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Horm Metab Res 2025; 57(02): 134-143
DOI: 10.1055/a-2460-7718
Original Article: Endocrine Care

Association Between Homocysteine and All-Cause Mortality Among Osteoarthritis Patients: A Cohort Study from the NHANES Database

Yu Shi
1   Department of Orthopedic Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
,
Minan Lu
1   Department of Orthopedic Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
,
Feng He
1   Department of Orthopedic Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
,
Jinzhong Chen
1   Department of Orthopedic Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
,
Chuanchuan Zheng
1   Department of Orthopedic Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
,
Lu Lu 
1   Department of Orthopedic Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
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Abstract

This study explored the association between serum Hcy level and the all-cause mortality among osteoarthritis (OA) patients. This cohort study included patients diagnosed as OA from the National Health and Nutrition Examination Survey (NHANES) 1999–2006. Abbott Homocysteine assay, a fully automated fluorescence polarization immunoassay (FPIA) method, was used to measure the level of serum Hcy. Covariates included sociodemographic information, lifestyles, history of diseases and medications were extracted from the database. The weighted univariate, multivariate Cox proportional hazard models and restricted cubic splines (RCS) were utilized to explore the association between Hcy level and all-cause mortality in OA patients, with hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analyses based on different age, gender, duration of OA, complications and C-reactive protein (CRP) were further assessed by this association. Totally 1384 OA patients were included in this study, of which 817 (59.03%) died by 31 December 2019. After adjusting all covariates, high Hcy level was associated with the high all-cause mortality among OA patients (HR=1.31, 95%CI: 1.02–1.67), especially in females (HR=1.43, 95%CI: 1.07–1.91), aged >60 years (HR=1.49, 95%CI: 1.14–1.94), duration of OA >10 years (HR=1.40, 95%CI: 1.01–1.95), with the history of hypertension (HR=1.37, 95%CI: 1.03–1.80), without the history of diabetes (HR=1.36, 95%CI: 1.01–1.82) or CRP >0.29 mg/l (HR=1.51, 95%CI: 1.04–2.19). High serum Hcy level was associated with high risk of all-cause mortality in OA patients. Our results suggest that serum Hcy is a promising biomarker for the prognosis of OA patients.

Keywords

osteoarthritis - homocysteine - all-cause mortality

Supplementary Material



Publication History

Received: 18 June 2024

Accepted after revision: 23 October 2024

Article published online:
11 December 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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