Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea.
J Korean Med Sci. 2013 Jul;28(7):1015-20. doi: 10.3346/jkms.2013.28.7.1015. Epub 2013 Jul 3.
Cardiovascular disease (CVD) is the primary cause of death in Korea. Hyperhomocysteinemia confers an independent risk for CVD comparable to the risk of smoking and hyperlipidemia. The purpose of this study was to assess the effect of cardiovascular risk factors and body composition change on homocysteine (Hcy) levels in Korean men and women. The association between body composition and Hcy levels was investigated in a 2-yr prospective cohort study of 2,590 Koreans (mean age 45.5±9.6 yr). There were 293 cases of hyperhomocysteinemia (>14 µM/L) at follow-up. Increases in total body fat proportion and decreases in lean body mass (LBM) were significantly associated with increases in Hcy concentration after controlling for confounding factors. Further adjustments for behavioral factors showed that decreases in LBM were associated with Hcy increase. Decrease in LBM also predicted hyperhomocysteinemia at follow-up, after controlling for confounding factors. There was no significant association between change in body mass index (BMI) and Hcy concentrations over time. Hcy changes over time were related to change in LBM and body fat content, whereas BMI or weight change did not predict change in Hcy levels. Changes in ratio of LBM to total fat mass may contribute to hyperhomocysteinemia.
心血管疾病（CVD）是韩国的主要死亡原因。高同型半胱氨酸血症与吸烟和高脂血症一样，是 CVD 的独立危险因素。本研究旨在评估心血管危险因素和身体成分变化对韩国男性和女性同型半胱氨酸（Hcy）水平的影响。在一项对 2590 名韩国人（平均年龄 45.5±9.6 岁）进行的为期 2 年的前瞻性队列研究中，研究了身体成分与 Hcy 水平之间的关系。随访时有 293 例高同型半胱氨酸血症（>14 μM/L）。在控制混杂因素后，总体脂比例增加和瘦体重（LBM）减少与 Hcy 浓度增加显著相关。进一步调整行为因素后，发现 LBM 减少与 Hcy 增加有关。在控制混杂因素后，LBM 减少也预测了随访时的高同型半胱氨酸血症。BMI 的变化与 Hcy 浓度随时间的变化之间没有显著关联。Hcy 随时间的变化与 LBM 和体脂肪含量的变化有关，而 BMI 或体重的变化不能预测 Hcy 水平的变化。LBM 与总脂肪质量比值的变化可能导致高同型半胱氨酸血症。
