泰国患者血清同型半胱氨酸、叶酸和维生素B12浓度与冠状动脉疾病之间的关联。

Moleerergpoom Worachat, Sura Thunyachai, Sritara Piyamitr

Division of Cardiology, Police General Hospital, Bangkok, Thailand.

J Med Assoc Thai. 2004 Jun;87(6):674-8.

BACKGROUND

Hyperhomocysteinemia, associated with low folate and low B12 levels, is known to be an independent risk factor for atherosclerosis. Only a few available data has been demonstrated in Thai patients.

OBJECTIVE

To evaluate serum fasting homocysteine, folate and B12 levels whether to see they are associated with coronary artery disease (CAD).

METHOD AND RESULT

Three hundred and one consecutive suspected CAD patients who underwent coronary angiography at the Police General Hospital were studied. The mean age of the patients, 195 males and 106 females, was 63.0 +/- 10.0 year (range 39-85). A total of 218 patients were angiographically demonstrated as having CAD. The mean serum homocysteine level of CAD patients had a non significant higher level than those of 83 non CAD patients: 11.4 +/- 6.2 vs 10.2 +/- 4.2 umol/L, p = 0.06. Means of folate and B12 level in the CAD patients and non CAD patients were 6.6 +/- 4.6 vs 7.0 +/- 4.3 nmol/L, p = 0.49 and 650.9 +/- 415.4 vs 613.3 +/- 443.2 pmol/L, p = 0.56 respectively. No significant correlations were found between homocysteine with folate and B12 levels. Logistic regression analysis showed a significant association between homocysteine and CAD with OR = 1.08 (95%CI, 1.01-1.16), p = 0.03 after being adjusted for age, sex, DM, HT history of hyperlipidemia, smoking, BMI, folate and B12 levels. No significant association between homocysteine level with the number of coronary vessel stenosis, age, BMI, DM, HT smoking and history of hyperlipidemia was observed in the present study.

CONCLUSION

Hyperhomocyteinemia, but not folate and B12 levels, may be an independent risk factor for coronary artery disease in Thai patients.

背景

高同型半胱氨酸血症与低叶酸和低维生素B12水平相关，已知是动脉粥样硬化的独立危险因素。在泰国患者中仅有少数可用数据。

目的

评估血清空腹同型半胱氨酸、叶酸和维生素B12水平，看它们是否与冠状动脉疾病（CAD）相关。

方法与结果

对在警察总医院接受冠状动脉造影的301例连续疑似CAD患者进行研究。患者平均年龄为63.0±10.0岁（范围39 - 85岁），其中男性195例，女性106例。共有218例患者经血管造影证实患有CAD。CAD患者的平均血清同型半胱氨酸水平略高于83例非CAD患者，但差异无统计学意义：11.4±6.2 vs 10.2±4.2 μmol/L，p = 0.06。CAD患者和非CAD患者的叶酸和维生素B12水平平均值分别为6.6±4.6 vs 7.0±4.3 nmol/L，p = 0.49和650.9±415.4 vs 613.3±443.2 pmol/L，p = 0.56。同型半胱氨酸与叶酸和维生素B12水平之间未发现显著相关性。多因素logistic回归分析显示，在校正年龄、性别、糖尿病、高血压、高脂血症病史、吸烟、体重指数、叶酸和维生素B12水平后，同型半胱氨酸与CAD之间存在显著关联，OR = 1.08（95%CI，1.01 - 1.16），p = 0.03。本研究未观察到同型半胱氨酸水平与冠状动脉血管狭窄数量、年龄、体重指数、糖尿病、高血压、吸烟和高脂血症病史之间存在显著关联。