ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition and Metabolism
Elevated homocysteine predicts impaired liver and renal function in women of reproductive age with polycystic ovary syndrome: a post hoc analysis of a randomized controlled trial
Provisionally accepted
- 1Zhejiang Chinese Medical University, Hangzhou, China
- 2Heilongjiang University of Chinese Medicine, Harbin, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background Polycystic ovary syndrome (PCOS) has been associated with liver and kidney injury. Homocysteine (Hcy) may be a link between liver/kidney health and PCOS. This research aims to evaluate the relationship between serum Hcy levels and indicators of liver/renal function in women of reproductive age with PCOS. Methods A post hoc analysis of a randomized controlled trial is performed in this study. A total of 1000 women diagnosed with PCOS were enrolled from secondary and tertiary hospitals in China. Demographic information, metabolic factors, sex hormones, parameters of liver/renal function, and Hcy were determined at baseline. Women with an Hcy level >15 µmol/L were diagnosed with hyperhomocysteinemia (HHcy). Parameters associated with liver function were aspartate transferase (AST), alanine transferase (ALT), bilirubin, and total bile acid, while indicators of renal function were blood urea nitrogen (BUN), creatinine (CREA), cystatin C, and β2 microglobulin. Renal function was also assessed by glomerular filtration rates (eGFR). Results Of the 938 PCOS women with available data, 149 (15.9%) were diagnosed with HHcy, while 789 (84.1%) had normal Hcy levels. Compared with the normal Hcy group, the HHcy group had increased AST (12.5 vs. 15.7, P<0.001), ALT (8.7 vs. 10.3, P=0.041), indirect bilirubin (4.2 vs. 4.7, P=0.013), CREA (41.8 vs. 48.7, P<0.001), BUN (4.3 vs. 4.7, P<0.001), β2 microglobulin (1.3 vs. 1.5, P<0.001), and cystatin C (0.4 vs. 0.6, P<0.001) levels, as well as lower eGFR (120.9 vs. 127.7, P<0.001). The levels of AST, ALT, CREA, and BUN were significantly increased in all Hcy quartiles, while eGFR was decreased across Hcy quartiles (P for trend <0.05). After adjustments for BMI, waist circumference, glucose, TC, and HDL, Hcy levels were positively associated with AST (β=0.268, P<0.001), total bilirubin (β=0.127, P<0.001), direct bilirubin (β=0.038, P=0.002), indirect bilirubin (β=0.087, P<0.001), total bile acid (β=0.051, P=0.015), CREA (β=0.812, P<0.001), BUN (β=0.051, P<0.001), β2 microglobulin (β=0.026, P<0.001), cystatin C (β=0.013, P<0.001), and eGFR (β=-0.810, P<0.001), but were not associated with ALT (β=0.051, P=0.381) after adjustment for confounding factors. Conclusions Elevated Hcy levels are significantly associated with indicators of impaired liver and renal function in women of reproductive age with PCOS.
Keywords: Homocysteine, Liver function, Renal function, pcos, randomized controlled trial
Received: 19 Aug 2025; Accepted: 31 Oct 2025.
Copyright: © 2025 Luo, Cai and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiao-Ke Wu, xiaokewu2002@vip.sina.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.