title: Determinants of hyperhomocysteinemia in healthy and hypertensive subjects: A population-based study and systematic review.
abstract: Hyperhomocysteinemia (HHcy) is known to increase the risk of many diseases. Factors influencing HHcy in healthy and hypertensive subjects remain under-researched.
  
  
  
  A large population-based study was conducted in 60 communities from Shenzhen, China. Responses to standardized questions on lifestyle factors and blood samples were collected from all participants after a 12-h overnight fast. Multiple linear and multivariate logistic regressions were used to explore risk factors for HHcy. Results were then compared to those from a systematic review of English-language articles listed in Pubmed, EBSCOhost, Web of Science, Embase and Cochrane libraries that investigated HHcy risk factors in healthy and hypertensive subjects.
  
  
  
  A total of 1586 healthy (Male/Female = 642/944) and 5935 hypertensive subjects (Male/Female = 2928/3007) participated in our population-based study. In logistic regression analyses, age, BMI and creatinine (Cr) were risk factors, while being female, fruit intake and physical activity were protective factors for HHcy in healthy subjects. In hypertensive subjects, seven [age, smoking, salt intake, systolic blood pressure (SBP), uric acid, triglycerides (TG), and Cr] and four [female, fruit intake, total cholesterol (TC), and glucose] factors were associated with higher and lower HHcy respectively. The review of 71 studies revealed that potential risk factors for Hcy included nutritional, physiologic, lifestyle habits, ethnicity, genetics, interactions between gene-environment, gene-gene, gene-nutritional, environment-environment, nutritional-nutritional.
  
  
  
  Our study indicates the potential importance of increasing folic acid and vitamin B supplementation, daily fruit and vegetable intake, regular exercise and refraining from tobacco smoking and alcohol consumption as preventive strategies for Hcy.
authors.affiliation: School of Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology, Ningbo University, Ningbo, 315211, China.
authors.forename: Liyuan
authors.initials: L
authors.lastname: Han
authors.affiliation: School of Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology, Ningbo University, Ningbo, 315211, China.
authors.forename: Yanfen
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Chronic Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, China.
authors.forename: Changyi
authors.initials: C
authors.lastname: Wang
authors.affiliation: Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China.
authors.forename: Linlin
authors.initials: L
authors.lastname: Tang
authors.affiliation: Population Wellbeing and Environment Research Lab (PowerLab), Faculty of Social Sciences, University of Wollongong, NSW, 2522, Australia; Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia.
authors.forename: Xiaoqi
authors.initials: X
authors.lastname: Feng
authors.affiliation: Population Wellbeing and Environment Research Lab (PowerLab), Faculty of Social Sciences, University of Wollongong, NSW, 2522, Australia; Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia.
authors.forename: Thomas
authors.initials: T
authors.lastname: Astell-Burt
authors.affiliation: Department of Chronic Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wen
authors.affiliation: School of Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology, Ningbo University, Ningbo, 315211, China.
authors.forename: Donghui
authors.initials: D
authors.lastname: Duan
authors.affiliation: School of Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology, Ningbo University, Ningbo, 315211, China.
authors.forename: Nanjia
authors.initials: N
authors.lastname: Lu
authors.affiliation: School of Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology, Ningbo University, Ningbo, 315211, China.
authors.forename: Guodong
authors.initials: G
authors.lastname: Xu
authors.affiliation: School of Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology, Ningbo University, Ningbo, 315211, China.
authors.forename: Kaiyue
authors.initials: K
authors.lastname: Wang
authors.affiliation: School of Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology, Ningbo University, Ningbo, 315211, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Zhang
authors.affiliation: School of Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology, Ningbo University, Ningbo, 315211, China.
authors.forename: Kaibo
authors.initials: K
authors.lastname: Gu
authors.affiliation: Department of Chronic Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, China.
authors.forename: Sihan
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Chronic Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, China.
authors.forename: Jianping
authors.initials: J
authors.lastname: Ma
authors.affiliation: Department of Chronic Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Department of Science and Technology, Kunming Medical University, Kunming, 650500, China. Electronic address: youdingyun@qq.com.
authors.forename: Dingyun
authors.initials: D
authors.lastname: You
authors.affiliation: School of Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology, Ningbo University, Ningbo, 315211, China. Electronic address: duanshiwei@nbu.edu.cn.
authors.forename: Shiwei
authors.initials: S
authors.lastname: Duan
mesh_terms: D001794:Blood Pressure; D015992:Body Mass Index; D002681:China; D003404:Creatinine / Q000097:blood; D000072001:Diet, Healthy; D019587:Dietary Supplements; D015444:Exercise; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage / Q000097:blood; D005638:Fruit; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D006973:Hypertension / Q000097:blood / Q000453:epidemiology*; D008019:Life Style; D008297:Male; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014527:Uric Acid / Q000097:blood; D014675:Vegetables; D014803:Vitamin B Complex / Q000008:administration & dosage / Q000097:blood
chemical_list: D014280:Triglycerides; D006710:Homocysteine; D014803:Vitamin B Complex; D014527:Uric Acid; D005492:Folic Acid; D003404:Creatinine
keywords: Healthy; Homocysteine; Hyperhomocysteinemia; Hypertension