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
