Association between occupational and health-related behaviors with hyperhomocysteinemia

Background Hyperhomocysteinemia (HHcy) is associated with a variety of chronic diseases such as hypertension and diabetes mellitus. Health-related behaviors such as smoking, alcohol drinking, and insufficient physical exercise are closely related to many chronic diseases including cardiovascular diseases, type 2 diabetes, and some cancers.

Objective This study investigates the distributional features of plasma total homocysteine (Hcy) and the prevalence of HHcy among adults in Xinqiao Community, Songjiang District of Shanghai, and explores the association of occupational and health-related behavioral factors with HHcy.

Methods A community-based cross-sectional study using randomized cluster sampling was conducted among adults aged 20-74 years in Xinqiao Community, Songjiang District of Shanghai. Distributional features of Hcy was described. Multiple logistic regression models were used to evaluate the association between occupational and health-related behavioral factors and HHcy.

Results Among 8207 participants, the mean plasma Hcy concentration was (15.29±7.33) μmol·L^-1, higher in males(18.09±9.42) μmol·L^-1 than in females(13.34±4.48) μmol·L^-1 (P < 0.001). The overall prevalence rate of HHcy was 32.47% (2 665/8 207), the rate was higher in males (52.64%, 1 172/3 366) than in females (18.45%, 893/4 841) (P < 0.001), and mild HHcy cases (n=2 418) were more than moderate and severe cases (n=247) (P < 0.001). The multiple logistic regression analysis results showed that, after adjusting for sex, age, body mass index, serum creatinine, and chronic disease prevalences, the prevalence rate of HHcy was positively associated with mentalmanual or manual occupations versus mental occupations, OR (95% CI):1.19 (1.03-1.38) and 1.29 (1.07-1.56) respectively; HHcy was negatively associated with physical exercise, OR (95% CI):0.88 (0.79-0.99); HHcy was positively associated with smoking, OR (95% CI):1.48 (1.29-1.71).

Conclusion The prevalence rate of HHcy is relatively high in adults in Xinqiao Community in Songjiang District of Shanghai. Mentalmanual or manual occupations may promote HHcy, while physical exercise may protect against the disease.