慢性阻塞性肺疾病（COPD）患者血浆同型半胱氨酸水平升高，且与COPD严重程度相关。
Plasma homocysteine is elevated in COPD patients and is related to COPD severity.
作者信息
Seemungal Terence A R, Lun Johanna Cho Fook, Davis Gershwin, Neblett Carlos, Chinyepi Nkhabe, Dookhan Christina, Drakes Samantha, Mandeville Elizabeth, Nana Fatima, Setlhake Seatshogeng, King Celia Poon, Pinto Pereira Lexley, Delisle Jerome, Wilkinson Thomas M A, Wedzicha Jagwiga A
机构信息
Department of Clinical Medical Sciences, University of the West Indies, St Augustine Campus, Trinidad and Tobago.
出版信息
Int J Chron Obstruct Pulmon Dis. 2007;2(3):313-21. doi: 10.2147/copd.s2147.
BACKGROUND
Although recent studies have found that total plasma homocysteine (tHCY) and chronic obstructive pulmonary disease (COPD) are both risk factors for cardiac disease, there have been few studies of plasma homocysteine levels in COPD patients. We tested the hypothesis that total plasma homocysteine (tHCY) would be elevated in patients diagnosed with COPD compared with controls.
METHODS
We studied 29 COPD outpatients and 25 asymptomatic subjects (controls) over age 55 years with measurement of forced expiratory volume in one second (FEV1), forced vital capacity (FVC), St. Georges Respiratory Questionnaire (SGRQ) score, tHCY and serum C-reactive protein (sCRP).
RESULTS
There was no difference between controls vs. COPD patients in mean age or gender but mean (SD) FEV1 was 2.25 (0.77) vs. 1.43 (0.60) L; FEV1% predicted 76.1 (17.2) vs. 49.1 (16.3) p < 0.001 in both cases. Median (IQR) tHCY was 8.22 (6.63, 9.55) in controls vs. 10.96 (7.56, 13.60) micromol/l for COPD, p = 0.006 and sCRP 0.89 (0.47, 2.55) vs. 2.05 (0.86, 6.19) mg/l, p = 0.023. tHCY(log) was also higher in (r, p) smokers (0.448, 0.001), patients with low FEV1% (-0.397, 0.003), males (0.475, < 0.001), but high SGRQ Total score (0.289, 0.034), and high sCRP (0.316, 0.038). tHCY(log) was independently related to (regression coefficient, p) sCRP(log) (0.087, 0.024), male gender (0.345, < 0.001) and presence of COPD (0.194, 0.031). Median (IQR) tHCY GOLD Stage I and II 8.05 (7.28, 11.04), GOLD Stage III and IV: 11.83 (9.30, 18.30); p = 0.023.
CONCLUSIONS
Plasma homocysteine is significantly elevated in COPD patients relative to age and sex-matched controls and is related to serum CRP and COPD severity.
背景
尽管近期研究发现血浆总同型半胱氨酸（tHCY）和慢性阻塞性肺疾病（COPD）均为心脏病的危险因素，但针对COPD患者血浆同型半胱氨酸水平的研究较少。我们检验了如下假设：与对照组相比，被诊断为COPD的患者血浆总同型半胱氨酸（tHCY）会升高。
方法
我们研究了29例COPD门诊患者和25名55岁以上无症状受试者（对照组），测量了一秒用力呼气容积（FEV1）、用力肺活量（FVC）、圣乔治呼吸问卷（SGRQ）评分、tHCY和血清C反应蛋白（sCRP）。
结果
对照组与COPD患者在平均年龄或性别上无差异，但平均（标准差）FEV1分别为2.25（0.77）L和1.43（0.60）L；FEV1%预计值分别为76.1（17.2）和49.1（16.3），两种情况均p<0.001。对照组的tHCY中位数（四分位间距）为8.22（6.63，9.55），COPD患者为10.96（7.56，13.60）微摩尔/升，p = 0.006；sCRP分别为0.89（0.47，2.55）和2.05（0.86，6.19）毫克/升，p = 0.023。tHCY（对数）在（相关系数，p值）吸烟者（0.448，0.001）、FEV1%低的患者（-0.397，0.003）、男性（0.475，<0.001）、SGRQ总分高的患者（0.289，0.034）以及sCRP高的患者（0.316，0.038）中也较高。tHCY（对数）与（回归系数，p值）sCRP（对数）（0.087，0.024）、男性性别（0.345，<0.001）以及COPD的存在（0.194，0.031）独立相关。tHCY中位数（四分位间距）在GOLD I期和II期为8.05（7.28，11.04），GOLD III期和IV期为11.83（9.30，18.30）；p = 0.023。
结论
相对于年龄和性别匹配的对照组，COPD患者的血浆同型半胱氨酸显著升高，且与血清CRP及COPD严重程度相关。
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