Martin S C, Rauz S, Marr J E, Martin N, Jones A F, Dodson P M
Department of Biochemistry, Birmingham Heartlands Hospital, UK.
Eye (Lond). 2000 Aug;14 ( Pt 4):590-3. doi: 10.1038/eye.2000.148.
Hyperhomocysteinaemia has been linked to macrovascular disease. Our aim was to investigate whether there is a relationship between fasting plasma total homocysteine levels and retinal vascular disease.
We measured the homocysteine levels in 70 patients with arterial or venous retinal vessel occlusion and compared them with the levels in 85 controls without evidence of ischaemic heart disease. Homocysteine levels were determined by high-performance liquid chromatography with electrochemical detection and compared after logarithmic transformation.
Homocysteine levels were found by univariate analysis (unpaired two-tailed t-test) to be significantly higher in the group with retinal artery occlusion than the group with retinal vein occlusion (p = 0.045) and in both groups compared with controls (18.4 and 13.8 vs 9.5 mumol/l; p = 0.0002 and < 0.0001, respectively). The controls, however, were significantly younger than the subjects (51.5 +/- 15.4 vs 66.2 +/- 11.9 years; p < 0.0001), but analysis of the results by age revealed significant differences between the groups and controls for the seventh decade (vein occlusions, p = 0.05) and for the eighth decade (artery occlusions, p = 0.037). Subgroup analysis of the retinal vessel occlusion group revealed significant differences in mean blood pressure between those with branch retinal vein occlusions (175/100 mmHg) and both those with central retinal vein occlusions (155/88 mmHg) and those with retinal artery occlusions (157/86 mmHg). Both vein occlusion subgroups also differed significantly with regard to homocysteine levels, branch < central (12.2 +/- 1.3 vs 15.0 +/- 1.6 mumol/l, p = 0.03). Multiple linear regression analysis revealed significant relationships between homocysteine levels and the presence of retinal vessel occlusion (p = 0.0002), serum creatinine (p = 0.001) and age (p = 0.003), but not gender.
We conclude that homocysteine may be a risk factor for retinal vascular disease and could be simply and cheaply treated with folate and vitamins B6 and B12.
高同型半胱氨酸血症与大血管疾病有关。我们的目的是研究空腹血浆总同型半胱氨酸水平与视网膜血管疾病之间是否存在关联。
我们测量了70例动脉或静脉视网膜血管阻塞患者的同型半胱氨酸水平，并将其与85例无缺血性心脏病证据的对照组患者的水平进行比较。同型半胱氨酸水平通过高效液相色谱电化学检测法测定，并在对数转换后进行比较。
单因素分析（未配对双尾t检验）发现，视网膜动脉阻塞组的同型半胱氨酸水平显著高于视网膜静脉阻塞组（p = 0.045），且两组与对照组相比均显著升高（分别为18.4和13.8 vs 9.5 μmol/L；p = 0.0002和<0.0001）。然而，对照组明显比受试者年轻（51.5±15.4 vs 66.2±11.9岁；p <0.0001），但按年龄对结果进行分析发现，在第七个十年（静脉阻塞，p = 0.05）和第八个十年（动脉阻塞，p = 0.037）时，各研究组与对照组之间存在显著差异。视网膜血管阻塞组的亚组分析显示，视网膜分支静脉阻塞患者（175/100 mmHg）与视网膜中央静脉阻塞患者（155/88 mmHg）和视网膜动脉阻塞患者（157/86 mmHg）的平均血压存在显著差异。两个静脉阻塞亚组在同型半胱氨酸水平方面也存在显著差异，分支<中央（12.2±1.3 vs 15.0±1.6 μmol/L，p = 0.03）。多元线性回归分析显示，同型半胱氨酸水平与视网膜血管阻塞的存在（p = 0.0002）、血清肌酐（p = 0.001）和年龄（p = 0.003）之间存在显著关系，但与性别无关。
我们得出结论，同型半胱氨酸可能是视网膜血管疾病的一个危险因素，并且可以通过叶酸、维生素B6和B12进行简单且低成本的治疗。
