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Int J Clin Exp Med 2013;6(9):779-784
Original Article
Relationship of serum homocysteine level with nutritional status and HbA1c level in
elderly inpatients
Sheng-Fang Chen, Chun-Li Cui, Ping Wu, Nan-Zi Xie
Department of Clinical Nutrition, Tongji Hospital of Tongji University, Shanghai 200065, China; Department of Nephrology, Tongji
Hospital of Tongji University, Shanghai 200065, China
Received August 16, 2013; Accepted September 17, 2013; Epub September 25, 2013; Published September 30, 2013
Abstract: Background: Hyperhomocysteinemia is a risk factor for vascular diseases. This study aimed to investigate the serum total
homocysteine (tHcy) level and nutritional status in elderly inpatients and determine the relationship between tHcy level and nutritional
status. Methods: This cross sectional study was carried out in the Tongji hospital, and 142 subjects were consecutively recruited.
Fasting blood was collected, and the liver and kidney function, blood glucose, glycosylated hemoglobin (HbA1c), plasma protein, lipid
profile, folic acid, vitamin B12 and serum total tHcy were measured. Anthropometric measurements, grip strength and the shortened
MNA form (MNA-SF) were used to assess the nutritional status. Results: Undernutrition was common in this population. Based on
MNA-SF scores, 34.2% of subjects were at risk of malnutrition, and malnourished subjects accounted for 4.9%. The mean tHcy was
14.10±5.46 µmol/l, and the prevalence of hyperhomocysteinemia was 32.4% (46/142). Hyperhomocysteinemia was a risk factor of
cerebral infarction (RR=1.636, 95% CI: 1.169-2.288); Serum tHcy was negatively correlated with serum folic acid, vitamin B12 and
MNA-SF score (r=-0.348, P=0.000; r=-0.236, P=0.005; r=-0.208, P=0.014), and positively with BMI within normal range (18.5-23.9;
r=0.232, P=0.044). Serum tHcy was negatively correlated with HbA1c, (r=-0.196, P=0.021) and positively with serum creatinine (r=0.327,
P=0.000), but unrelated to fasting blood glucose (r=-0.098, P=0.250). Multivariate stepwise regression analysis showed serum folic
acid, serum creatinine, MNA-SF score and HbA1c were independent determinants of serum tHcy. Conclusion: Elderly subjects have
higher serum tHcy level. Compromised renal function, poor nutritional status and lower blood glucose are likely to influence the serum
tHcy level. (IJCEM1308019).
Keywords: Homocysteine, nutritional status, MNA-SF, HbA1c
Address correspondence to: Chun-Li Cui, Department of Nephrology, Tongji Hospital of Tongji University, 389 Xunchun Road,
Shanghai, China. Tel: 86+21-66111370; E-mail: fandachen@tongji.edu.cn; cuichunli123@126.com
Original Article
Relationship of serum homocysteine level with nutritional status and HbA1c level in
elderly inpatients
Sheng-Fang Chen, Chun-Li Cui, Ping Wu, Nan-Zi Xie
Department of Clinical Nutrition, Tongji Hospital of Tongji University, Shanghai 200065, China; Department of Nephrology, Tongji
Hospital of Tongji University, Shanghai 200065, China
Received August 16, 2013; Accepted September 17, 2013; Epub September 25, 2013; Published September 30, 2013
Abstract: Background: Hyperhomocysteinemia is a risk factor for vascular diseases. This study aimed to investigate the serum total
homocysteine (tHcy) level and nutritional status in elderly inpatients and determine the relationship between tHcy level and nutritional
status. Methods: This cross sectional study was carried out in the Tongji hospital, and 142 subjects were consecutively recruited.
Fasting blood was collected, and the liver and kidney function, blood glucose, glycosylated hemoglobin (HbA1c), plasma protein, lipid
profile, folic acid, vitamin B12 and serum total tHcy were measured. Anthropometric measurements, grip strength and the shortened
MNA form (MNA-SF) were used to assess the nutritional status. Results: Undernutrition was common in this population. Based on
MNA-SF scores, 34.2% of subjects were at risk of malnutrition, and malnourished subjects accounted for 4.9%. The mean tHcy was
14.10±5.46 µmol/l, and the prevalence of hyperhomocysteinemia was 32.4% (46/142). Hyperhomocysteinemia was a risk factor of
cerebral infarction (RR=1.636, 95% CI: 1.169-2.288); Serum tHcy was negatively correlated with serum folic acid, vitamin B12 and
MNA-SF score (r=-0.348, P=0.000; r=-0.236, P=0.005; r=-0.208, P=0.014), and positively with BMI within normal range (18.5-23.9;
r=0.232, P=0.044). Serum tHcy was negatively correlated with HbA1c, (r=-0.196, P=0.021) and positively with serum creatinine (r=0.327,
P=0.000), but unrelated to fasting blood glucose (r=-0.098, P=0.250). Multivariate stepwise regression analysis showed serum folic
acid, serum creatinine, MNA-SF score and HbA1c were independent determinants of serum tHcy. Conclusion: Elderly subjects have
higher serum tHcy level. Compromised renal function, poor nutritional status and lower blood glucose are likely to influence the serum
tHcy level. (IJCEM1308019).
Keywords: Homocysteine, nutritional status, MNA-SF, HbA1c
Address correspondence to: Chun-Li Cui, Department of Nephrology, Tongji Hospital of Tongji University, 389 Xunchun Road,
Shanghai, China. Tel: 86+21-66111370; E-mail: fandachen@tongji.edu.cn; cuichunli123@126.com
