Association of serum VLDL level with hyperhomocysteinemia in hypertensive patients: A cross-sectional study

ABSTRACT

Background

Increasing evidence suggests that hyperhomocysteinemia (HHcy) and hyperlipidemia have been recognized as two independent risks for cardiovascular disease. However, the association between hyperlipidemia and HHcy in hypertensive patients has not been systemically elucidated. The aim of this study was to investigate the relation between very low-density lipoprotein (VLDL) and HHcy in hypertensive patients.

Methods

From July 2013 to March 2014, a large cross-sectional study was performed using 4012 participants from urban and rural communities in Hunan province, China. Participants underwent accurate assessment of lipid profiles, homocysteine (Hcy), anthropometric, blood pressure, and other biochemical indicators.

Results

Among 1257 participants with hypertension, 626 (49.80%) were men and 631 (50.20%) were women. In total, 1081 (86.00%) of the participants were found to have HHcy, of which 559 (44.47%) were men and 522 (41.53%) were women. In the univariate analysis, the OR for patients with hypertension associated with hyperhomocysteinemia was significantly enhanced as the quartiles of the Log VLDL were increased. OR for quartile 4 was significantly higher than that for quartile 1 (OR = 3.7, 95% CI: 2.6–5.1; P< .001). Additional adjustment for the confounding variables did not reduce the ORs for the association between the Log VLDL and hypertension associated with hyperhomocysteinemia (OR = 3.8, 95% CI: 2.7–5.5; P< .001; OR = 4.3, 95% CI: 1.6–11.8; P= .004, respectively). We also conducted analyses with Log VLDL as a continuous variable. Each unit increase in the Log VLDL was associated with the 1.3-fold increased risk of hypertension associated with hyperhomocysteinemia (95% CI: 1.9–2.9; P< .001). Adjusting for Cr, TG, TC, and HDL did not affect the relationship.

Conclusions

Our data indicate that the Log VLDL concentrations appear to be an independent contributor to hypertension associated with hyperhomocysteinemia, even after adjusting for age and other covariables. The utility of the Log VLDL as a diagnostic, prognostic, and therapeutic indicator for the disease warrants further investigation.

Abbreviations

HHcy: hyperhomocysteinemia; Hcy: homocysteine; VLDL: very low-density lipoprotein; CVD: cardiovascular disease; SBP: systolic blood pressure; DBP: diastolic blood pressure; BMI: body mass index; ALT: alanine aminotransferase; Cr: creatinine; UA: uric acid; TG: triglycerides; TC: total cholesterol; HDL: high-density lipoprotein; LDL: low-density lipoprotein; FBG: fasting blood glucose; CRP: C-reactive protein; MTHFR: methylene tetrahydrofolate reductase; NO: nitric oxide; HDL-C: high-density lipoprotein cholesterol.

KEYWORDS:

• Very low-density lipoprotein (VLDL)
• homocysteine (Hcy)
• hypertension associated with hyperhomocysteinemia

Authors’ contributions

JC contributed to data analysis and writing the manuscript. JL, JW, DZ, and YZ collected and read the literature. Xiuqin Hong was responsible for the study design and data analysis. All authors read and approved the final manuscript.

Competing interests

The authors declare that they have no competing interests.

Consent for publication

All the authors approved the submission of the manuscript to Lipid in Health and Disease for onward publication after peer-review processes.

Ethics approval and consent to participate

This study was approved by the Institutional Ethics Review Board of Hunan Provincial People’s Hospital, Changsha, China. All subjects were provided written informed consent to be included in this study.

Availability of data material

The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.

Additional information

Funding

National Natural Science Foundation of China Youth Science Fund Project [grant number 81202281]. National Natural Science Foundation of China General Program [grant number 81773530].