Handy Diane E, Loscalzo Joseph
Whitaker Cardiovascular Institute, Boston University School of Medicine, 715 Albany Street, Boston, MA 02118, USA.
Curr Atheroscler Rep. 2003 Jul;5(4):276-83. doi: 10.1007/s11883-003-0050-x.
Hyperhomocysteinemia has long been recognized as a risk factor for cardiovascular disease. Many cross-sectional and retrospective case-control studies have shown an association between elevated total homocysteine levels and coronary, peripheral, and cerebral vascular disease; prospective studies, however, have been inconsistent. Overall, there is evidence to suggest a modest association between elevated homocysteine levels and cardiovascular disease risk. Folate supplementation has been shown to reduce plasma homocysteine even when levels are in the normal range. Clinical studies suggest that lowering plasma homocysteine may improve endothelial dysfunction, a marker of atherothrombotic risk. The long-term effects of folate supplementation on homocysteine levels and cardiovascular disease risk await the results of ongoing clinical trials. However, several recent studies suggest a benefit for reduction of plasma homocysteine levels, as individuals with lower homocysteine have reduced cardiovascular event rates.
高同型半胱氨酸血症长期以来一直被认为是心血管疾病的一个危险因素。许多横断面研究和回顾性病例对照研究表明，总同型半胱氨酸水平升高与冠状动脉、外周血管和脑血管疾病之间存在关联；然而，前瞻性研究的结果并不一致。总体而言，有证据表明同型半胱氨酸水平升高与心血管疾病风险之间存在适度关联。即使同型半胱氨酸水平处于正常范围，补充叶酸也已被证明可降低血浆同型半胱氨酸水平。临床研究表明，降低血浆同型半胱氨酸水平可能改善内皮功能障碍，这是动脉粥样硬化血栓形成风险的一个标志物。补充叶酸对同型半胱氨酸水平和心血管疾病风险的长期影响有待正在进行的临床试验结果。然而，最近的几项研究表明，降低血浆同型半胱氨酸水平有益，因为同型半胱氨酸水平较低的个体心血管事件发生率降低。
