Guo Hangyuan, Lee Jong-Dae, Ueda Takanori, Cheng Jianfeng, Shan Jiang, Wang Jian'an
Department of Cardiology, Sir Run Run Shaw Hospital, Medical College, Zhejiang University, Hangzhou 310016, China.
Indian J Med Res. 2004 Jan;119(1):33-7.
BACKGROUND & OBJECTIVES: Many traditional independent risk factors such as diabetes mellitus, hypertension, hypercholesterolaemia, smoking, male sex, old age, etc., contribute to the development of coronary artery disease (CAD). Hyperhomocysteinaemia is an independent risk factor of CAD but the role of plasma homocysteine (Hcy) in high risk patients (> or = 3 risk factors) is not known. We investigated the role of plasma Hcy, folic acid, vitamin B12 in patients with high risk (> or = 3 risk factors) of CAD and effects of supplementation of folic acid in the patients with hyperhomocysteinaemia.
The plasma Hcy levels in 152 patients with > or = 3 risk factors of CAD and 136 patients with 1-2 risk factors and 48 individuals with no risk factors were measured using high performance liquid chromatography (HPLC) with fluorescence detection. Plasma folic acid and vitamin B12 levels were also measured in these patients with immunoassays. The patients with hyperhomocysteinaemia were treated with 5 mg of folic acid for 8 wk, and plasma levels of Hcy were measured after treatment.
The plasma Hcy level was significantly higher in the patients with > or = 3 risk factors of CAD than in those with 1-2 risk factors and controls. The plasma levels of folic acid and vitamin B12 were significantly lower in the patients with > or = 3 risk factors of CAD compared to those with 1-2 risk factors and controls. The Hcy levels in the patients with > or = 3 risk factors of CAD significantly reduced by 33.5 per cent after 8 wk folic acid administration.
INTERPRETATION & CONCLUSION: Plasma Hcy level was elevated significantly in patients with > or = 3 risk factors of CAD. Hyperhomocysteinaemia appears to play an important role in the pathogenesis of CAD. Folic acid supplementation may be useful in reducing plasma Hcy level in high risk patients with hyperhomocysteinaemia.
许多传统的独立危险因素，如糖尿病、高血压、高胆固醇血症、吸烟、男性、老年等，都与冠状动脉疾病（CAD）的发生有关。高同型半胱氨酸血症是CAD的一个独立危险因素，但血浆同型半胱氨酸（Hcy）在高危患者（≥3个危险因素）中的作用尚不清楚。我们研究了血浆Hcy、叶酸、维生素B12在CAD高危患者（≥3个危险因素）中的作用，以及叶酸补充对高同型半胱氨酸血症患者的影响。
采用高效液相色谱法（HPLC）结合荧光检测，测定152例CAD危险因素≥3个的患者、136例有1 - 2个危险因素的患者和48例无危险因素个体的血浆Hcy水平。同时采用免疫分析法测定这些患者的血浆叶酸和维生素B12水平。对高同型半胱氨酸血症患者给予5mg叶酸治疗8周，治疗后测定血浆Hcy水平。
CAD危险因素≥3个的患者血浆Hcy水平显著高于有1 - 2个危险因素的患者和对照组。与有1 - 2个危险因素的患者和对照组相比，CAD危险因素≥3个的患者血浆叶酸和维生素B12水平显著降低。给予叶酸治疗8周后，CAD危险因素≥3个的患者Hcy水平显著降低了33.5%。
CAD危险因素≥3个的患者血浆Hcy水平显著升高。高同型半胱氨酸血症似乎在CAD的发病机制中起重要作用。补充叶酸可能有助于降低高同型半胱氨酸血症高危患者的血浆Hcy水平。
