Association of Serum Homocysteine with Peripheral Arterial Disease in Non-Diabetic Patients: A Study Based on National Health and Nutrition Examination Survey Database.

To investigate association of serum homocysteine (Hcy) levels with peripheral arterial disease (PAD) in non-diabetic patients based on data from National Health and Nutrition Examination Survey (NHANES). The study utilized data from three survey cycles (1999-2004) in NHANES database as the research dataset. Serum Hcy levels were considered as independent variable, while PAD was dependent variable. Weighted logistic regression and restricted cubic spline (RCS) methods were used to explore the relationship between Hcy level and PAD risk in non-diabetic patients. A total of 4,819 samples were included. In the weighted logistics regression model, a significant positive association was observed between Hcy levels and the risk of PAD (OR>1, p<0.05). Subgroup analysis results indicated a particularly significant association between Hcy levels and PAD risk in the elderly population (age≥60), those with a history of smoking, and individuals without a history of myocardial infarction (all OR>1, p<0.05) (p<0.05). Exploring the non-linear association between Hcy levels and PAD risk through RCS curves revealed an overall significant trend (P-allover <0.05). In conclusion, elevated Hcy levels increased the risk of PAD, with a more pronounced effect observed in non-diabetic patient populations, especially among older individuals (age ≥60), those with smoking history, and those without a history of MI.