Association Between Plasma Homocysteine, Folate, Vitamin B12 Levels, and Metabolic Dysfunction Indices in Elderly with Arterial Stiffness

Abstract

Background/Objectives: Arterial stiffness is a prevalent age-related condition that can significantly increase the risk of cardiovascular disease and mortality in older adults. Understanding the factors that contribute to vascular health, including metabolic dysfunction and hyperhomocysteinemia, alongside vitamin B status, is essential for developing effective interventions. This study aimed to explore the relationship between plasma levels of homocysteine, folate, and vitamin B12, as well as various indices of metabolic dysfunction, in elderly individuals with arterial stiffness. Methods: We conducted a cross-sectional analysis involving 884 participants aged 65 and older, assessing arterial stiffness using the cardio/ankle vascular index method. Additionally, we collected fasting blood samples to evaluate plasma homocysteine, folate, vitamin B12 levels, and other relevant biochemical markers. Results: Higher plasma homocysteine levels are significantly correlated with elevated CAVI scores and increased indices of metabolic dysfunction (p < 0.05). Furthermore, a multivariate logistic regression analysis demonstrated that elevated plasma homocysteine levels, along with higher levels of lipid accumulation product (LAP), triglyceride/glucose index (TyG), and visceral adiposity index (VAI), are associated with increased arterial stiffness. Conclusions: These findings suggest that monitoring and optimizing homocysteine, folate, and vitamin B12 levels may be beneficial for preventing or managing arterial stiffness and related metabolic disorders in the elderly population.

Keywords: arterial stiffness; cardio/ankle vascular index; elderly; hyperhomocysteinemia; metabolic dysfunction indices.

Figure 1

CONSORT flow diagram of this cross-sectional study.

Figure 2

CAVI measurement. Pulse wave velocity (PWV) was obtained by measuring the distance between the aortic valve to the ankle (L), divided by time for the pulse wave to propagate from the aortic valve to the ankle (T). The PWV was then put into the equation for scale conversion. Ps, systolic blood pressure; Pd, diastolic blood pressure; ΔP =Ps − Pd; ρ, blood density; tba, time between rise in brachial pulse wave and rise in ankle pulse wave; tb, time between closing sound of aortic valve and notch in brachial pulse wave.

Figure 3

Results of logistic regression analysis between arterial stiffness (with a high CAVI (≥9) and clinical variables. aOR, adjusted odds ratio; CI, confidence interval; OR, odd ratio; model 1 adjusted for age, sex, and smoking and alcohol drinking status; model 2: model 1 adjusted for number of MetS, hypertension, type 2 diabetes, dyslipidemia, plasma homocysteine, and vitamin B12, CMI, LAP, TyG, and VAI; Data are presented as mean ± SD or number (percent), as indicated. AIP: atherogenic index of plasma; BMI: body mass index; CAVI: cardio/ankle vascular index; CMI: cardiometabolic index; DBP: diastolic blood pressure; HDL-C: high-density lipoprotein cholesterol; LAP: lipid accumulation product; LDL-C: low-density lipoprotein cholesterol; SBP: systolic blood pressure; TC: total plasma cholesterol; TG: triglycerides; TG/HDL-C; triglyceride to HDL-C ratio; TyG: triglyceride/glucose index; TyG-BMI: triglyceride-adjusted body mass index; TyG-WC: triglyceride-adjusted waist circumference index; VAI: visceral adiposity index.