Cavalca V, Cighetti G, Bamonti F, Loaldi A, Bortone L, Novembrino C, De Franceschi M, Belardinelli R, Guazzi M D
Istituto di Cardiologia, Università degli Studi di Milano, 20138 Milan, Italy.
Clin Chem. 2001 May;47(5):887-92.
Oxidative stress is present in cardiovascular diseases (CVDs), and hyperhomocysteinemia, an independent risk factor for these diseases, may play a role by inducing production of oxygen free radicals.
To evaluate the possible role of homocysteine (Hcy) in inducing oxidative stress in coronary artery disease (CAD), plasma Hcy was measured in 68 consecutive cardiovascular patients, and plasma malondialdehyde (MDA), both free and total (free + bound), was measured in 40 patients with CAD (18 with chronic stable angina and 22 with unstable angina). As controls, we tested 70 healthy volunteers. Hcy was measured by an immunoenzymatic method and MDA, an index of lipid peroxidation, by gas chromatography-mass spectrometry.
Plasma Hcy concentrations were significantly higher in cardiovascular patients than in controls (10.2 vs 8.9 micromol/L; P <0.0002), with no significant difference between values in the stable and unstable angina subgroups. Similarly, total MDA was significantly higher in the CAD group than in the controls (2.6 vs 1.3 micromol/L; P <0.00001), again with no significant difference between stable and unstable angina patients. By contrast, free MDA, which was significantly higher in the CAD patients than the controls (0.4 vs 0.2 micromol/L; P < 0.00001), was also significantly higher in the unstable than in the stable angina group (0.5 vs 0.3 micromol/L; P <0.03). However, no correlation was observed among Hcy and free and total MDA.
Our findings show that a moderate increase of Hcy is associated with CVD but that Hcy at the detected values cannot be considered completely responsible for oxidative damage. That lipid peroxidation is involved in CAD is shown by our observation of significantly increased plasma free and total MDA concentrations compared with controls. Moreover, free MDA values discriminated between unstable and chronic stable angina, and could thus represent a new diagnostic tool.
氧化应激存在于心血管疾病（CVDs）中，高同型半胱氨酸血症作为这些疾病的一个独立危险因素，可能通过诱导氧自由基的产生发挥作用。
为评估同型半胱氨酸（Hcy）在冠状动脉疾病（CAD）中诱导氧化应激的可能作用，对68例连续的心血管疾病患者测定血浆Hcy，并对40例CAD患者（18例慢性稳定型心绞痛患者和22例不稳定型心绞痛患者）测定血浆丙二醛（MDA），包括游离型和总型（游离型 + 结合型）。作为对照，检测了70名健康志愿者。采用免疫酶法测定Hcy，采用气相色谱 - 质谱法测定脂质过氧化指标MDA。
心血管疾病患者的血浆Hcy浓度显著高于对照组（10.2对8.9 μmol/L；P <0.0002），稳定型和不稳定型心绞痛亚组之间的值无显著差异。同样，CAD组的总MDA显著高于对照组（2.6对1.3 μmol/L；P <0.00001），稳定型和不稳定型心绞痛患者之间再次无显著差异。相比之下，CAD患者的游离MDA显著高于对照组（0.4对0.2 μmol/L；P <0.00001），在不稳定型心绞痛组中也显著高于稳定型心绞痛组（0.5对0.3 μmol/L；P <0.03）。然而，未观察到Hcy与游离型和总型MDA之间存在相关性。
我们的研究结果表明，Hcy的适度升高与CVD相关，但检测值的Hcy不能被认为完全是氧化损伤的原因。与对照组相比，我们观察到血浆游离型和总型MDA浓度显著升高，这表明脂质过氧化与CAD有关。此外，游离MDA值可区分不稳定型和慢性稳定型心绞痛，因此可能代表一种新的诊断工具。
