Gauthier Gregory M, Keevil Jon G, McBride Patrick E
Department of Medicine, University of Wisconsin Hospital and Clinics, Madison, Wisconsin 53792, USA.
Clin Cardiol. 2003 Dec;26(12):563-8. doi: 10.1002/clc.4960261204.
Hyperhomocysteinemia has been associated with increased risk of atherosclerosis and myocardial infarction by a number of prospective case-control studies. A variety of genetic mutations, nutritional deficiencies, disease states, and drugs can elevate homocysteine concentrations. Treatment with folic acid with or without B-complex vitamins effectively lowers homocysteine levels. Whether therapy corresponds with decreased risk of coronary events is unknown, but may be promising. This article reviews the biochemistry of homocysteine metabolism, pathogeneisis, and etiology of hyperhomocysteinemia, along with its association with coronary artery disease, screening, and treatment.
多项前瞻性病例对照研究表明，高同型半胱氨酸血症与动脉粥样硬化和心肌梗死风险增加有关。多种基因突变、营养缺乏、疾病状态和药物均可使同型半胱氨酸浓度升高。使用叶酸加或不加复合维生素B进行治疗可有效降低同型半胱氨酸水平。治疗是否与降低冠状动脉事件风险相关尚不清楚，但可能很有前景。本文综述了同型半胱氨酸代谢的生物化学、高同型半胱氨酸血症的发病机制和病因，以及它与冠状动脉疾病、筛查和治疗的关系。
