# Verhoogd homocysteine voorspelt alle-oorzaak sterfte bij gevorderd CKM-syndroom

*geplaatst 2026-11-13 · Nierziekte · Medical science monitor : international medical journal of experimental and clinical research · doi 10.12659/MSM.954605 · https://hartvaat.nl/2026/11/06/verhoogd-homocysteine-voorspelt-alle-oorzaak-sterfte-bij-gevorderd-ckm-syndroom/*

Onderzoekers onderzochten de prognostische waarde van homocysteine bij 3658 volwassenen met gevorderd cardiovasculair-nier-metabool (CKM) syndroom. Na volledige aanpassing voor confounders was het hoogste tertiel homocysteine significant geassocieerd met een hoger risico op alle-oorzaak sterfte (HR 1,43; p<0,001), terwijl de associatie met cardiovasculaire sterfte statistisch niet significant bleef. Deze bevindingen ondersteunen het gebruik van homocysteine als aanvullende prognostische marker voor risicostratificatie in de dagelijkse praktijk, hoewel interventiestudies nog uitblijven.

## English: Association of Homocysteine With All-Cause and Cardiovascular Mortality in Individuals With Advanced Cardiovascular-Kidney-Metabolic Syndrome: A Nationwide Prospective Cohort Study.

Researchers evaluated the prognostic value of serum homocysteine in 3,658 adults with advanced cardiovascular-kidney-metabolic (CKM) syndrome. After multivariable adjustment, the highest homocysteine tertile was significantly associated with increased all-cause mortality (HR 1.43; p<0.001), whereas the link to cardiovascular mortality did not reach statistical significance. These results support homocysteine as a supplementary prognostic marker for risk stratification in routine clinical care, though therapeutic implications remain to be established.

## Abstract (original, from the publication)

BACKGROUND Cardiovascular-kidney-metabolic (CKM) syndrome reflects the overlap of cardiovascular disease, chronic kidney disease, and metabolic disorders. The prognostic relevance of homocysteine (Hcy) in advanced CKM syndrome remains unclear. This study aimed to evaluate the associations of serum Hcy levels with all-cause and cardiovascular mortality in adults with advanced CKM syndrome. MATERIAL AND METHODS This prospective cohort study included 3658 adults with advanced CKM syndrome from the National Health and Nutrition Examination Survey (NHANES) 1999-2006. Hcy was analyzed continuously and by tertiles. The primary analyses used survey-weighted Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CI). Restricted cubic splines assessed potential nonlinear associations. RESULTS During a mean follow-up of 153.4 months, 2008 all-cause deaths and 686 cardiovascular deaths occurred. After full adjustment, each 1-unit increase in Hcy was associated with higher all-cause mortality (HR 1.01, 95% CI 1.00-1.02; P=0.014), and the highest vs lowest Hcy tertile was associated with increased all-cause mortality (HR 1.43, 95% CI 1.19-1.72; P<0.001). For cardiovascular mortality, associations were directionally positive but not statistically significant after full multivariable adjustment for either continuous Hcy (HR 1.01, 95% CI 1.00-1.02; P=0.053) or the highest vs lowest tertile (HR 1.34, 95% CI 0.96-1.86; P=0.082). Restricted cubic spline analysis suggested nonlinear associations. CONCLUSIONS Higher Hcy was independently associated with increased all-cause mortality in adults with advanced CKM syndrome. The association with cardiovascular mortality was directionally positive but did not reach statistical significance after full multivariable adjustment.

Auteurs: Huifeng Shang, Xionghai Li, Xuewei Zhang, Jingdong Wan, Ping Yan, Tao Wang, Jing Liu, Lili Niu

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Bron: Medical science monitor : international medical journal of experimental and clinical research, https://doi.org/10.12659/MSM.954605. Bijgewerkt 2026-11-07T02:15:41Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.