Leng Yvonne Lee Yin, Zhou Yuling, Ke Honghong, Jelinek Herbert, McCabe Joel, Assareh Hassan, McLachlan Craig S
From the Rural Clinical School, Faculty of Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia (YLYL, YZ, JM, HA, CSM); Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China (HK); and School of Community Health, Centre for Research in Complex Systems, Charles Sturt University, Albury, NSW, Australia (HJ).
Medicine (Baltimore). 2015 Jul;94(27):e1080. doi: 10.1097/MD.0000000000001080.
Homocysteine levels in the low to moderate range for cardiovascular risk have been previously associated with left ventricular cardiac hypertrophy (LVH). Electrocardiogram (ECG) derived QRS duration has also been used as an epidemiological screening marker for cardiac hypertrophy risk. QRS duration cut offs have not been previously modeled to assess homocysteine levels in community populations. Our aims are to determine if QRS duration is associated with an elevated homocysteine level in a cross-sectional Australian aging rural population.A retrospective study design utilizing a rural health diabetic screening clinic database containing observational data from the period January 9, 2002 till September 25, 2012. One hundred seventy-eight individuals (>21 years of age) from the database were included in the study. Inclusion criteria included being nondiabetic and having both a QRS duration measure and a matching homocysteine level within the same subject. All participants were from the Albury-Wodonga area, with a mean age of >64 years for both sexes.Mean population homocysteine plasma levels were 10.4 μmol/L (SD = 3.6). The mean QRS duration was 101.8 ms (SD = 17.4). Groups were stratified on the basis of QRS duration (≤120 ms [n = 157] and >120 ms [n = 21]). QRS duration subgroup (≤120 ms vs >120 ms) mean differences across homocysteine levels were 10.1 μmol/L (SD = 3.3) and 12.2 μmol/L (SD = 4.7), respectively (P = 0.016). Other ECG parameters (PQ interval, QTc interval, and QT dispersion) measurements were not significantly associated with differences in plasma homocysteine (P = not significant).We conclude that in community populations homocysteine may be moderately elevated when QRS durations are >120 ms. Small additional increases in homocysteine levels may suggest a risk factor for ECG diagnosis of LVH.
心血管风险处于低至中等范围的同型半胱氨酸水平先前已与左心室心肌肥厚(LVH)相关联。源自心电图(ECG)的QRS波时限也已被用作心脏肥厚风险的流行病学筛查标志物。此前尚未建立QRS波时限的临界值模型来评估社区人群中的同型半胱氨酸水平。我们的目的是确定在澳大利亚老龄化农村横断面人群中,QRS波时限是否与同型半胱氨酸水平升高相关。
一项回顾性研究设计,利用一个农村健康糖尿病筛查诊所数据库,该数据库包含2002年1月9日至2012年9月25日期间的观察数据。数据库中的178名个体(年龄>21岁)被纳入研究。纳入标准包括非糖尿病患者且在同一受试者中同时有QRS波时限测量值和匹配的同型半胱氨酸水平。所有参与者均来自阿尔伯里 - 沃东加地区,男女平均年龄均>64岁。
人群同型半胱氨酸血浆平均水平为10.4μmol/L(标准差 = 3.6)。QRS波时限平均为101.8毫秒(标准差 = 17.4)。根据QRS波时限(≤120毫秒[n = 157]和>120毫秒[n = 21])对人群进行分层。QRS波时限亚组(≤120毫秒与>120毫秒)同型半胱氨酸水平的平均差异分别为10.1μmol/L(标准差 = 3.3)和12.2μmol/L(标准差 = 4.7)(P = 0.016)。其他心电图参数(PQ间期、QTc间期和QT离散度)测量值与血浆同型半胱氨酸差异无显著相关性(P = 无显著性)。
我们得出结论,在社区人群中,当QRS波时限>120毫秒时,同型半胱氨酸可能会适度升高。同型半胱氨酸水平的小幅额外升高可能提示心电图诊断LVH的一个风险因素。