Serum homocysteine and risk of dementia in Japan
ObjectiveTo examine the association between serum total homocysteine levels (tHcy) and dementia risk.MethodsA total of 1588 Japanese adults aged ≥60 years without dementia were prospectively followed from 2002 to 2012. Cox proportional hazards models and restricted cubic splines were used to estimat...
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Published in | Journal of neurology, neurosurgery and psychiatry Vol. 91; no. 5; pp. 540 - 546 |
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Main Authors | , , , , , , , , , , , |
Format | Journal Article |
Language | English |
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BMJ Publishing Group Ltd
01.05.2020
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Series | Original research |
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ISSN | 0022-3050 1468-330X 1468-330X |
DOI | 10.1136/jnnp-2019-322366 |
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Abstract | ObjectiveTo examine the association between serum total homocysteine levels (tHcy) and dementia risk.MethodsA total of 1588 Japanese adults aged ≥60 years without dementia were prospectively followed from 2002 to 2012. Cox proportional hazards models and restricted cubic splines were used to estimate the HRs of tHcy levels on the risk of dementia.ResultsDuring the follow-up, 372 subjects developed all-cause dementia; 247 had Alzheimer’s disease (AD) and 98 had vascular dementia (VaD). Compared with the lowest tHcy quintile (≤6.4 µmol/L), the multivariable-adjusted HRs (95% CI) of the highest quintile (≥11.5 µmol/L) were 2.28 (1.51–3.43) for all-cause dementia, 1.96 (1.19–3.24) for AD and 2.51 (1.14–5.51) for VaD. In restricted cubic splines, the risk of all-cause dementia steadily increased between approximately 8–15 µmol/L and plateaued thereafter, with a similar non-linear shape observed for AD and VaD (all p for non-linearity ≤0.02). In stratified analyses by the most recognised genetic polymorphism affecting tHcy concentrations (methylenetetrahydrofolate reductase C677T), the positive association of tHcy with all-cause dementia persisted in both non-carriers and carriers of the risk allele, and even tended to be stronger in the former (p for heterogeneity=0.07).ConclusionHigh serum tHcy levels are associated with an elevated risk of dementia, AD and VaD in a non-linear manner, such that an exposure-response association is present only within a relatively high range of tHcy levels. Non-genetic factors affecting serum tHcy concentrations may play important roles in tHcy-dementia associations irrespective of the genetic susceptibility for raised tHcy. |
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AbstractList | ObjectiveTo examine the association between serum total homocysteine levels (tHcy) and dementia risk.MethodsA total of 1588 Japanese adults aged ≥60 years without dementia were prospectively followed from 2002 to 2012. Cox proportional hazards models and restricted cubic splines were used to estimate the HRs of tHcy levels on the risk of dementia.ResultsDuring the follow-up, 372 subjects developed all-cause dementia; 247 had Alzheimer’s disease (AD) and 98 had vascular dementia (VaD). Compared with the lowest tHcy quintile (≤6.4 µmol/L), the multivariable-adjusted HRs (95% CI) of the highest quintile (≥11.5 µmol/L) were 2.28 (1.51–3.43) for all-cause dementia, 1.96 (1.19–3.24) for AD and 2.51 (1.14–5.51) for VaD. In restricted cubic splines, the risk of all-cause dementia steadily increased between approximately 8–15 µmol/L and plateaued thereafter, with a similar non-linear shape observed for AD and VaD (all p for non-linearity ≤0.02). In stratified analyses by the most recognised genetic polymorphism affecting tHcy concentrations (methylenetetrahydrofolate reductase C677T), the positive association of tHcy with all-cause dementia persisted in both non-carriers and carriers of the risk allele, and even tended to be stronger in the former (p for heterogeneity=0.07).ConclusionHigh serum tHcy levels are associated with an elevated risk of dementia, AD and VaD in a non-linear manner, such that an exposure-response association is present only within a relatively high range of tHcy levels. Non-genetic factors affecting serum tHcy concentrations may play important roles in tHcy-dementia associations irrespective of the genetic susceptibility for raised tHcy. To examine the association between serum total homocysteine levels (tHcy) and dementia risk. A total of 1588 Japanese adults aged ≥60 years without dementia were prospectively followed from 2002 to 2012. Cox proportional hazards models and restricted cubic splines were used to estimate the HRs of tHcy levels on the risk of dementia. During the follow-up, 372 subjects developed all-cause dementia; 247 had Alzheimer's disease (AD) and 98 had vascular dementia (VaD). Compared with the lowest tHcy quintile (≤6.4 µmol/L), the multivariable-adjusted HRs (95% CI) of the highest quintile (≥11.5 µmol/L) were 2.28 (1.51-3.43) for all-cause dementia, 1.96 (1.19-3.24) for AD and 2.51 (1.14-5.51) for VaD. In restricted cubic splines, the risk of all-cause dementia steadily increased between approximately 8-15 µmol/L and plateaued thereafter, with a similar non-linear shape observed for AD and VaD (all p for non-linearity ≤0.02). In stratified analyses by the most recognised genetic polymorphism affecting tHcy concentrations (methylenetetrahydrofolate reductase C677T), the positive association of tHcy with all-cause dementia persisted in both non-carriers and carriers of the risk allele, and even tended to be stronger in the former (p for heterogeneity=0.07). High serum tHcy levels are associated with an elevated risk of dementia, AD and VaD in a non-linear manner, such that an exposure-response association is present only within a relatively high range of tHcy levels. Non-genetic factors affecting serum tHcy concentrations may play important roles in tHcy-dementia associations irrespective of the genetic susceptibility for raised tHcy. To examine the association between serum total homocysteine levels (tHcy) and dementia risk.OBJECTIVETo examine the association between serum total homocysteine levels (tHcy) and dementia risk.A total of 1588 Japanese adults aged ≥60 years without dementia were prospectively followed from 2002 to 2012. Cox proportional hazards models and restricted cubic splines were used to estimate the HRs of tHcy levels on the risk of dementia.METHODSA total of 1588 Japanese adults aged ≥60 years without dementia were prospectively followed from 2002 to 2012. Cox proportional hazards models and restricted cubic splines were used to estimate the HRs of tHcy levels on the risk of dementia.During the follow-up, 372 subjects developed all-cause dementia; 247 had Alzheimer's disease (AD) and 98 had vascular dementia (VaD). Compared with the lowest tHcy quintile (≤6.4 µmol/L), the multivariable-adjusted HRs (95% CI) of the highest quintile (≥11.5 µmol/L) were 2.28 (1.51-3.43) for all-cause dementia, 1.96 (1.19-3.24) for AD and 2.51 (1.14-5.51) for VaD. In restricted cubic splines, the risk of all-cause dementia steadily increased between approximately 8-15 µmol/L and plateaued thereafter, with a similar non-linear shape observed for AD and VaD (all p for non-linearity ≤0.02). In stratified analyses by the most recognised genetic polymorphism affecting tHcy concentrations (methylenetetrahydrofolate reductase C677T), the positive association of tHcy with all-cause dementia persisted in both non-carriers and carriers of the risk allele, and even tended to be stronger in the former (p for heterogeneity=0.07).RESULTSDuring the follow-up, 372 subjects developed all-cause dementia; 247 had Alzheimer's disease (AD) and 98 had vascular dementia (VaD). Compared with the lowest tHcy quintile (≤6.4 µmol/L), the multivariable-adjusted HRs (95% CI) of the highest quintile (≥11.5 µmol/L) were 2.28 (1.51-3.43) for all-cause dementia, 1.96 (1.19-3.24) for AD and 2.51 (1.14-5.51) for VaD. In restricted cubic splines, the risk of all-cause dementia steadily increased between approximately 8-15 µmol/L and plateaued thereafter, with a similar non-linear shape observed for AD and VaD (all p for non-linearity ≤0.02). In stratified analyses by the most recognised genetic polymorphism affecting tHcy concentrations (methylenetetrahydrofolate reductase C677T), the positive association of tHcy with all-cause dementia persisted in both non-carriers and carriers of the risk allele, and even tended to be stronger in the former (p for heterogeneity=0.07).High serum tHcy levels are associated with an elevated risk of dementia, AD and VaD in a non-linear manner, such that an exposure-response association is present only within a relatively high range of tHcy levels. Non-genetic factors affecting serum tHcy concentrations may play important roles in tHcy-dementia associations irrespective of the genetic susceptibility for raised tHcy.CONCLUSIONHigh serum tHcy levels are associated with an elevated risk of dementia, AD and VaD in a non-linear manner, such that an exposure-response association is present only within a relatively high range of tHcy levels. Non-genetic factors affecting serum tHcy concentrations may play important roles in tHcy-dementia associations irrespective of the genetic susceptibility for raised tHcy. |
Author | Oishi, Emi Kitazono, Takanari Chen, Sanmei Ohara, Tomoyuki Yoshida, Daigo Honda, Takanori Furuta, Yoshihiko Sakata, Satoko Hirakawa, Yoichiro Hata, Jun Shibata, Mao Ninomiya, Toshiharu |
AuthorAffiliation | 4 Department of Medicine and Clinical Sciences, Graduate School of Medical Sciences , Kyushu University , Fukuoka , Japan 1 Department of Epidemiology and Public Health, Graduate School of Medical Sciences , Kyushu University , Fukuoka , Japan 3 Center for Cohort Studies, Graduate School of Medical Sciences , Kyushu University , Fukuoka , Japan 2 Department of Neuropsychiatry, Graduate School of Medical Sciences , Kyushu University , Fukuoka , Japan |
AuthorAffiliation_xml | – name: 1 Department of Epidemiology and Public Health, Graduate School of Medical Sciences , Kyushu University , Fukuoka , Japan – name: 2 Department of Neuropsychiatry, Graduate School of Medical Sciences , Kyushu University , Fukuoka , Japan – name: 3 Center for Cohort Studies, Graduate School of Medical Sciences , Kyushu University , Fukuoka , Japan – name: 4 Department of Medicine and Clinical Sciences, Graduate School of Medical Sciences , Kyushu University , Fukuoka , Japan |
Author_xml | – sequence: 1 givenname: Sanmei orcidid: 0000-0003-0811-1701 surname: Chen fullname: Chen, Sanmei organization: Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan – sequence: 2 givenname: Takanori orcidid: 0000-0002-1011-9879 surname: Honda fullname: Honda, Takanori organization: Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan – sequence: 3 givenname: Tomoyuki surname: Ohara fullname: Ohara, Tomoyuki organization: Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan – sequence: 4 givenname: Jun surname: Hata fullname: Hata, Jun organization: Department of Medicine and Clinical Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan – sequence: 5 givenname: Yoichiro surname: Hirakawa fullname: Hirakawa, Yoichiro organization: Department of Medicine and Clinical Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan – sequence: 6 givenname: Daigo surname: Yoshida fullname: Yoshida, Daigo organization: Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan – sequence: 7 givenname: Mao surname: Shibata fullname: Shibata, Mao organization: Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan – sequence: 8 givenname: Satoko surname: Sakata fullname: Sakata, Satoko organization: Department of Medicine and Clinical Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan – sequence: 9 givenname: Emi surname: Oishi fullname: Oishi, Emi organization: Department of Medicine and Clinical Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan – sequence: 10 givenname: Yoshihiko surname: Furuta fullname: Furuta, Yoshihiko organization: Department of Medicine and Clinical Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan – sequence: 11 givenname: Takanari surname: Kitazono fullname: Kitazono, Takanari organization: Department of Medicine and Clinical Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan – sequence: 12 givenname: Toshiharu surname: Ninomiya fullname: Ninomiya, Toshiharu email: nino@eph.med.kyushu organization: Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32234968$$D View this record in MEDLINE/PubMed |
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Snippet | ObjectiveTo examine the association between serum total homocysteine levels (tHcy) and dementia risk.MethodsA total of 1588 Japanese adults aged ≥60 years... To examine the association between serum total homocysteine levels (tHcy) and dementia risk. A total of 1588 Japanese adults aged ≥60 years without dementia... To examine the association between serum total homocysteine levels (tHcy) and dementia risk.OBJECTIVETo examine the association between serum total... |
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SubjectTerms | Blood pressure Dementia Diabetes Epidemiology Homocysteine Hypertension Medical imaging Neuropsychiatry Polymorphism Population Psychiatrists Studies Surveillance Trends Vitamin B Womens health |
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Title | Serum homocysteine and risk of dementia in Japan |
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