Linking Diet and Homocysteine to complexity of coronary artery disease using SYNTAX score – A cross sectional study

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Clinical Epidemiology and Global Health Pub Date : 2025-03-26 DOI:10.1016/j.cegh.2025.102012

Sowndarya Kollampare , Anupama Hegde , Arpit Jain , Padmanabh Kamath , Ramya Shenoy , Poornima A. Manjrekar

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Abstract

Background

Hyperhomocystinemia (HHcy) attributed to various causes is considered an independent risk factor in the development and progression of coronary artery disease (CAD). Homocysteine (Hcy) levels are affected by aging, renal dysfunction, hypothyroidism, oral hypoglycemics, dietary deficiency of folic acid (FA), vitamin B6, B12 (B12) and genetic defects. Influence of diet on Hcy and its relation to SYNTAX score was evaluated in newly diagnosed CAD.

Methods

A cross-sectional analytical study was conducted in 160 patients aged 40–59 years diagnosed as CAD by the Cardiologist at a tertiary healthcare center. SYNTAX score was calculated using a computer program. Hcy was estimated on the COBAS Pro c503, vitamin B12 (B12) and FA levels were estimated on the COBAS Pro e801 using ROCHE kits.

Results

HHcy (>15 μmol/L) was detected in 82 CAD patients and the point estimate of odds ratio was 1.157 with 95 % CI (1.056–1.267) of CAD. CAD patients with HHcy were labelled as Group I; Group II were those with Normal Homocysteine (NHcy) (≤15 μmol/L; n = 78). Hcy had a statistically significant correlation to SYNTAX score (Group I: r = 0.429; Group II: r = 0.233). Majority (n = 65) of Group I were vegetarians showing equal prevalence of high and intermediate risk SYNTAX score. Among them, substantial patients (n = 48) were found to have combined B12 and FA deficiency. Significant number (n = 57) of Group II patients had low risk SYNTAX score irrespective of deficient or sufficient B12/FA status.

Conclusion

HHcy was a common finding in nutritionally compromised vegetarian CAD patients contributing to higher risk SYNTAX score.

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使用SYNTAX评分将饮食和同型半胱氨酸与冠状动脉疾病复杂性联系起来——一项横断面研究

背景各种原因导致的高同型半胱氨酸血症（HHcy）被认为是冠状动脉疾病（CAD）发生和发展的独立危险因素。同型半胱氨酸（Hcy）水平会受到衰老、肾功能障碍、甲状腺功能减退、口服降糖药、饮食中叶酸（FA）、维生素 B6、B12（B12）缺乏和遗传缺陷的影响。方法对一家三级医疗保健中心的心脏病专家诊断为 CAD 的 160 名 40-59 岁患者进行了横断面分析研究。使用计算机程序计算 SYNTAX 评分。结果在 82 名 CAD 患者中检测出 HHcy（>15 μmol/L），CAD 的点估计几率比为 1.157，95 % CI 为 (1.056-1.267)。患有 HHcy 的 CAD 患者被称为 I 组；II 组为同型半胱氨酸正常者（NHcy）（≤15 μmol/L；n = 78）。在统计学上，同型半胱氨酸与 SYNTAX 评分有明显的相关性（第一组：r = 0.429；第二组：r = 0.233）。第一组的大多数患者（n = 65）是素食者，SYNTAX 评分的高危和中危比例相当。其中，大量患者（n = 48）合并有 B12 和 FA 缺乏症。无论 B12/FA 缺乏或充足与否，第二组患者中有相当数量（n = 57）的 SYNTAX 评分风险较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.60

自引率

7.70%

发文量

218

审稿时长

66 days

期刊介绍： Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.