{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T13:22:29Z","timestamp":1770902549058,"version":"3.50.1"},"reference-count":41,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2015,5,19]],"date-time":"2015-05-19T00:00:00Z","timestamp":1431993600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Objective: Homocysteine (Hcy) is a relevant biomarker of vascular disease: serum Hcy concentrations will increase the risk of systolic hypertension, whereas hyperhomocysteinemia (HHcy) has a synergistic effect with hypertension and increases the risk of cardiovascular disease. However, information has primarily been gathered from high-income and urban settings, and little is known regarding low-income rural settings. This study focused on a low-income rural and nomadic minority residing in far western China. Hcy levels were tested, and the prevalences of HHcy and H-type hypertension were investigated in this population. Methods: This study used a stratified cluster random sampling method, selecting 2,180 individuals as subjects from Kazakh and Uyghur inhabitants (\u226525 years old) of 18 villages in Xinjiang, China, which is approximately  4407 km from the capital, Beijing. Hcy levels were determined using a double reagent enzymatic cycling method. HHcy (Hcy &gt; 10 \u03bcmol\/L) was defined by the criteria of the American Heart Association. Results: The Kazakh geometrical mean of Hcy was  13.34 \u03bcmol\/L, and the Uyghur mean was 13.75 \u03bcmol\/L; the mean values were higher in males than in females of both ethnicities (15.99 \u03bcmol\/L vs. 11.63 \u03bcmol\/L; 15.71 \u03bcmol\/L vs. 11.91 \u03bcmol\/L, respectively, p &lt; 0.01). The serum levels of Hcy increased with increasing age in both ethnicities, and except for Kazakh individuals &gt;65 years old, Hcy serum levels were higher in males than in females in all age groups of both ethnicities, with a p value less than 0.01. The Kazakh prevalence of HHcy was 80.0%, and the Uyghur prevalence was 78.2%; the male prevalence was higher than that in females for both ethnicities (93.5% vs. 69.6%; 90.8% vs. 64.6%, respectively, p &lt; 0.05). Among the Kazakh, the prevalence of hypertension was 35.1%, and the prevalence was higher in males than in females (44.3% vs. 28.1%, p &lt; 0.001); 87.6% of the Kazakh individuals had H-type hypertension, and the prevalence was higher in males than in females (95.0% vs. 80.0%, p &lt; 0.05). In Uyghur, the prevalence of hypertension was 30.6%, and the prevalence was higher in males than in females (37.9% vs. 22.8%, p &lt; 0.001); 88.0% of the Uyghur individuals had H-type hypertension, and the prevalence was higher in males than in females (93.9% vs. 79.1%,  p &lt; 0.05). Conclusions: HHcy was found to be common among the Kazakh and Uyghur. The prevalences of HHcy and H-type hypertension were high among both ethnicities and differed depending on gender and age. Community interventions should be conducted to improve public health conditions among the Kazakh and Uyghur in Xinjiang.<\/jats:p>","DOI":"10.3390\/ijerph120505373","type":"journal-article","created":{"date-parts":[[2015,5,19]],"date-time":"2015-05-19T10:35:57Z","timestamp":1432031757000},"page":"5373-5385","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Ethnic Differences in the Prevalence of High Homocysteine Levels Among Low-Income Rural Kazakh and Uyghur  Adults in Far Western China and Its Implications for  Preventive Public Health"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3227-0710","authenticated-orcid":false,"given":"Shuxia","family":"Guo","sequence":"first","affiliation":[{"name":"Key Laboratory of Xinjiang Endemic and Ethnic Diseases, School of Medicine, Shihezi University, Beier Road, Shihezi City, Xinjiang Uyghur Autonomous Region 832000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongrui","family":"Pang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Xinjiang Endemic and Ethnic Diseases, School of Medicine, Shihezi University, Beier Road, Shihezi City, Xinjiang Uyghur Autonomous Region 832000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heng","family":"Guo","sequence":"additional","affiliation":[{"name":"Key Laboratory of Xinjiang Endemic and Ethnic Diseases, School of Medicine, Shihezi University, Beier Road, Shihezi City, Xinjiang Uyghur Autonomous Region 832000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Xinjiang Endemic and Ethnic Diseases, School of Medicine, Shihezi University, Beier Road, Shihezi City, Xinjiang Uyghur Autonomous Region 832000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia","family":"He","sequence":"additional","affiliation":[{"name":"Key Laboratory of Xinjiang Endemic and Ethnic Diseases, School of Medicine, Shihezi University, Beier Road, Shihezi City, Xinjiang Uyghur Autonomous Region 832000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yizhong","family":"Yan","sequence":"additional","affiliation":[{"name":"Key Laboratory of Xinjiang Endemic and Ethnic Diseases, School of Medicine, Shihezi University, Beier Road, Shihezi City, Xinjiang Uyghur Autonomous Region 832000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiang","family":"Niu","sequence":"additional","affiliation":[{"name":"Key Laboratory of Xinjiang Endemic and Ethnic Diseases, School of Medicine, Shihezi University, Beier Road, Shihezi City, Xinjiang Uyghur Autonomous Region 832000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"family":"Muratbek","sequence":"additional","affiliation":[{"name":"Key Laboratory of Xinjiang Endemic and Ethnic Diseases, School of Medicine, Shihezi University, Beier Road, Shihezi City, Xinjiang Uyghur Autonomous Region 832000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongsheng","family":"Rui","sequence":"additional","affiliation":[{"name":"Key Laboratory of Xinjiang Endemic and Ethnic Diseases, School of Medicine, Shihezi University, Beier Road, Shihezi City, Xinjiang Uyghur Autonomous Region 832000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shugang","family":"Li","sequence":"additional","affiliation":[{"name":"Key Laboratory of Xinjiang Endemic and Ethnic Diseases, School of Medicine, Shihezi University, Beier Road, Shihezi City, Xinjiang Uyghur Autonomous Region 832000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rulin","family":"Ma","sequence":"additional","affiliation":[{"name":"Key Laboratory of Xinjiang Endemic and Ethnic Diseases, School of Medicine, Shihezi University, Beier Road, Shihezi City, Xinjiang Uyghur Autonomous Region 832000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Xinjiang Endemic and Ethnic Diseases, School of Medicine, Shihezi University, Beier Road, Shihezi City, Xinjiang Uyghur Autonomous Region 832000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiaming","family":"Liu","sequence":"additional","affiliation":[{"name":"Key Laboratory of Xinjiang Endemic and Ethnic Diseases, School of Medicine, Shihezi University, Beier Road, Shihezi City, Xinjiang Uyghur Autonomous Region 832000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusong","family":"Ding","sequence":"additional","affiliation":[{"name":"Key Laboratory of Xinjiang Endemic and Ethnic Diseases, School of Medicine, Shihezi University, Beier Road, Shihezi City, Xinjiang Uyghur Autonomous Region 832000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2015,5,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1038\/labinvest.3780275","article-title":"Impaired homocysteine metabolism and atherothrombotic disease","volume":"81","author":"Durand","year":"2001","journal-title":"Lab Invest."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1038\/sj.ejcn.1602097","article-title":"Prevalences of hyperhomocysteinaemia, unfavorable cholesterol profile and hypertension in European populations","volume":"59","author":"Mennen","year":"2005","journal-title":"Eur. J. Clin. Nutr"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Fakhrzadeh, H., Ghotbi, S., Pourebrahim, R., Nouri, M., Heshmat, R., Bandarian, F., Shafaee, A., and Larijani, B. (2006). Total plasma homocysteine, folate, and vitamin B12 status in healthy Iranian adults: The Tehran homocysteine survey (2003\u20132004)\/a cross-sectional population based study. BMC Public Health, 6.","DOI":"10.1186\/1471-2458-6-29"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e409","DOI":"10.1161\/circ.113.10.e409","article-title":"Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: A statement for healthcare professionals from the American Heart Association\/American Stroke Association Council on Stroke: Cosponsored by the Council on Cardiovascular Radiology and Intervention","volume":"113","author":"Sacco","year":"2006","journal-title":"Circulation"},{"key":"ref_5","first-page":"253","article-title":"Etiopathogenesis and pathogenesis of H type hypertension","volume":"33","author":"Zhang","year":"2012","journal-title":"Adv. Cardiovasc. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Yakub, M., and Iqbal, M.P. (2010). Association of blood lead (Pb) and plasma homocysteine: A cross sectional survey in Karachi, Pakistan. PLoS One, 5.","DOI":"10.1371\/journal.pone.0011706"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1289\/ehp.7369","article-title":"Blood lead is a predictor of homocysteine levels in a population-based study of older adults","volume":"113","author":"Schafer","year":"2005","journal-title":"Environ. Health Perspect."},{"key":"ref_8","first-page":"897","article-title":"Homocysteine concentration and the risk of death in the adult Polish population","volume":"70","author":"Sygnowska","year":"2012","journal-title":"Kardiol. Pol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/S0140-6736(05)70152-5","article-title":"Homocysteine and stroke: Evidence on a causal link from mendelian randomization","volume":"365","author":"Casas","year":"2005","journal-title":"Lancet"},{"key":"ref_10","first-page":"3676","article-title":"Association factors of target organ damage: Analysis of 17,682 elderly hypertensive patients in China","volume":"124","author":"Cui","year":"2011","journal-title":"Chin. Med. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1136\/bmj.325.7374.1202","article-title":"Homocysteine and cardiovascular disease: Evidence on causality from a meta-analysis","volume":"325","author":"Wald","year":"2002","journal-title":"BMJ."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.ejim.2014.04.011","article-title":"Elevated plasma homocysteine level is associated with ischemic stroke in Chinese hypertensive patients","volume":"25","author":"Wang","year":"2014","journal-title":"Eur. J. Intern. Med."},{"key":"ref_13","first-page":"156","article-title":"Measurement analysis on the literatures about hyperhomocysteinemia","volume":"10","author":"Xing","year":"2006","journal-title":"Chin. J. Clin. Rehabil."},{"key":"ref_14","unstructured":"Chinese Guidelines for the Management of Hypertension (2010). 2010 Chinese guidelines for the management of hypertension. Chin. J. Hypertens., 19, 701\u2013743. (In Chinese)."},{"key":"ref_15","first-page":"976","article-title":"Prevention of stroke relies on valid control \u201cH\u201d type hypertension","volume":"47","author":"Hu","year":"2008","journal-title":"Chin. J. Intern. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.1016\/S0140-6736(06)68770-9","article-title":"Global and regional burden of disease and risk factors, 2001: Systematic analysis of population health data","volume":"367","author":"Lopez","year":"2006","journal-title":"Lancet."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.1016\/S0140-6736(05)67344-8","article-title":"Preventing chronic diseases in China","volume":"366","author":"Wang","year":"2005","journal-title":"Lancet."},{"key":"ref_18","first-page":"269","article-title":"The gene polymorphisms of homocysteine metabolism-related enzymes and the associated factors in isolated systolic hypertension","volume":"31","author":"Sun","year":"2003","journal-title":"Chin. J. Cardiol."},{"key":"ref_19","first-page":"614","article-title":"Efficacy and safety of Enalapril-Folate acid tablets in lowering blood pressure and plasma homocysteine","volume":"39","author":"Li","year":"2007","journal-title":"J. Peking Univ.: Health Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1093\/jn\/137.2.407","article-title":"High prevalence of hyperhomocysteinemia in Chinese adults is associated with low folate, vitamin B-12, and vitamin B-6 status","volume":"137","author":"Hao","year":"2007","journal-title":"J. Nutr."},{"key":"ref_21","first-page":"1696","article-title":"The distribution characteristics of homocysteine in healthy people in Fuzhou district","volume":"8","author":"Yang","year":"2011","journal-title":"Lab. Med. Clin."},{"key":"ref_22","first-page":"2957","article-title":"The effect of baseline homocysteine level on the efficacy of enalapril maleate and folic acid tablet in lowering blood pressure and plasma homocysteine","volume":"88","author":"Zhao","year":"2008","journal-title":"Natl. Med. J. China."},{"key":"ref_23","first-page":"945","article-title":"Study on the distribution of serum homocysteine and on multi-stepwise regression analysis of the associated factors in the population of community areas in Wuhan","volume":"25","author":"Hu","year":"2004","journal-title":"Chin. J. Epidemiol."},{"key":"ref_24","first-page":"32","article-title":"The distribution of serum homocysteine and its associated factors in a population of 1168 subjects in Beijing area","volume":"23","author":"Wang","year":"2002","journal-title":"Chin. J. Epidemiol."},{"key":"ref_25","first-page":"1164","article-title":"Prevalence of hypertension in Uygur, Kazakhs and Han people in rural areas of Xinjiang","volume":"21","author":"Ma","year":"2013","journal-title":"Chin. J. Hypertens."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2693","DOI":"10.1001\/jama.1993.03510220049033","article-title":"Vitamin status and intake as primary determinants of homocysteinemia in an elderly population","volume":"270","author":"Selhub","year":"1993","journal-title":"JAMA"},{"key":"ref_27","first-page":"250","article-title":"Association of B vitamins status and homocysteine levels in elderly Taiwanese","volume":"14","author":"Chen","year":"2005","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/s00391-004-0169-6","article-title":"Age-associated changes in the metabolism of vitamin B(12) and folic acid: Prevalence, aetiopathogenesis and pathophysiological consequences","volume":"37","author":"Wolters","year":"2004","journal-title":"Z Gerontol. Geriatr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1253\/circj.CJ-08-1077","article-title":"Use of serum homocysteine to predict stroke, coronary heart disease and death in ethnic Chinese 12-year prospective cohort study","volume":"73","author":"Sun","year":"2009","journal-title":"Circ. J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"173","DOI":"10.4103\/1119-3077.151036","article-title":"Reference intervals for serum cystatin C and creatinine of an indigenous adult Nigerian population","volume":"18","author":"Okonkwo","year":"2015","journal-title":"Niger. J. Clin. Pract."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1016\/j.clinbiochem.2013.05.061","article-title":"Reference intervals for serum creatinine levels in the healthy geriatric population","volume":"46","author":"Huang","year":"2013","journal-title":"Clin. Biochem."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/S0026-0495(97)90248-1","article-title":"Cortisol and estradiol: Nongenetic factors for hyperhomocyst(e)inemia","volume":"46","author":"Kim","year":"1997","journal-title":"MetaboLism"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.arcmed.2007.07.009","article-title":"The 677 C\/T MTHFR polymorphism is associated with essential hypertension, coronary artery disease, and higher homocysteine levels","volume":"39","author":"Ilhan","year":"2008","journal-title":"Arch. Med. Res."},{"key":"ref_34","first-page":"254","article-title":"The correlation analysis of total homocysteine level and methylene tetrahydrofolate reductase gene polymorphism with other risk factors in patients of acute coronary syndrome","volume":"28","author":"Yin","year":"2013","journal-title":"Chin. Circ. J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.3945\/ajcn.110.004671","article-title":"MTHFR 677C\u2192T genotype is associated with folate and homocysteine concentrations in a large, population-based, double-blind trial of folic acid supplementation","volume":"93","author":"Crider","year":"2011","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_36","first-page":"209","article-title":"Relationship between homocysteine level, 5,10-methylen-etetrahydrofolate reductase gene polymorphism with primary lower extremity deep venous thrombosis formation","volume":"29","author":"Zheng","year":"2014","journal-title":"Chin. Circulation J."},{"key":"ref_37","first-page":"6247","article-title":"Association of Homocysteine and its metabolic enzyme genes polymorphismswith essential hypertension in Xinjiang Kazakhs","volume":"14","author":"Wang","year":"2010","journal-title":"J. Clin. Rehabil. Tissue Eng. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/07315724.2003.10719270","article-title":"Folate: A key to opt-imizing health and reducing disease risk in the elderly","volume":"22","author":"Rampersaud","year":"2003","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_39","first-page":"365","article-title":"A comparative study of plasma level of folic acid between Kazakh and Han patients with hypertension","volume":"41","author":"Chen","year":"2012","journal-title":"Chongqing Med. J."},{"key":"ref_40","first-page":"250","article-title":"H type hypertension-hypertension with elevated homocysteine","volume":"33","author":"Luo","year":"2012","journal-title":"Adv. Cardiovasc. Dis."},{"key":"ref_41","first-page":"216","article-title":"Elevated blood pressure in healthy people with elevated Hcy epidemiological investigation","volume":"26","author":"Zhu","year":"2013","journal-title":"J. Radioimmanol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/12\/5\/5373\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T20:46:32Z","timestamp":1760215592000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/12\/5\/5373"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,5,19]]},"references-count":41,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2015,5]]}},"alternative-id":["ijerph120505373"],"URL":"https:\/\/doi.org\/10.3390\/ijerph120505373","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,5,19]]}}}