Guo Shuxia, Pang Hongrui, Guo Heng, Zhang Mei, He Jia, Yan Yizhong, Niu Qiang, Rui Dongsheng, Li Shugang, Ma Rulin, Zhang Jingyu, Liu Jiaming, Ding Yusong
Key Laboratory of Xinjiang Endemic and Ethnic Diseases, School of Medicine, Shihezi University, Beier Road, Shihezi City, Xinjiang Uyghur Autonomous Region 832000, China.
Int J Environ Res Public Health. 2015 May 19;12(5):5373-85. doi: 10.3390/ijerph120505373.
Homocysteine (Hcy) is a relevant biomarker of vascular disease: serum Hcy concentrations will increase the risk of systolic hypertension, whereas hyperhomocysteinemia (HHcy) has a synergistic effect with hypertension and increases the risk of cardiovascular disease. However, information has primarily been gathered from high-income and urban settings, and little is known regarding low-income rural settings. This study focused on a low-income rural and nomadic minority residing in far western China. Hcy levels were tested, and the prevalences of HHcy and H-type hypertension were investigated in this population.
This study used a stratified cluster random sampling method, selecting 2,180 individuals as subjects from Kazakh and Uyghur inhabitants (≥25 years old) of 18 villages in Xinjiang, China, which is approximately 4407 km from the capital, Beijing. Hcy levels were determined using a double reagent enzymatic cycling method. HHcy (Hcy > 10 μmol/L) was defined by the criteria of the American Heart Association.
The Kazakh geometrical mean of Hcy was 13.34 μmol/L, and the Uyghur mean was 13.75 μmol/L; the mean values were higher in males than in females of both ethnicities (15.99 μmol/L vs. 11.63 μmol/L; 15.71 μmol/L vs. 11.91 μmol/L, respectively, p < 0.01). The serum levels of Hcy increased with increasing age in both ethnicities, and except for Kazakh individuals >65 years old, Hcy serum levels were higher in males than in females in all age groups of both ethnicities, with a p value less than 0.01. The Kazakh prevalence of HHcy was 80.0%, and the Uyghur prevalence was 78.2%; the male prevalence was higher than that in females for both ethnicities (93.5% vs. 69.6%; 90.8% vs. 64.6%, respectively, p < 0.05). Among the Kazakh, the prevalence of hypertension was 35.1%, and the prevalence was higher in males than in females (44.3% vs. 28.1%, p < 0.001); 87.6% of the Kazakh individuals had H-type hypertension, and the prevalence was higher in males than in females (95.0% vs. 80.0%, p < 0.05). In Uyghur, the prevalence of hypertension was 30.6%, and the prevalence was higher in males than in females (37.9% vs. 22.8%, p < 0.001); 88.0% of the Uyghur individuals had H-type hypertension, and the prevalence was higher in males than in females (93.9% vs. 79.1%, p < 0.05).
HHcy was found to be common among the Kazakh and Uyghur. The prevalences of HHcy and H-type hypertension were high among both ethnicities and differed depending on gender and age. Community interventions should be conducted to improve public health conditions among the Kazakh and Uyghur in Xinjiang.
同型半胱氨酸（Hcy）是血管疾病的一项相关生物标志物：血清Hcy浓度会增加收缩期高血压风险，而高同型半胱氨酸血症（HHcy）与高血压具有协同作用并增加心血管疾病风险。然而，相关信息主要来自高收入和城市地区，对于低收入农村地区知之甚少。本研究聚焦于居住在中国最西部的一个低收入农村游牧少数民族群体。检测了该人群的Hcy水平，并调查了HHcy和H型高血压的患病率。
本研究采用分层整群随机抽样方法，从距离首都北京约4407公里的中国新疆18个村庄的哈萨克族和维吾尔族居民（≥25岁）中选取2180人作为研究对象。采用双试剂酶循环法测定Hcy水平。HHcy（Hcy>10μmol/L）根据美国心脏协会的标准定义。
哈萨克族Hcy几何均值为13.34μmol/L，维吾尔族均值为13.75μmol/L；两个民族男性的均值均高于女性（分别为15.99μmol/L对11.63μmol/L；15.71μmol/L对11.91μmol/L，p<0.01）。两个民族的血清Hcy水平均随年龄增长而升高，除65岁以上的哈萨克族个体外，两个民族各年龄组男性的Hcy血清水平均高于女性，p值小于0.01。哈萨克族HHcy患病率为80.0%，维吾尔族患病率为78.2%；两个民族男性患病率均高于女性（分别为93.5%对69.6%；90.8%对64.6%，p<0.05）。哈萨克族中，高血压患病率为35.1%，男性患病率高于女性（44.3%对28.1%，p<0.001）；87.6%的哈萨克族个体患有H型高血压，男性患病率高于女性（95.0%对80.0%，p<0.05）。维吾尔族中，高血压患病率为30.6%，男性患病率高于女性（37.9%对22.8%，p<0.001）；88.0%的维吾尔族个体患有H型高血压，男性患病率高于女性（93.9%对79.1%，p<0.05）。
发现HHcy在哈萨克族和维吾尔族中较为常见。两个民族的HHcy和H型高血压患病率均较高，且因性别和年龄而异。应开展社区干预以改善新疆哈萨克族和维吾尔族的公共卫生状况。
