Jacob N, Bruckert E, Giral P, Foglietti M J, Turpin G
Laboratory of Biochemistry C, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Atherosclerosis. 1999 Sep;146(1):53-9. doi: 10.1016/s0021-9150(99)00128-8.
Several studies have reported that moderate hyperhomocysteinemia is related to an increased risk for atherosclerosis, but few data are available with regard to any other thiol compound having a potential vascular toxicity. Therefore, we measured both total cysteine and homocysteine plasma levels in patients with hyperlipidemia (242 males and 147 females, 41-65 years old). Homocysteine was higher in males than in females, 13.2+/-4.1 versus 11.1+/-3.4 micromol/l (P<0.0001). The mean cysteine level was 243.3+/-45.7 micromol/l in the whole study population. The subjects were split in two groups, symptomatic patients with cardiovascular disease (n = 106) and asymptomatic subjects (n = 283). Blood pressure, smoking status, total cholesterol, LDL-cholesterol and triglycerides did not statistically differ between groups, but the mean HDL-cholesterol level was lower in symptomatic patients (1.24+/-0.38 versus 1.42+/-0.41, P<0.0001). Cysteine levels were higher in patients with cardiovascular disease than in asymptomatic patients, respectively 254.7+/-47.7 versus 239.1+/-44.3 micromol/l (P = 0.003). A similar result was found for homocysteine, respectively 13.1+/-4.3 versus 12.2+/-3.9 micromol/l (P = 0.05). To analyse whether cysteine levels were related to atherosclerosis independently of age, adjusted levels were compared between asymptomatic patients with normal carotid arteries (n = 176), carotid atherosclerosis (n = 107) and symptomatic patients (n = 106). Age adjusted cysteine levels differed significantly between groups (P = 0.027) while the P-value was of borderline significance for homocysteine (P = 0.09). Odds ratios for having symptomatic cardiovascular disease were 1.81 (95% CI, 1.02-3.21) and 2.05 (95% CI, 1.16-3.60) for the mid and highest tertiles of cysteine using the lowest as the reference. After adjustment in a multivariate model including age, sex, and creatinine, the odds ratio for disease remained significant between the highest tertile versus the lowest (OR = 1.89). Adjusted odds ratios were found to be weaker when homocysteine tertiles were compared. Our data suggest that plasma total cysteine is a risk factor for atherosclerosis in hyperlipidemic patients.
多项研究报告称，中度高同型半胱氨酸血症与动脉粥样硬化风险增加有关，但关于其他具有潜在血管毒性的硫醇化合物的数据却很少。因此，我们测量了高脂血症患者（242名男性和147名女性，年龄在41 - 65岁之间）血浆中总半胱氨酸和同型半胱氨酸的水平。男性的同型半胱氨酸水平高于女性，分别为13.2±4.1与11.1±3.4微摩尔/升（P<0.0001）。在整个研究人群中，半胱氨酸的平均水平为243.3±45.7微摩尔/升。受试者被分为两组，有心血管疾病症状的患者（n = 106）和无症状受试者（n = 283）。两组之间的血压、吸烟状况、总胆固醇、低密度脂蛋白胆固醇和甘油三酯在统计学上无差异，但有症状患者的平均高密度脂蛋白胆固醇水平较低（1.24±0.38与1.42±0.41，P<0.0001）。心血管疾病患者的半胱氨酸水平高于无症状患者，分别为254.7±47.7与239.1±44.3微摩尔/升（P = 0.003）。同型半胱氨酸也有类似结果，分别为13.1±4.3与12.2±3.9微摩尔/升（P = 0.05）。为了分析半胱氨酸水平是否独立于年龄与动脉粥样硬化相关，我们比较了颈动脉正常的无症状患者（n = 176）、有颈动脉粥样硬化的患者（n = 107）和有症状患者（n = 106）之间的校正水平。年龄校正后的半胱氨酸水平在各组之间有显著差异（P = 0.027），而同型半胱氨酸的P值处于临界显著水平（P = 0.09）。以最低三分位数为参照，半胱氨酸处于中间和最高三分位数的患者发生有症状心血管疾病的比值比分别为1.81（95%置信区间，1.02 - 3.21）和2.05（95%置信区间，1.16 - 3.60）。在纳入年龄、性别和肌酐的多变量模型进行校正后，最高三分位数与最低三分位数相比，疾病的比值比仍然显著（OR = 1.89）。当比较同型半胱氨酸三分位数时，校正后的比值比则较弱。我们的数据表明，血浆总半胱氨酸是高脂血症患者动脉粥样硬化的一个风险因素。
