Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China.
Stroke Vasc Neurol. 2016 Dec 19;1(4):154-160. doi: 10.1136/svn-2016-000037. eCollection 2016 Dec.
We wish to determine if homocysteine (Hcy) is an independent risk factor for carotid atherosclerosis in a rural Chinese population.
2291 individuals (1016 men and 1275 women), aged 64.6±7.4 years, from Lvliang, China participated in this study. Tests performed included carotid artery ultrasound scan and blood analysis, to measure Hcy levels and other blood components.
The mean serum Hcy level was 24.7±18.0 µmol/L. The overall detection rate of carotid atherosclerotic lesions was 76.3% and the detection rate of plaque was 48.6%. Participants were divided into 4 groups based on their Hcy levels, <14.49, 14.49-19.43, 19.44-28.30, and ≥28.30 µmol/L. The relative risk of carotid atherosclerosis for each quartile as compared with the risk for the lowest quartile was estimated as the OR derived from the logistic regression coefficients. After adjusting for age and gender, the OR of carotid atherosclerosis in the third and fourth quartiles of Hcy were 1.219 (95% CI 0.922 to 1.612) and 1.156 (95% CI 0.859 to 1.555; p>0.05), respectively. After controlling for demographic variables (age, gender, current smoker, fasting blood glucose, low-density lipoprotein and systolic blood pressure) the OR of carotid plaque(s) in the third and fourth quartiles were 1.246 (95% CI 0.967 to 1.606) and 1.259 (95% CI 0.963 to 1.646; p>0.05).
The mean value of Hcy among participants in this study was much higher than that previously reported. However, no significant correlation between elevated Hcy and carotid atherosclerosis was found.
我们希望确定同型半胱氨酸(Hcy)是否是中国农村人群颈动脉粥样硬化的独立危险因素。
本研究纳入了 2291 名年龄为 64.6±7.4 岁的个体(男 1016 人,女 1275 人),来自中国吕梁。检测包括颈动脉超声扫描和血液分析,以测量 Hcy 水平和其他血液成分。
血清 Hcy 平均水平为 24.7±18.0µmol/L。颈动脉粥样硬化病变的总检出率为 76.3%,斑块检出率为 48.6%。根据 Hcy 水平将参与者分为 4 组,<14.49、14.49-19.43、19.44-28.30 和≥28.30µmol/L。使用逻辑回归系数估计每个四分位数与最低四分位数相比的颈动脉粥样硬化相对风险,得到比值比(OR)。在调整年龄和性别后,Hcy 第 3 和第 4 四分位数的颈动脉粥样硬化 OR 分别为 1.219(95%CI 0.922 至 1.612)和 1.156(95%CI 0.859 至 1.555;p>0.05)。在控制人口统计学变量(年龄、性别、现吸烟者、空腹血糖、低密度脂蛋白和收缩压)后,Hcy 第 3 和第 4 四分位数颈动脉斑块的 OR 分别为 1.246(95%CI 0.967 至 1.606)和 1.259(95%CI 0.963 至 1.646;p>0.05)。
本研究参与者的 Hcy 平均值明显高于以往报道,但未发现 Hcy 升高与颈动脉粥样硬化之间存在显著相关性。