Kazemi M B Sharif, Eshraghian K, Omrani G R, Lankarani K Bagheri, Hosseini E
Department of Internal Medicine Shiraz University of Medical Sciences, Shiraz, Iran.
Angiology. 2006 Jan-Feb;57(1):9-14. doi: 10.1177/000331970605700102.
Atherosclerosis, and its most common manifestation, coronary artery disease (CAD), are rather common causes of morbidity and mortality worldwide. Recognition of its various risk factors is important to planning effective preventive measures. After the homocysteine theory was presented in 1969, attention has been directed toward the serum homocysteine level as a coronary artery disease risk factor. The authors aimed to assess the relationship between hyperhomocysteinemia and CAD in an Iranian population. In a case control study, 197 individuals (male: 123 [62.4%]) who were scheduled for coronary angiography were selected. Venous samples were taken from the patients in fasting state before angiography. Data about age, sex, risk factors (eg, hypertension, diabetes, smoking, hyperlipidemia, obesity) were obtained from prepared questionnaires. Homocysteine levels in patients were measured by ELISA method. A homocysteine level above 15 mumol/liter was considered high. Angiography reports and homocysteine levels were analyzed by independent sample t test, one-way ANOVA, multiple linear regression, and stratified analysis. In comparison with the patients with normal angiography reports (32.5%), patients with abnormal angiography reports (67.5%) had increased levels of homocysteine (p = 0.001). About 28.1% of patients with normal angiography reports had hyperhomocysteinemia. After further evaluation, linear correlations were detected between the numbers of involved vessels and homocysteine level (p = 0.000). Multiple linear regression analysis of data detected that in individuals without any risk factors, the relationship was stronger and more meaningful (p = 0.000). These data show that hyperhomocysteinemia is related to CAD as an independent risk factor. In individuals without any risk factors a linear correlation between homocysteine level and numbers of coronary artery involvement was present. If this equation is confirmed prospectively in other studies, the level of plasma homocysteine may he used as a noninvasive way of predicting the number of diseased coronary arteries.
动脉粥样硬化及其最常见的表现形式——冠状动脉疾病（CAD），是全球范围内发病率和死亡率相当常见的原因。识别其各种风险因素对于制定有效的预防措施至关重要。自1969年同型半胱氨酸理论提出后，血清同型半胱氨酸水平作为冠状动脉疾病的一个风险因素受到了关注。作者旨在评估伊朗人群中高同型半胱氨酸血症与CAD之间的关系。在一项病例对照研究中，选取了197名计划进行冠状动脉造影的个体（男性：123名[62.4%]）。在造影前空腹状态下从患者采集静脉样本。通过已准备好的问卷获取有关年龄、性别、风险因素（如高血压、糖尿病、吸烟、高脂血症、肥胖）的数据。采用酶联免疫吸附测定（ELISA）法测量患者的同型半胱氨酸水平。同型半胱氨酸水平高于15微摩尔/升被视为升高。通过独立样本t检验、单因素方差分析、多元线性回归和分层分析对造影报告和同型半胱氨酸水平进行分析。与造影报告正常的患者（32.5%）相比，造影报告异常的患者（67.5%）同型半胱氨酸水平升高（p = 0.001）。造影报告正常的患者中约28.1%有高同型半胱氨酸血症。进一步评估后，检测到受累血管数量与同型半胱氨酸水平之间存在线性相关性（p = 0.000）。对数据进行多元线性回归分析发现，在没有任何风险因素的个体中，这种关系更强且更有意义（p = 0.000）。这些数据表明，高同型半胱氨酸血症作为一个独立风险因素与CAD相关。在没有任何风险因素的个体中，同型半胱氨酸水平与冠状动脉受累数量之间存在线性相关性。如果这一关系在其他研究中得到前瞻性证实，血浆同型半胱氨酸水平可能会被用作预测病变冠状动脉数量的一种非侵入性方法。
