The Cross-sectional Study And Correlation Analysis Between Frailty And Hyperhomocysteinemia In Community Elders

BackgroundFrailty is related to a series of clinical adverse events.Homocysteine(Hcy)is a risk factor for cerebro-cardiovascular diseases.The aims of the study were to investigate the frailty and Hcy level in community-dwelling elderly people aged 60 years or older,and explore the association between frailty and hyperhomocysteinemia(HHcy)in the elderly.MethodsA resident group of 1931 subjects aged 60 years or older was selected for a cross-sectional survey from May 2020 to December 2020.Frailty and pre-frailty were defined using Fried’s criteria.Hcy level was measured by enzymatic cycling assay and HHcy was defined as Hcy≥10μmol/L.The daily intake of folate-rich foods including coarse cereals,vegetables,fruits,soy products,dairy products and eggs was documented by a food frequency questionnaire and the dietary diversity score(DDS)of folate-rich foods was calculated.c2 test was used to compare frailty and HHcy in different age and sex groups.Binary logistic regression analysis was applied to analyze the risk factors of frailty,the associations between each phenotype of Fried’s criteria and HHcy,frailty and the DDS of folate-rich foods.Associations between frailty,pre-frailty or the number of Fried’s criteria and HHcy were assessed by multiple logistic regression.Multiple linear regression was used to analyze the association between the DDS of folate-rich foods and HHcy,and examine the mediating effect of the DDS of folate-rich foods between frailty and HHcy.Results1.154 people(8.0%)were defined as frailty and 1013 people(52.4%)were defined as pre-frailty in the total population.The prevalence of frailty was higher in females than in males,and increased with age(P<0.05).The age,living alone,bereft of spouse,stroke prevalence,systolic blood pressure,creatinine and Hcy level in frailty group were higher than those in non-frailty group,while the male ratio,diastolic blood pressure,hemoglobin,grip strength and gait speed in frailty group were lower than those in non-frailty group(all P<0.05).In the multivariate analysis of risk factors for frailty,frailty was positively correlated with age,sex,albumin and Hcy level.2.The average Hcy level was 8.45(5.84,11.22)μmol/L and 677 people(35.1%)were diagnosed with HHcy in the total population.The prevalence of HHcy was higher in males than in females,and increased with age(P<0.05).Compared with the normal Hcy level group(Hcy<10mol/L),the prevalence of hypertension,coronary heart disease and stroke in the HHcy group was higher(P<0.05).3.The highest daily intake rates of the six folate-rich foods in the total population were vegetables,eggs and fruits,which were 95.6%,80.5% and 69.2%,respectively.The intake rates of vegetables,fruits and the DDS of folate-rich foods in the HHcy group were lower than those in the normal Hcy group(all P<0.05).4.Multiple logistic regression analysis of frailty,pre-frailty and HHcy showed that the risk of frailty was positively correlated with HHcy(OR=2.015,95%CI:1.184～3.429),but there was no correlation between pre-frailty and HHcy(P>0.05).Binary logistic regression analysis showed that,compared with the normal Hcy group,the risk of frailty in Hcy 10～15mol/L group was 1.994 times that of normal Hcy group(95%CI: 1.179～3.371),the risk of frailty in Hcy ≥ 15mol/L group was 2.251 times(95%CI: 1.114～4.551).5.Binary logistic regression analysis between five phenotypes of Fried’s criteria and HHcy showed that only exhaustion was associated with HHcy(OR=1.448,95%CI:1.031～2.034).Multiple logistic regression analysis between the number of Fried’s criteria and HHcy showed that,compared with the normal Hcy group,the probability of4 phenotypes in the HHcy group was significantly higher(OR=7.060,95%CI:2.334～21.360).6.The mediating effect analysis showed that the DDS of folate-rich foods played a partial mediating role between frailty and HHcy,and the mediating effect accounted for11.3% of the total effect.ConclusionIn this study,the prevalence of frailty and HHcy in the elderly was 8.0% and35.1%.With the increase of Hcy level,the elderly with frailty increased,and the risk of frailty was higher in elders with HHcy than elders with normal Hcy.The DDS of folate-rich foods played a partial mediating role between frailty and HHcy.This study suggested that the intervention of frailty should be paid attention to the level of Hcy and the supplement of folate-rich food.