Vol 70, No 9 (2012)
Original articles
Published online: 2012-09-20
Homocysteine concentration and the risk of death in the adult Polish population
DOI: 10.33963/v.kp.78798
Kardiol Pol 2012;70(9):897-902.
Abstract
Background: Although there is a considerable epidemiologic evidence for a relation between homocysteine (Hcy) level and
cardiovascular disease (CVD). The role of Hcy as a causal risk factor remains controversial.
Aim: To determine associations between Hcy level and all-cause and cardiovascular mortality in general population of Poland.
Methods: Within the frame of the National Multicenter Health Survey (WOBASZ), a representative sample of whole Polish population aged 20–74 was screened in years 2003–2005 and prospectively followed up until 2009. Baseline determinations, among other classical risk factors, included Hcy level in 7165 responders, performed by an immunoenzymatic method using IMMULITE 1 analyser and DPC reagents. Survival rates were followed up until 2009 and average follow up time was 5.4 years.
Results: During the 38,818.9 person-years of follow-up there were 270 deaths including 108 due to CVD, 37 due to coronary heart disease and 21 due to stroke. The relative risk of all-cause and CVD mortality was significantly higher in the highest (> 10.51 μmol/L) compared to the lowest (< 8.20 μmol/L) Hcy tercile in crude and multivariable proportional hazards models adjusted for sex, age, smoking status, hypertension, body mass index, total cholesterol, glucose and high sensitivity-C- -reactive protein. Hazards ratios (95% confidence intervals) were as follows: all-cause mortality HR (95% CI): crude = 4.528 (2.947–6.154), multivariable-adjusted = 1.766 (1.197–2.605), CVD mortality crude = 4.322 (2.426–7.700), multivariable- -adjusted = 1.937 (1.051–3.569).
Conclusions: In Polish adult population Hcy concentration is independently associated with all-cause and CVD mortality.
Aim: To determine associations between Hcy level and all-cause and cardiovascular mortality in general population of Poland.
Methods: Within the frame of the National Multicenter Health Survey (WOBASZ), a representative sample of whole Polish population aged 20–74 was screened in years 2003–2005 and prospectively followed up until 2009. Baseline determinations, among other classical risk factors, included Hcy level in 7165 responders, performed by an immunoenzymatic method using IMMULITE 1 analyser and DPC reagents. Survival rates were followed up until 2009 and average follow up time was 5.4 years.
Results: During the 38,818.9 person-years of follow-up there were 270 deaths including 108 due to CVD, 37 due to coronary heart disease and 21 due to stroke. The relative risk of all-cause and CVD mortality was significantly higher in the highest (> 10.51 μmol/L) compared to the lowest (< 8.20 μmol/L) Hcy tercile in crude and multivariable proportional hazards models adjusted for sex, age, smoking status, hypertension, body mass index, total cholesterol, glucose and high sensitivity-C- -reactive protein. Hazards ratios (95% confidence intervals) were as follows: all-cause mortality HR (95% CI): crude = 4.528 (2.947–6.154), multivariable-adjusted = 1.766 (1.197–2.605), CVD mortality crude = 4.322 (2.426–7.700), multivariable- -adjusted = 1.937 (1.051–3.569).
Conclusions: In Polish adult population Hcy concentration is independently associated with all-cause and CVD mortality.
Keywords: homocysteinemortalityrisk of deathcardiovascular diseasefollow-up studyPolish population
