Ajabnoor Mohamed A, AL-Ama Mohamed N, Banjar Zainy, Rafee Adel A, Sheweita Salah A
Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Med Sci Monit. 2003 Dec;9(12):CR523-7.
Atherosclerosis is the main cause of cardiovascular morbidity and mortality in many countries. It is believed that hyperhomocysteinemia is a risk factor for premature atherosclerosis and other cardiovascular diseases (CVD) in both men and women.
MATERIAL/METHODS: Plasma samples from 31 non-CVD and 51 CVD patients with diabetes were studied. Informed consent was obtained from all subjects. Blood samples were collected after overnight fasting. Total homocysteine (H [e]), the levels of high and low density lipoproteins (HDL, LDL), total cholesterol, urea and creatinine were determined with commercial kits.
The levels of homocysteine, vitamin B12, creatinine, and urea in CVD patients were significantly higher than those found in the normal subjects. On the other hand, the levels of folic acid, HDL and LDL were lower in CVD patients than in normal subjects. Interestingly, a linear relationship was found between the levels of homocysteine and total cholesterol in CVD samples, whereas no such linear relationship was present in normal subjects.
The level of homocysteine in plasma is known to be mainly dependent on the levels of folic acid and vitamin B12. However, in the present study the level of homocysteine in the plasma of CVD patients is dependent on the level of folic acid and not on the level of vitamin B12. Subjects with high homocysteine levels should be advised to consume a folic acid-fortified diet in order to reduce the homocysteine level in patients at high risk for cardiovascular disease.
在许多国家，动脉粥样硬化是心血管疾病发病和死亡的主要原因。人们认为，高同型半胱氨酸血症是男性和女性过早发生动脉粥样硬化及其他心血管疾病（CVD）的一个危险因素。
材料/方法：对31名无心血管疾病的糖尿病患者和51名患有心血管疾病的糖尿病患者的血浆样本进行了研究。所有受试者均签署了知情同意书。空腹过夜后采集血样。使用商用试剂盒测定总同型半胱氨酸（H[e]）、高密度脂蛋白（HDL）和低密度脂蛋白（LDL）水平、总胆固醇、尿素和肌酐水平。
心血管疾病患者的同型半胱氨酸、维生素B12、肌酐和尿素水平显著高于正常受试者。另一方面，心血管疾病患者的叶酸、HDL和LDL水平低于正常受试者。有趣的是，在心血管疾病样本中发现同型半胱氨酸水平与总胆固醇水平之间存在线性关系，而在正常受试者中不存在这种线性关系。
已知血浆中同型半胱氨酸水平主要取决于叶酸和维生素B12水平。然而，在本研究中，心血管疾病患者血浆中的同型半胱氨酸水平取决于叶酸水平，而不取决于维生素B12水平。应建议同型半胱氨酸水平高的受试者食用富含叶酸的饮食，以降低心血管疾病高危患者的同型半胱氨酸水平。
