title: Hyperhomocysteinaemia as a potential marker of early renal function decline in middle-aged Asian people without chronic kidney disease.
abstract: OBJECTIVE
  High levels of serum total homocysteine (tHcy), often observed in chronic kidney disease (CKD) patients, are a risk factor for cardiovascular disease. However, little is known about the relationship between tHcy and renal function in healthy individuals. We examined whether tHcy levels are related to renal function in Asian individuals without CKD.
  
  
  METHODS
  This cross-sectional study examined 2032 subjects, aged 40-64 years. Individuals with kidney diseases or other conditions that could affect tHcy were excluded. Renal function was determined by estimated glomerular filtration rate (eGFR) from levels of serum creatinine (sCr) and cystatin C.
  
  
  RESULTS
  Age, tHcy, sCr, and cystatin C of the subjects were 54.1 ± 6.0 years, 9.5 (8.0-11.4) μmol/L, 0.81 ± 0.1 mg/dL, and 0.82 ± 0.1 mg/L, respectively. In a multiple linear regression analysis, tHcy was a significant independent determinant of sCr and cystatin C in men (β = 0.206 and β = 0.282, respectively) and women (β = 0.247 and β = 0.229, respectively). Highest tHcy levels were independently associated with increased cystatin C (>s1.10 mg/L) with an odds ratio (OR) of 5.00 [95% confidence interval (CI) 2.81-8.09] and decreased eGFR (<90 mL/min/1.73 m(2)) with an OR of 1.69 (95% CI 1.36-2.11) compared to tHcy levels in the 1st-3rd quartiles.
  
  
  CONCLUSIONS
  Higher levels of tHcy are independently associated with sCr and cystatin C elevation. Our study suggests that tHcy levels may be influenced by renal function in Asian populations without CKD. Future studies are needed to define the role of tHcy in renal function.
authors.affiliation: Department of Family Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.|Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Tak
authors.affiliation: Department of Family Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea. dwjeong75@hanmail.net.|Medical Research Institute, Pusan National University School of Medicine, Yangsan, Republic of Korea. dwjeong75@hanmail.net.|Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea. dwjeong75@hanmail.net.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Jeong
authors.affiliation: Department of Family Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.|Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
authors.forename: Yun Jin
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Medical Education Unit, Pusan National University School of Medicine, Yangsan, Republic of Korea.
authors.forename: Sang Yeoup
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Family Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.|Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
authors.forename: Jeong Gyu
authors.initials: JG
authors.lastname: Lee
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.
authors.forename: Sang Heon
authors.initials: SH
authors.lastname: Song
authors.affiliation: Department of Cardiology and Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
authors.forename: Kwang Soo
authors.initials: KS
authors.lastname: Cha
authors.affiliation: Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.|Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
authors.forename: Yang Ho
authors.initials: YH
authors.lastname: Kang
mesh_terms: D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D015415:Biomarkers; D006710:Homocysteine
keywords: Cystatin C; Glomerular filtration rate; Homocysteine; Kidney function test; Serum creatinine