Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands; Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Eur J Clin Invest. 2014 Feb;44(2):200-8. doi: 10.1111/eci.12208. Epub 2013 Dec 14.
Homoarginine is an amino acid that may be involved in nitric oxide and energy metabolism. Previous studies in patient populations showed that low homoarginine levels indicate an increased risk of mortality and cardiovascular disease. We evaluated whether low plasma levels of homoarginine are associated with elevated, overall and cause-specific mortality.
The Hoorn study is a population-based study among older men and women. We calculated Cox proportional hazard ratios (HRs) for overall and cause-specific mortality according to sex-specific homoarginine quartiles.
We included 606 study participants (51·3% women; 70·0 ± 6·6 years). Homoarginine concentrations were higher in men (1·63 ± 0·51 μM), compared with women (1·30 ± 0·44 μM; P < 0·001). After a median follow-up time of 7·8 years, 112 study participants died, including 31 deaths due to cardiovascular diseases and 30 due to cancer. Associations between homoarginine levels and mortality showed a threshold effect with a significant risk increase from the second to the first quartile. Compared with the upper three quartiles, the age-, sex- and BMI-adjusted HR (with 95% CI) in the first quartile was 2·26 (1·52-3·32) for overall mortality, 4·20 (2·03-8·69) for cardiovascular mortality and 1·25 (0·55-2·85) for cancer mortality. These associations remained materially unchanged after multivariate adjustments.
Low plasma concentrations of homoarginine are a risk marker for overall mortality and especially for cardiovascular mortality in the older general population. Further studies are warranted to elucidate the underlying pathophysiological mechanisms.
精氨酸是一种可能参与一氧化氮和能量代谢的氨基酸。以前在患者人群中的研究表明，低精氨酸水平表明死亡和心血管疾病的风险增加。我们评估了低血浆精氨酸水平是否与升高的总死亡率和特定原因死亡率相关。
霍恩研究是一项针对老年男性和女性的基于人群的研究。我们根据性别特异性精氨酸四分位值计算了总死亡率和特定原因死亡率的 Cox 比例风险比 (HR)。
我们纳入了 606 名研究参与者（51.3%为女性；70.0±6.6 岁）。男性的精氨酸浓度较高（1.63±0.51 μM），而女性的精氨酸浓度较低（1.30±0.44 μM；P<0.001）。中位随访时间为 7.8 年后，112 名研究参与者死亡，包括 31 例心血管疾病死亡和 30 例癌症死亡。精氨酸水平与死亡率之间的关联显示出阈值效应，从第二到第一四分位的风险显著增加。与上三个四分位相比，第一四分位的年龄、性别和 BMI 调整后的 HR（95%CI）分别为总死亡率的 2.26（1.52-3.32）、心血管死亡率的 4.20（2.03-8.69）和癌症死亡率的 1.25（0.55-2.85）。这些关联在多变量调整后仍然基本不变。
低血浆精氨酸浓度是老年人群总死亡率的风险标志物，尤其是心血管死亡率的风险标志物。需要进一步研究阐明潜在的病理生理机制。
