Kiseljaković Emina, Valjevac Amina, Hasić Sabaheta, Nakas-Ićindić Emina, Dzubur Alen, Jadrić Radivoj
Department of Medical Biochemistry, Medical Faculty, University of Sarajevo, Bosnia and Herzegovina.
Med Glas (Zenica). 2011 Feb;8(1):126-33.
To assess the association between total homocysteine (tHcy) and traditional and nontraditional risk factors in patients with atherosclerotic vascular disease (ASVD).
This cross-sectional study included 99 ASVD patients and 40 control subjects in whom we determined lipid profile, high sensitivity C-reactive protein (hsCRP), uric acid (UA) and tHcy.
The median tHcy concentration was significantly higher in ASVD group compared to the controls ((18.7(13.65-24.45) vs. 11.48 (10.03-14.2) micromol/L (p < 0.001)). Mean serum cholesterol, low-density lipoprotein cholesterol levels (LDLc) and atherogenic index were significantly lower, while mean serum UA concentration was significantly higher in hyperhomocysteinemic compared to normohomocysteinemic ASVD patients and control subjects. In hyperhomocysteinemic ASVD patients a significant negative correlation between serum logtHcy and cholesterol (r = -0.32), LDLc (r = -0.24), very-low-density lipoprotein cholesterol (VLDLc) (r = -0.295) and atherogenic index (r = -0.25) was observed. In normo-homocysteinemic ASVD patients serum logtHcy was significantly positively correlated with UA (r = 0.46) and hsCRP (r = 0.383). Multivariate linear regression analysis revealed that serum logtHcy was independently positively associated only with UA in normohomocysteinemic ASVD patients.
The results of our study have shown that the association between tHcy and traditional and non-traditional risk factors depends on tHcy serum level. It was observed a negative association between serum tHcy and lipids in hyperhomocysteinemic ASVD patients. On the other hand, in ASVD patients with serum tHcy levels within the reference range a positive independent association between serum tHcy and UA might reflect an underlying elevated tension of redox stress.
评估动脉粥样硬化性血管疾病（ASVD）患者总同型半胱氨酸（tHcy）与传统及非传统危险因素之间的关联。
这项横断面研究纳入了99例ASVD患者和40例对照受试者，测定了他们的血脂谱、高敏C反应蛋白（hsCRP）、尿酸（UA）和tHcy。
与对照组相比，ASVD组的tHcy浓度中位数显著更高（（18.7（13.65 - 24.45）对11.48（10.03 - 14.2）微摩尔/升，p < 0.001））。与正常同型半胱氨酸血症的ASVD患者及对照受试者相比，高同型半胱氨酸血症患者的平均血清胆固醇、低密度脂蛋白胆固醇水平（LDLc）和致动脉粥样硬化指数显著更低，而平均血清UA浓度显著更高。在高同型半胱氨酸血症的ASVD患者中，观察到血清logtHcy与胆固醇（r = -0.32）、LDLc（r = -0.24）、极低密度脂蛋白胆固醇（VLDLc）（r = -0.295）和致动脉粥样硬化指数（r = -0.25）之间存在显著负相关。在正常同型半胱氨酸血症的ASVD患者中，血清logtHcy与UA（r = 0.46）和hsCRP（r = 0.383）显著正相关。多变量线性回归分析显示，在正常同型半胱氨酸血症的ASVD患者中，血清logtHcy仅与UA独立正相关。
我们的研究结果表明，tHcy与传统及非传统危险因素之间的关联取决于血清tHcy水平。在高同型半胱氨酸血症的ASVD患者中，观察到血清tHcy与血脂之间存在负相关。另一方面，在血清tHcy水平在参考范围内的ASVD患者中，血清tHcy与UA之间的正独立关联可能反映了氧化还原应激潜在的升高张力。
