Elevated Serum Homocysteine Associated with Left Ventricular Remodeling in Patients with IgA Nephropathy

Background: Homocysteine(Hcy) is a non-traditional independent risk factor for cardiovascular disease. Left ventricular remodeling(LVR) is a predictor of poor cardiovascular and renal outcomes in patients with chronic kidney disease(CKD). However, there is little known about LVR in IgA nephropathy(IgAN). We aimed to explore the association between serum Hcy and LVR in IgAN patients. Methods: This retrospective study included 257 patients with IgAN who underwent echocardiography. LVR was defined as left ventricular mass index(LVMI)>115g/m2 in men and>95g/m2 in women or relative wall thickness(RWT)>0.42. Spearman correlation and logistic regression analysis were performed to explore the association between Hcy and LVR. Results: In our study, 28.79% of patients had LVR, and the proportion increased with CKD progression. Patients with LVR were older and had higher serum Hcy[13.95(10.65,19.10) vs 10.90(8.80,13.70)µmol/L, P<0.001], body mass index(BMI), blood pressure(BP), serum creatinine(Scr), 24-hour urine protein, triglyceride(TG), and serum phosphorus(P), but lower haemoglobin(Hb) and serum bicarbonate compared to patients without LVR. An adjusted multivariate logistic regression model indicated that elevated serum Hcy was independently associated with increased risk of LVR(OR=1.072, 95%CI=1.001-1.149, P=0.047). Conclusion: Serum Hcy was associated with LVR independent of traditional cardiovascular risk factors as BP, Scr and TG in IgAN patients.Levels of serum Hcy in LVR group and non-LVR group. ***P<0.001Levels of serum Hcy in groups according to heart structure. ***P<0.001