Thakre Tushar P, Mamtani Manju, Ujaoney Shweta, Kulkarni Hemant
Lata Medical Research Foundation, Nagpur, 440022, India ; Cleveland Clinic Sleep Disorders Center, Cleveland, OH 44195, USA.
Sleep Disord. 2012;2012:634920. doi: 10.1155/2012/634920. Epub 2011 Dec 29.
High levels of plasma homocysteine are implicated in the pathogenesis of cardiovascular diseases especially if accompanied by sleep apnea, but a direct pathogenetic link between plasma homocysteine levels and obstructive sleep apnea is debatable. This association can have far-reaching public health implications considering the inverse association between folate and plasma homocysteine. We used data from the 2005-2006 cycle of the National Health and Nutrition Examination Survey (NHANES) to test the hypothesized associations. Of the 4490 subjects included in analysis, 177 reported sleep apnea. Age-standardized and design-effect-corrected prevalence rates were differential across gender, plasma homocysteine, and red cell folate status. Plasma homocysteine was positively correlated with age (r = 0.38, P < 0.0001). Multivariate analyses using sociodemographic and clinical covariates demonstrated that plasma homocysteine levels retained their respective associations with self-reported sleep apnea in all models except when age was included as a covariate. Our results demonstrate that the claimed association of plasma homocysteine with sleep apnea may be confounded by age.
血浆同型半胱氨酸水平升高与心血管疾病的发病机制有关，尤其是在伴有睡眠呼吸暂停的情况下，但血浆同型半胱氨酸水平与阻塞性睡眠呼吸暂停之间的直接致病联系仍存在争议。考虑到叶酸与血浆同型半胱氨酸之间的负相关关系，这种关联可能具有深远的公共卫生意义。我们使用了2005 - 2006年国家健康与营养检查调查（NHANES）的数据来检验假设的关联。在纳入分析的4490名受试者中，177人报告有睡眠呼吸暂停。年龄标准化和设计效应校正后的患病率在性别、血浆同型半胱氨酸和红细胞叶酸状态方面存在差异。血浆同型半胱氨酸与年龄呈正相关（r = 0.38，P < 0.0001）。使用社会人口统计学和临床协变量进行的多变量分析表明，在所有模型中，血浆同型半胱氨酸水平与自我报告的睡眠呼吸暂停保持各自的关联，但将年龄作为协变量纳入时除外。我们的结果表明，所声称的血浆同型半胱氨酸与睡眠呼吸暂停之间的关联可能受年龄的混杂影响。
