Relationship Of The Serum Homocysteine Level Between Coronary Heart Disease And Sarcopenia

Objective To study the correlation between homocysteine and lean body mass,which is one of the important phenotypes of sarcopenia,and to explore the pathogenesis of homocysteine in sarcopenia;to analyze whether the possible factors leading to coronary heart disease include the loss of lean body mass;To serve the clinic with the above findings,that is,to develop new clinical ideas for the prevention and treatment of sarcopenia and coronary heart disease.At last,to find effective methods to prevent and delay the occurrence and development of sarcopenia and coronary heart disease,improve the quality of life of the elderly,and reduce the disability rate and mortality of the elderly.Methods From August 2017 to August2019,257 patients with coronary heart disease were randomly drawn from the cardiology department,geriatrics center and health examination center of Inner Mongolia People's hospital.257 well matched non coronary heart disease patients who were admitted or examined in the same period were randomly drawn as controls.All participants signed informed consent.The exclusion criteria included patients with disability,dementia and incapability in bed,with endocrine diseases such as diabetes,hypertension,severe liver and kidney dysfunction,major diseases of digestive system and respiratory system,and recent hormone drugs,anti-tumor drugs,drugs containing folic acid and vitamin B12,B6,Chronic alcoholics,etc.Questionnaire was completed under the guidance of skilled personnel,including gender,age,height,disease history,medication history,etc.All participants were required to complete two examinations before the invasive coronary artery examination:1)Blood biochemical tests,including fasting plasma glucose(FSG),triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)and homocysteine(HCY);2)Skeletal muscle mass index(RSMI),which was measured by a DXA instrument and was adjusted by height.Participants were divided into a HHcy group and a non-HHcy group by their Hcy results.Age,gender distribution and lean mass were compared between the two groups.Participants were also divided into a RSMI reduction group and a RSMI normal group by their RSMI results,and were further divided into sub-groups by gender and age.The correlation between Hcy and lean body mass and between lean body mass and coronary heart disease was compared across groups.Finally,we performed a regression analysis to demonstrate whether loss of lean mass was an independent risk factor for coronary heart disease.Results A total of 514 participants were included in this study,284 in the HHcy group and 230 in the non-HHcy group.Analysis of the baseline measurements showed that the HHcy group was older than the non-HHcy group,and the difference was statistically significant(P<0.05).When comparing lean mass at various skeletal sites,lean mass at whole body,left leg,left arm and right arm in the HHcy group was lower than that in the non-HHcy group,and the difference was statistically significant(all P<0.05).The Hcy level in the HHcy group was significantly higher than that in the non-hhcy group(P<0.001).Other measures,including fasting blood glucose,triglyceride,total cholesterol,high-density lipoprotein cholesterol and low-density lipoprotein cholesterol in the HHcy group were also higher than those in the non-hhcy group,but they were statistically non-significant(P>0.05).When comparing the prevalence rate between groups,we found that there was a statistically significant difference in the detection rate of HHcy between the male RSMI reduction group and the normal RSMI group,and the HHcy detection rate of the male RSMI reduction group was higher(61.2%vs 47.8%,?~2=2.75,P=0.013).In the comparison of the incidence of coronary heart disease,we found that the incidence of coronary heart disease in the RSMI reduction group was higher than that in the RSMI normal group,and the difference was statistically significant(?~2=13.93,P<0.001),which may be related to aging and decreased testosterone.The results of regression analysis suggested that Hcy was an independent risk factor for coronary heart disease,and lean body mass was a protective factor for coronary heart disease(95%CI=0.541-0.715,P<0.001).Conclusion 1.Hcy concentration is related to age and increases with age.2.Lean body mass is negatively correlated with the level of Hcy,probably as a result of oxidation,promoting inflammation and increasing the level of blood glucose and blood lipids led by HHcy.3.Lean body mass is an protective factor for coronary heart disease,the harm of lean body mass loss to coronary heart disease which is related to aging and gender.