the effect of diabetes mellitus (P = 0.01).

Table 2. Final multiple logistic regression model using ASVD as the outcome variable after manual backward stepwise elimination

Predictor variables	Odds ratio	P	95%Cl for odds ratio
Upper quartile homocysteine level	2.878	0.030	1.109–7.467
Sex (men = 0, women = 1)	0.489	0.056	0.235–1.018
Age (decades)	1.001	0.930	0.979–1.023
Diabetes mellitus	1.155	0.658	0.610–2.185
Smoking	0.438	0.049	0.193–0.997
Family history of ASVD	1.386	0.623	0.377–5.100