Association Between Homocysteine And Sarcopenia In Chinese Elderly Residents Of Urban Community

Background/Objective: Sarcopenia is characterized by age-related skeletal muscle mass decline with decreased muscle strength or physical function.It is a predictor of all-cause mortality of the elderly in the community.Previous studies have found that homocysteine(Hcy)is associated with muscle strength and physical performance in the elderly,but whether there are gender differences remain unclear.So far seldom research has studies on the relationship between Hcy and sarcopenia at home and abroad.The purpose of this study is to examine the relationship between Hcy and sarcopenia in Chinese elderly residents of urban community,both cross-sectionally and longitudinally,and discuss gender differences.Methods: Data were from the Health and Chronic Disease Management Study of Ningbo Community Elderly between November 2016 and May 2017.A total of 795 subjects who completed the measurements of serum total homocysteine(t Hcy),body composition,grip strength and walking speed were included.676 of them completed one-year follow-up.The diagnosis of sarcopenia was based on the criteria of Asian sarcopenia working group.To discuss possible sex differences,all statistical analyses were stratified by gender.Multiple logistic regression analysis was used to observe the association between Hyperhomocysteinemia(HHcy)and sarcopenia.Multiple linear regression analysis was used to observe the relationship between t Hcy and skeletal muscle mass index(SMI),percent body fat(PBF),grip strength and walking speed.Significance level was set at P <0.05.Results: A total of 795 people(302 men and 493 women)were included in the cross-sectional analysis,and 676 people(263 men and 413 women)were followed up for longitudinal analysis.At baseline,in men,mean age was(71.9 ± 5.1)years old,mean t Hcy concentration was(15.25 ± 5.64)μ mol / L,prevalence of sarcopenia was 8.3%,while in women,mean age was(71.5 ± 5.2)years old,mean t Hcy concentration was(12.18 ± 4.07)μ mol / L,prevalence of sarcopenia was 8.9%.There was no statistical difference in age and prevalence of sarcopenia between two groups,but the level of t Hcy was higher in men than in women(P<0.001).Multiple logistic regression analysis showed that in the elderly,HHcy was associated with sarcopenia(OR=5.47;95%CI: 2.56,11.71;P < 0.001).HHcy was significantly associated with sarcopenia in women(OR=8.71;95%CI: 3.00,25.31;P<0.001),but not in men.Multiple liner regression analysis showed that in men,the highest quartile of t Hcy were associated with lower SMI(β=-0.25;95%CI:-0.42,-0.08;P=0.004)and higher PBF(β= 2.37;95%CI: 0.98,3.77;P=0.001)compared with the first quartile;in women,the highest quartile of t Hcy were associated with weaker grip strength(β=-1.96;95%CI:-3.29,-0.62;P=0.004)and slower gait speed(β=-0.08;95%CI:-0.14,-0.02;P=0.008)compared with the first quartile.No statistically significant associations were revealed in longitudinal analysis between t Hcy and SMI,grip strength,and gait speed.Conclusion: In Chinese elderly residents of urban community,HHcy was associated with sarcopenia in the elderly,especially in elderly women.In elderly women,elevated t Hcy was related to weak grip strength and slow gait speed;In elderly men,elevated t Hcy was related to low SMI.