Leibovitzh Haim, Cohen Eytan, Levi Amos, Kramer Michal, Shochat Tzippy, Goldberg Elad, Krause Ilan
Department of Medicine F-Recanati Clinical Pharmacology Unit Department of Ophthalmology, Rabin Medical Center, Petah Tikva Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
Medicine (Baltimore). 2016 Sep;95(38):e4858. doi: 10.1097/MD.0000000000004858.
The relationship between homocysteine levels and glaucoma has been questioned in previous studies without conclusive results. In the current study, we assessed the relationship between homocysteine levels and intraocular pressure which is one of the main factors in the development of glaucoma in men and women.A retrospective cross-sectional analysis of a database from a screening center in Israel which assessed 11,850 subjects, within an age range 20 to 80 years. The relationship between homocysteine and intraocular pressure has been investigated by comparing intraocular pressure in subjects with elevated and normal homocysteine and by comparing homocysteine levels in subjects with elevated and normal intraocular pressure. In addition, we compared the levels of homocysteine in subjects with and without a confirmed diagnosis of glaucoma.The mean IOP (±SD) in subjects with normal homocysteine levels(≤15 μmol/L) was 13.2 ± 2.3 mm Hg and 13.4 ± 2.4 mm Hg in those with high homocysteine levels (>15 μmol/L) (P < 0.008, 95% confidence interval [CI] 0.3-0.09).Nonetheless, after multivariate adjustment for age, gender, vitamin B12, and folic acid statistical significance was no longer demonstrated (P = 0.37). Mean homocysteine levels (±SD) in subjects with normal intraocular pressure of ≤ 21 mm Hg was 11.7 ± 5.5 μmol/L and 12.09 ± 3.43 μmol/L in those with elevated intraocular pressure (P = 0.4, 95%CI 1.1-1.8). Mean homocysteine levels (±SD) in subjects with glaucoma were 11.2 ± 3.5 μmol/L compared to 11.7 ± 5.5 μmol/L in subjects without glaucoma and normal intraocular pressure ≤ 21 mm Hg (P = 0.4, 95% CI 1.2-2.1).The current study displays no clinical correlation between the homocysteine level and the intraocular pressure. Homocysteine may not be used as a predictive parameter to recognize those subjects prone to develop elevated intraocular pressure.
同型半胱氨酸水平与青光眼之间的关系在以往研究中受到质疑,尚无定论。在本研究中,我们评估了同型半胱氨酸水平与眼压之间的关系,眼压是男女青光眼发病的主要因素之一。对以色列一个筛查中心数据库进行回顾性横断面分析,该数据库评估了11850名年龄在20至80岁之间的受试者。通过比较同型半胱氨酸水平升高和正常的受试者的眼压,以及比较眼压升高和正常的受试者的同型半胱氨酸水平,研究了同型半胱氨酸与眼压之间的关系。此外,我们比较了确诊青光眼和未确诊青光眼的受试者的同型半胱氨酸水平。同型半胱氨酸水平正常(≤15μmol/L)的受试者的平均眼压(±标准差)为13.2±2.3mmHg,同型半胱氨酸水平高(>15μmol/L)的受试者为13.4±2.4mmHg(P<0.008,95%置信区间[CI]0.3-0.09)。然而,在对年龄、性别、维生素B12和叶酸进行多变量调整后,不再显示统计学显著性(P=0.37)。眼压≤21mmHg的正常受试者的平均同型半胱氨酸水平(±标准差)为1个1.7±5.5μmol/L,眼压升高的受试者为12.09±3.43μmol/L(P=0.4,95%CI 1.1-1.8)。青光眼患者的平均同型半胱氨酸水平(±标准差)为11.2±3.5μmol/L,而眼压正常(≤21mmHg)且无青光眼的受试者为11.7±5.5μmol/L(P=0.4,95%CI 1.2-2.1)。本研究显示同型半胱氨酸水平与眼压之间无临床相关性。同型半胱氨酸可能不能用作识别那些容易发生眼压升高的受试者的预测参数。