Increased plasma homocysteine levels are associated with left ventricular hypertrophy in hypertensive patients with normal renal function.

Introduction: Renal function has an important bearing on plasma homocysteine levels. Plasma homocysteine is related to left ventricular hypertrophy (LVH). However, it remains unclear whether the association between plasma homocysteine levels and LVH is influenced by renal function. This study aimed to investigate relationships among left ventricular mass index (LVMI), plasma homocysteine levels and renal function in a population from southern China. Methods: A cross-sectional study was performed in 2464 patients from June 2016 to July 2021. Patients were divided into three groups based on gender-specific tertiles of homocysteine levels. LVMI >= 115 g/m2 for man, or >= 95 g/m2 for woman was defined as LVH. Results: LVMI and the percentage of LVH were increased, while estimated glomerular filtration rate (eGFR) was decreased with the increase in homocysteine levels, both significantly. Multivariate stepwise regression analysis showed that eGFR and homocysteine were independently associated with LVMI in patients with hypertension. No correlation was observed between homocysteine and LVMI in patients without hypertension. Stratified by eGFR, further analysis confirmed homocysteine was independently associated with LVMI (beta = 0.126, t = 4.333, P < 0.001) only in hypertensive patients with eGFR >= 90 mL/(min center dot 1.73m2), not with 60 <= eGFR < 90mL/(min center dot 1.73m2). Multivariate logistic regression indicated that in hypertensive patients with eGFR >= 90 mL/(min center dot 1.73m2), the patients in high tertile of homocysteine levels had a nearly twofold increased risk of occurring LVH compared with those in low tertile (high tertile: OR = 2.780, 95% CI: 1.945 - 3.975, P < 0.001). Conclusion: Plasma homocysteine levels were independently associated with LVMI in hypertensive patients with normal eGFR.