Don’t just fight cholesterol, homocysteine ​​is also a risk factor for cardiovascular disease

Author: Cui Yihui, registered dietitian, master of medicine

Reviewer: Wang Junbo, Associate Professor and Doctoral Supervisor, Peking University Health Science Center

The human body produces a lot of "byproducts" during daily metabolism, which can also be called "intermediate products" of metabolism. If these "byproducts" cannot be transformed or removed in time, they will "cause" a lot of trouble when they gather together, such as free radicals, uric acid, and today's protagonist - homocysteine ​​(for easy memorization, it can be abbreviated as "companion").

Homocysteine ​​does not come directly from food, but is an intermediate metabolite of methionine (an essential amino acid for the human body). This byproduct called "companion" needs to be further transformed or metabolized, but this metabolic process requires the help of B vitamins.

If the B vitamins are not in optimal condition and are not effective, homocysteine ​​cannot be converted, and more and more "companions" will gather in the blood, forming hyperhomocysteinemia.

Hyperhomocysteinemia has been clearly labeled as an independent risk factor for cardiovascular and cerebrovascular diseases. The so-called "independent risk factor" means that it can increase the risk of cardiovascular diseases on its own without the "interference" of other factors.

People used to struggle with cholesterol, believing that the level of cholesterol had predictive significance for the risk of heart disease. Later it was discovered that the concentration of this unfriendly "companion" in the blood was also a risk factor for cardiovascular disease.

● The harm of high homocysteine ​​to health

❖ Causes arterial inflammation, which in turn leads to vascular disease

High homocysteine ​​can damage vascular endothelial cells, destroy the elastic layer and collagen fibers of the blood vessel wall, leading to severe arterial inflammation and thus triggering vascular disease. Both cardiovascular and cerebrovascular vessels cannot withstand the torment of high homocysteine. The higher its concentration in the blood, the more serious the degree of blood vessel damage, and the higher the risk of cardiovascular and cerebrovascular diseases.

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Especially for people with high blood pressure, if "high blood pressure" meets "high homocysteine" (the so-called H-type hypertension), the consequence of the two "working together" will be various sequelae and complications, and the quality of life will be greatly reduced.

It is reported that 75% of hypertensive people in China have type H hypertension. No wonder Chinese hypertensive patients have a higher incidence of stroke than their Western counterparts.

❖ Affects the development and differentiation of cells, leading to premature aging of the body

In addition to being positively correlated with the incidence of cardiovascular and cerebrovascular diseases, hyperhomocysteinemia also increases the risk of Alzheimer's disease (also known as "senile dementia"), making diabetic patients more susceptible to complications such as coronary heart disease, kidney disease, and retinopathy.

In addition, hyperhomocysteinemia can easily cause pregnancy complications, such as miscarriage, preeclampsia, premature birth, low birth weight and certain birth defects.

● Adverse factors that induce hyperhomocysteinemia

❖ Congenital gene defects: Congenital gene defects are defects due to hereditary factors.

❖ Age and gender : The older you are, the more likely you are to develop hyperhomocysteinemia. The risk is higher in men than in women, but the ratio is similar after menopause.

❖ Levels of B vitamins in the body : Long-term deficiency of B vitamins, especially insufficient intake of vitamin B12 and folic acid, can easily lead to hyperhomocysteinemia.

❖ Long-term chronic diseases : Patients with chronic diseases such as diabetes, hypothyroidism, renal insufficiency, and tumors are prone to hyperhomocysteinemia, which in turn aggravates the occurrence of other complications, forming a vicious cycle.

❖ Unhealthy lifestyle and eating habits : smoking, excessive drinking or coffee, high-salt diet, high-fat diet, lack of exercise or excessive exercise, long-term vegetarianism without timely supplementation of B vitamins, can easily lead to an increase in the concentration of "companion children" in the blood.

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● How to deal with high homocysteine

❖ Have regular physical examinations to understand the concentration of "homocysteine" (high homocysteine) in your blood to determine whether you are at risk. It is recommended that homocysteine ​​must be included in the mandatory examination items during physical examinations. If your homocysteine ​​level reaches 6μmol/L or above, you should pay attention and take corresponding measures to reduce the indicator to the normal range as soon as possible.

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❖ Ensure adequate intake of B vitamins to improve the body's ability to convert homocysteine. People who have been vegetarians for a long time must supplement B vitamins every day. People whose blood homocysteine ​​exceeds the safe range are also recommended to supplement B vitamins.

❖ A low-fat diet rich in fruits and vegetables helps lower the level of homocysteine ​​in the blood. The DASH diet is very suitable for lowering the level of homocysteine ​​in people with hypertension. The main features of this diet are to eat enough vegetables, fruits, low-fat (or skim) milk, and to minimize the amount of fat in the diet (especially animal fats rich in saturated fatty acids).

❖ Consciously correct the bad living and eating habits mentioned above.