No association between elevated homocysteine levels and carotid atherosclerosis in a rural population in China.

Objectives: We wish to determine if homocysteine (Hcy) is an independent risk factor for carotid atherosclerosis in a rural Chinese population.

Methods: 2291 individuals (1016 men and 1275 women), aged 64.6±7.4 years, from Lvliang, China participated in this study. Tests performed included carotid artery ultrasound scan and blood analysis, to measure Hcy levels and other blood components.

Results: The mean serum Hcy level was 24.7±18.0 µmol/L. The overall detection rate of carotid atherosclerotic lesions was 76.3% and the detection rate of plaque was 48.6%. Participants were divided into 4 groups based on their Hcy levels, <14.49, 14.49-19.43, 19.44-28.30, and ≥28.30 µmol/L. The relative risk of carotid atherosclerosis for each quartile as compared with the risk for the lowest quartile was estimated as the OR derived from the logistic regression coefficients. After adjusting for age and gender, the OR of carotid atherosclerosis in the third and fourth quartiles of Hcy were 1.219 (95% CI 0.922 to 1.612) and 1.156 (95% CI 0.859 to 1.555; p>0.05), respectively. After controlling for demographic variables (age, gender, current smoker, fasting blood glucose, low-density lipoprotein and systolic blood pressure) the OR of carotid plaque(s) in the third and fourth quartiles were 1.246 (95% CI 0.967 to 1.606) and 1.259 (95% CI 0.963 to 1.646; p>0.05).

Conclusions: The mean value of Hcy among participants in this study was much higher than that previously reported. However, no significant correlation between elevated Hcy and carotid atherosclerosis was found.