Moroz Paul, Le Max T Q, Norman Paul E
School of Surgery and Pathology, University of Western Australia, Fremantle Hospital, Perth, Western Australia, Australia.
ANZ J Surg. 2007 May;77(5):329-32. doi: 10.1111/j.1445-2197.2007.04052.x.
There is evidence to suggest that increased levels of homocysteine play a significant role in vascular disease. It has been suggested that lowering homocysteine levels by dietary folate supplementation may reduce the risk of stroke and coronary heart disease. It is plausible that homocysteine may also play a role in the pathogenesis of abdominal aortic aneurysms (AAA) and that patients with this disease may benefit from folate supplementation. Our objective was to review the published work with regard to the role of homocysteine in the pathogenesis of AAA. Searches were carried out in published work in English with the keywords 'abdominal aortic aneurysm' and 'homocysteine'. There is evidence from in vitro and animal model studies that activation of metalloproteinases by homocysteine can influence aortic wall structure. Several case-control studies report an association between increased levels of homocysteine and the presence of an AAA. There are conflicting genotypic data concerning the association between methylenetetrahydrofolate reductase gene variants and AAA. Although there is evidence for an association between homocysteine and AAA, it is not strong enough to conclude that it plays a causal role in the pathogenesis of AAA. Further research is needed, given the potential benefit that simple vitamin supplementation may have for patients with AAA.
有证据表明，同型半胱氨酸水平升高在血管疾病中起重要作用。有人提出，通过饮食补充叶酸降低同型半胱氨酸水平可能会降低中风和冠心病的风险。同型半胱氨酸也可能在腹主动脉瘤（AAA）的发病机制中起作用，并且患有这种疾病的患者可能会从叶酸补充中受益。我们的目的是回顾已发表的关于同型半胱氨酸在AAA发病机制中作用的研究。使用关键词“腹主动脉瘤”和“同型半胱氨酸”对已发表的英文研究进行了检索。体外和动物模型研究有证据表明，同型半胱氨酸激活金属蛋白酶可影响主动脉壁结构。几项病例对照研究报告了同型半胱氨酸水平升高与AAA存在之间的关联。关于亚甲基四氢叶酸还原酶基因变异与AAA之间的关联，存在相互矛盾的基因数据。虽然有证据表明同型半胱氨酸与AAA之间存在关联，但这种关联还不够强，不足以得出它在AAA发病机制中起因果作用的结论。鉴于简单的维生素补充可能对AAA患者有益，因此需要进一步研究。
