BACKGROUND: Cardiovascular risk and plasma total @entity1255 (tHcy) are high in @entity1 with @entity177 . High tHcy may account for a substantial part of the increased risk. We assessed mediation by tHcy of the association of estimated glomerular filtration rate ( @entity470 CKD/EPI) with carotid total plaque area (TPA) and @entity543 . METHODS: TPA and @entity543 were measured by ultrasound. Multiple linear regression was used to assess the effects of @entity470 and/or tHcy after adjustment for age, sex, systolic blood pressure (SBP), smoking, LDL, HDL and weight. RESULTS: Complete data were available for 1967 @entity1 . @entity470 decreased, and TPA and total @entity850 increased linearly with age. After adjustment [age, sex, SBP, smoking (in pack years), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and weight], @entity470 and tHcy were independently associated with TPA (P < 0.01), but when both were added to the model, their significance was attenuated (P = 0.06 for @entity470 , 0.03 for tHcy). Mediation analysis showed that tHcy seems to contribute to a significant mediation of the association of @entity470 with TPA but not @entity850 ; after adjustment for the set of risk factors listed above, tHcy still demonstrated significant mediation on TPA (P = 0.03), but not on @entity850 (P = 0.16). CONCLUSIONS: tHcy accounts for a significant part, but not all of the effect of @entity8 on @entity731 . Other uremic toxins including metabolic products of the intestinal microbiome may explain residual effects of @entity177 on @entity731 . Therapeutic approaches arising from that hypothesis are discussed.

Effect of @entity8 on @entity731 : only partially mediated by XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity8 :: ('MESH:D007674', 'Disease') :: ['renal impairment'] @entity1255 :: ('MESH:D006710', 'Chemical') :: ['homocysteine'] @entity470 :: ('1956', 'Gene') :: ['eGFR'] @entity177 :: ('MESH:D051437', 'Disease') :: ['renal failure'] @entity731 :: ('MESH:D050197', 'Disease') :: ['atherosclerosis'] @entity850 :: ('MESH:D003251', 'Disease') :: ['stenosis'] @entity543 :: ('MESH:D016893', 'Disease') :: ['carotid stenosis']
@entity1255 :: (MESH:D006710,Chemical) :: ['homocysteine']
