Anan Futoshi, Masaki Takayuki, Tatsukawa Hiroshi, Nagano Shuji, Oribe Motohiro, Eshima Nobuoki, Saikawa Tetsunori, Yoshimatsu Hironobu
Department of Cardiology, Oita Red Cross Hospital, Oita 870-0033, Japan.
Metabolism. 2009 Jan;58(1):69-73. doi: 10.1016/j.metabol.2008.08.008.
The presence of white matter lesions (WML) is an important prognostic factor for the development of stroke. Plasma total homocysteine (tHcy), which increases with diabetes, has been flagged as a novel predictor for cerebrovascular events. We tested the hypothesis that the presence of WML correlates with tHcy in rheumatoid arthritis patients. Based on brain magnetic resonance imaging findings, 65 rheumatoid arthritis patients were divided into 2 groups: WML-positive group (61 +/- 6 years, mean +/- SD; n = 25) and WML-negative group (60 +/- 7 years, n = 40). The level of metabolic parameters was assessed by total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting plasma glucose, and homocysteine (tHcy). The duration of rheumatoid arthritis was longer in the WML-positive group than in the WML-negative group (P < .05). Plasma levels of triglyceride was higher whereas high-density lipoprotein cholesterol was lower in the WML-positive group than in the WML-negative group (P < .05 and P < .01, respectively). Fasting plasma glucose (P < .05) and tHcy (<.0001) levels were higher in the WML-positive group than in the WML-negative group. Multivariate logistic analysis revealed that WML was independently predicted by the tHcy (odds ratio, 1.35; 95% confidence interval, 1.12-1.63; P < .0001). Our findings indicate that the presence of WML was associated with the tHcy in Japanese patients with rheumatoid arthritis.
白质病变（WML）的存在是中风发生的一个重要预后因素。血浆总同型半胱氨酸（tHcy）水平会随糖尿病病情加重而升高，它已被视为脑血管事件的一个新的预测指标。我们检验了这样一个假设：类风湿关节炎患者中WML的存在与tHcy相关。根据脑磁共振成像结果，65例类风湿关节炎患者被分为两组：WML阳性组（61±6岁，均值±标准差；n = 25）和WML阴性组（60±7岁，n = 40）。通过总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、空腹血糖和同型半胱氨酸（tHcy）来评估代谢参数水平。WML阳性组的类风湿关节炎病程比WML阴性组长（P < 0.05）。WML阳性组的血浆甘油三酯水平较高，而高密度脂蛋白胆固醇水平较低，与WML阴性组相比差异有统计学意义（分别为P < 0.05和P < 0.01）。WML阳性组的空腹血糖（P < 0.05）和tHcy（P < 0.0001）水平高于WML阴性组。多因素逻辑回归分析显示，tHcy可独立预测WML的存在（比值比，1.35；95%置信区间，1.12 - 1.63；P < 0.0001）。我们的研究结果表明，在日本类风湿关节炎患者中，WML的存在与tHcy有关。
