Garofolo L, Barros N, Miranda F, D'Almeida V, Cardien L C, Ferreira S R
Post-Graduation Course on Cardiac, Vascular and Thoracic Surgery, Surgery Department, Federal University of Sao Paulo, Sao Paulo, Brazil.
Eur J Vasc Endovasc Surg. 2007 Jul;34(1):23-8. doi: 10.1016/j.ejvs.2007.02.008. Epub 2007 May 7.
Our aim was to evaluate the possible association between homocysteine levels and peripheral arterial disease (PAD) in a population-based study of Japanese-Brazilians.
This cross-sectional study was derived from a population-based survey on the prevalence of diabetes and associated diseases conducted in Japanese-Brazilians. A total of 1330 male and female subjects aged>or=30 years were submitted to clinical examination and laboratory procedures including homocysteine measurement. The ankle-brachial index (ABI) was calculated; subjects with ABI values <0.9 were diagnosed with PAD. The evaluable population included 1008 subjects. Logistic regression was used taking PAD as the dependent variable.
Mean age of the population was 56.5 years and overall prevalence of PAD was 20%. A worse cardiovascular profile was found in male patients, including significantly higher homocysteine levels (11.9+/-1.8 vs. 9.1+/-1.1micromol/L, p<0.001). Men with PAD had higher prevalence rates of hyperhomocysteinemia compared to women (22.7% vs 7.6%). Univariate analysis showed an odds ratio of hyperhomocysteinemia for PAD of 1.51 [1.02-2.25] in men and 1.69 [1.06-2.68] in women. After adjustment for other cardiovascular risk factors, higher levels of homocysteine were only significantly related to PAD in men.
In a Japanese-Brazilian population, elevated levels of homocysteine are associated with PAD in men. Prospective studies are necessary to confirm this finding.
在一项针对日裔巴西人的基于人群的研究中，我们旨在评估同型半胱氨酸水平与外周动脉疾病（PAD）之间可能存在的关联。
这项横断面研究源自一项针对日裔巴西人进行的关于糖尿病及相关疾病患病率的基于人群的调查。共有1330名年龄≥30岁的男性和女性受试者接受了临床检查及包括同型半胱氨酸测量在内的实验室检测。计算踝臂指数（ABI）；ABI值<0.9的受试者被诊断为患有PAD。可评估人群包括1008名受试者。以PAD作为因变量，采用逻辑回归分析。
人群的平均年龄为56.5岁，PAD的总体患病率为20%。在男性患者中发现了更差的心血管状况，包括显著更高的同型半胱氨酸水平（11.9±1.8 vs. 9.1±1.1微摩尔/升，p<0.001）。与女性相比，患有PAD的男性高同型半胱氨酸血症的患病率更高（22.7%对7.6%）。单因素分析显示，男性中高同型半胱氨酸血症与PAD的比值比为1.51 [1.02 - 2.25]，女性为1.69 [1.06 - 2.68]。在对其他心血管危险因素进行调整后，仅在男性中，较高水平的同型半胱氨酸与PAD显著相关。
在日裔巴西人群中，同型半胱氨酸水平升高与男性的PAD相关。需要进行前瞻性研究来证实这一发现。
