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Open Access Research article

Hyperhomocysteinemia is independently associated with albuminuria in the population-based CoLaus study

Franziska Marti1, Peter Vollenweider2, Pedro-Manuel Marques-Vidal13, Vincent Mooser4, Gérard Waeber2, Fred Paccaud1 and Murielle Bochud1*

Author Affiliations

1 University Institute of Social and Preventive Medicine (IUMSP), University of Lausanne and Centre Hospitalier Universitaire Vaudois (CHUV), 1005 Lausanne, Switzerland

2 Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland

3 CardioMet, University of Lausanne, Switzerland

4 Department of pathology and laboratory medicine, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland

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BMC Public Health 2011, 11:733  doi:10.1186/1471-2458-11-733

Published: 26 September 2011

Abstract

Background

Increased serum levels of homocysteine and uric acid have each been associated with cardiovascular risk. We analyzed whether homocysteine and uric acid were associated with glomerular filtration rate (GFR) and albuminuria independently of each other. We also investigated the association of MTHFR polymorphisms related to homocysteine with albuminuria to get further insight into causality.

Methods

This was a cross-sectional population-based study in Caucasians (n = 5913). Hyperhomocysteinemia was defined as total serum homocysteine ≥ 15 μmol/L. Albuminuria was defined as urinary albumin-to-creatinine ratio > 30 mg/g.

Results

Uric acid was associated positively with homocysteine (r = 0.246 in men and r = 0.287 in women, P < 0.001). The prevalence of albuminuria increased across increasing homocysteine categories (from 6.4% to 17.3% in subjects with normal GFR and from 3.5% to 14.5% in those with reduced GFR, P for trend < 0.005). Hyperhomocysteinemia (OR = 2.22, 95% confidence interval: 1.60-3.08, P < 0.001) and elevated serum uric acid (OR = 1.27, 1.08-1.50, per 100 μmol/L, P = 0.004) were significantly associated with albuminuria, independently of hypertension and type 2 diabetes. The 2-fold higher risk of albuminuria associated with hyperhomocysteinemia was similar to the risk associated with hypertension or diabetes. MTHFR alleles related to higher homocysteine were associated with increased risk of albuminuria.

Conclusions

In the general adult population, elevated serum homocysteine and uric acid were associated with albuminuria independently of each other and of renal function.