[风湿性疾病中高同型半胱氨酸血症的临床研究]

[A clinical study of hyperhomocysteinemia in rheumatological diseases].

作者信息

Xu Xiao-yan, Zhou Wei-hua, Xiao Chuan-shi, Li Xiao-feng, Wang Lai-yuan

机构信息

Department of Rheumatology, Zhongda Hospital of Southeast University, Nanjing, Jangsu 210009, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2005 Feb;44(2):111-4.

PMID:15840222

Abstract

OBJECTIVE

To analysis plasma homocysteine (Hcy) level and some relative factors in some rheumatological diseases.

METHODS

54 cases with systemic lupus erythematosus (SLE), 48 cases with rheumatoid arthritis (RA), 60 cases with ankylosing spondylitis (AS), 30 cases with undifferentiated spondyloarthropathy (uSpA) and 62 controls were recruited to participate the study. Plasma Hcy, vitamin B(12), folate and the MTHFR gene C677T polymorphism were measured in all patients and controls.

RESULTS

(1) Plasma Hcy levels were higher significantly in all disease groups than in the controls, the mean plasma Hcy level was (19.04 +/- 6.86) micromol/L for SLE, (19.07 +/- 7.43) micromol/L for RA, (16.47 +/- 6.50) micromol/L for AS, (16.59 +/- 6.72) micromol/L for uSpA and (12.24 +/- 3.58) micromol/L for controls (P < 0.01). (2) Significant inverse correlation was found between plasma Hcy level and vitamin B(12), folate (r = -0.701, -0.443, respectively; P < 0.01). (3) The MTHFR gene mutation make Hcy level dramatically rise, CC genotype (13.41 +/- 5.78) micromol/L, CT genotype (16.81 +/- 4.22) micromol/L, TT genotype (20.88 +/- 6.60) micromol/L (P < 0.05). TT genotype is susceptible for hyperhomocysteinemia and SLE (OR = 84.46, 7.56 respectively; P < 0.05).

CONCLUSIONS

(1) Hyperhomocysteinemia is found in most SLE, RA, AS and uSpA patients. (2) There are lots of factors associated with Hcy concentration, such as folate, vitamin B12 and MTHFR gene mutation. (3) TT genotype of MTHFR is susceptible for hyperhomocysteinemia and SLE.

摘要

目的

分析某些风湿性疾病患者的血浆同型半胱氨酸（Hcy）水平及一些相关因素。

方法

招募54例系统性红斑狼疮（SLE）患者、48例类风湿关节炎（RA）患者、60例强直性脊柱炎（AS）患者、30例未分化脊柱关节病（uSpA）患者及62名对照者参与研究。检测所有患者及对照者的血浆Hcy、维生素B12、叶酸水平及亚甲基四氢叶酸还原酶（MTHFR）基因C677T多态性。

结果

（1）所有疾病组患者的血浆Hcy水平均显著高于对照组，SLE患者血浆Hcy平均水平为（19.04±6.86）μmol/L，RA患者为（19.07±7.43）μmol/L，AS患者为（16.47±6.50）μmol/L，uSpA患者为（16.59±6.72）μmol/L，对照组为（12.24±3.58）μmol/L（P<0.01）。（2）血浆Hcy水平与维生素B12、叶酸呈显著负相关（r分别为-0.701、-0.443；P<0.01）。（3）MTHFR基因突变使Hcy水平显著升高，CC基因型为（13.41±5.78）μmol/L，CT基因型为（16.81±4.22）μmol/L，TT基因型为（20.88±6.60）μmol/L（P<0.05）。TT基因型易患高同型半胱氨酸血症及SLE（OR分别为84.46、7.56；P<0.05）。