Clarke R, Stansbie D
Clinical Trial Service Unit, Nuffield Department of Clinical Medicine, Radcliffe Infirmary, Oxford, UK.
Ann Clin Biochem. 2001 Nov;38(Pt 6):624-32. doi: 10.1258/0004563011901046.
Elevated plasma total homocysteine concentrations are a marker of vitamin deficiency and a risk factor for cardiovascular disease. It is possible that vitamin supplementation with folic acid and other B vitamins, which lower plasma homocysteine concentrations, may reduce the risk of cardiovascular disease. Large-scale clinical trials are currently underway to assess the homocysteine hypothesis of cardiovascular disease. Pending the outcome of such trials, measurement of plasma homocysteine concentrations in people at high risk of cardiovascular disease may help to identify patients who could benefit from more intensive treatment of classical cardiovascular risk factors. The introduction of immunoassays for homocysteine determination has made assessment of homocysteine status accessible to most routine hospital laboratories, and this review summarizes the evidence on why and how to assess homocysteine as a risk factor for cardiovascular disease in clinical practice.
血浆总同型半胱氨酸浓度升高是维生素缺乏的一个标志，也是心血管疾病的一个危险因素。补充叶酸和其他B族维生素可降低血浆同型半胱氨酸浓度，有可能降低心血管疾病风险。目前正在进行大规模临床试验以评估心血管疾病的同型半胱氨酸假说。在此类试验结果出来之前，对心血管疾病高危人群的血浆同型半胱氨酸浓度进行检测，可能有助于识别那些能从强化治疗经典心血管危险因素中获益的患者。同型半胱氨酸测定免疫分析法的引入，使大多数常规医院实验室都能够评估同型半胱氨酸状态，本综述总结了在临床实践中为何以及如何将同型半胱氨酸评估为心血管疾病危险因素的证据。
