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Hyperhomocysteinemia is independently associated with albuminuria in the population-based CoLaus study
Franziska Marti1, Peter Vollenweider, Pedro-Manuel Marques-Vidal
1University Institute of Social and Preventive Medicine, University of Lausanne and Centre Hospitalier Universitaire Vaudois, 1005 Lausanne, Switzerland.
Insights
Elevated homocysteine and uric acid levels are linked to albuminuria in adults, independent of kidney function. Hyperhomocysteinemia poses a significant risk, comparable to hypertension or diabetes.
Area of Science:
- Nephrology
- Cardiovascular Risk Factors
- Genetics
Background:
- Elevated serum homocysteine and uric acid are known cardiovascular risk factors.
- The independent association of these markers with kidney function, specifically glomerular filtration rate (GFR) and albuminuria, requires further investigation.
- Understanding the causal link between homocysteine and albuminuria through MTHFR polymorphisms is crucial.
Purpose of the Study:
- To determine if serum homocysteine and uric acid levels are associated with GFR and albuminuria independently.
- To investigate the association between MTHFR polymorphisms and albuminuria for causal insights.
Main Methods:
- Cross-sectional, population-based study of 5913 Caucasian individuals.
- Defined hyperhomocysteinemia as serum homocysteine ≥ 15 μmol/L.
- Defined albuminuria as urinary albumin-to-creatinine ratio > 30 mg/g.
Main Results:
- Serum uric acid positively correlated with homocysteine (r = 0.246-0.287, P < 0.001).
- Albuminuria prevalence increased with higher homocysteine categories (P for trend < 0.005).
- Hyperhomocysteinemia (OR = 2.22) and elevated uric acid (OR = 1.27) were independently associated with albuminuria, irrespective of hypertension and diabetes. MTHFR alleles linked to higher homocysteine increased albuminuria risk.
Conclusions:
- Elevated serum homocysteine and uric acid are independently associated with albuminuria in the general adult population.
- These associations persist regardless of renal function.
- Hyperhomocysteinemia presents a significant risk for albuminuria, comparable to hypertension or diabetes.
Background:
Increased serum levels of homocysteine and uric acid have each been associated with cardiovascular risk. We analyzed whether homocysteine and uric acid were associated with glomerular filtration rate (GFR) and albuminuria independently of each other. We also investigated the association of MTHFR polymorphisms related to homocysteine with albuminuria to get further insight into causality.
Methods:
This was a cross-sectional population-based study in Caucasians (n = 5913). Hyperhomocysteinemia was defined as total serum homocysteine ≥ 15 μmol/L. Albuminuria was defined as urinary albumin-to-creatinine ratio > 30 mg/g.
Results:
Uric acid was associated positively with homocysteine (r = 0.246 in men and r = 0.287 in women, P < 0.001). The prevalence of albuminuria increased across increasing homocysteine categories (from 6.4% to 17.3% in subjects with normal GFR and from 3.5% to 14.5% in those with reduced GFR, P for trend < 0.005). Hyperhomocysteinemia (OR = 2.22, 95% confidence interval: 1.60-3.08, P < 0.001) and elevated serum uric acid (OR = 1.27, 1.08-1.50, per 100 μmol/L, P = 0.004) were significantly associated with albuminuria, independently of hypertension and type 2 diabetes. The 2-fold higher risk of albuminuria associated with hyperhomocysteinemia was similar to the risk associated with hypertension or diabetes. MTHFR alleles related to higher homocysteine were associated with increased risk of albuminuria.
Conclusions:
In the general adult population, elevated serum homocysteine and uric acid were associated with albuminuria independently of each other and of renal function.
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