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中国人群中高同型半胱氨酸血症与胸主动脉瘤及腹主动脉瘤的相关性。

The Association between Hyperhomocysteinemia and Thoracoabdominal Aortic Aneurysms in Chinese Population.

机构信息

Department of Vascular and Endovascular Surgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.

Department of General Surgery, Chinese PLA No.983 Hospital, Tianjin, China.

出版信息

Biomed Res Int. 2020 Jul 28;2020:4691026. doi: 10.1155/2020/4691026. eCollection 2020.

Abstract

OBJECTIVE

To shed light on the association between hyperhomocysteinemia (HHcy) and thoracoabdominal aortic aneurysms (TAAAs).

METHODS

From July 2013 to March 2017, we conducted a matched case-control study involving individuals who presented to the Chinese People's Liberation Army General Hospital and underwent thoracoabdominal magnetic resonance angiography or computed tomography angiography. A total of 73 patients with TAAAs were enrolled in the case group, and 219 sex-matched subjects without TAAAs were included in the control group. We then examined the relationship between HHcy and TAAAs by logistic regression models and subgroup as well as interaction analyses.

RESULTS

Serum total homocysteine (tHcy) concentrations and the proportion of HHcy were significantly higher in the patients with TAAAs than in those without TAAAs ( < 0.001). Furthermore, the multivariate logistic regression models indicated that participants with HHcy had a 2.14-fold higher risk of TAAAs than those with a normal serum tHcy level (adjusted odds ratio (OR), 2.14; 95% confidence interval, 1.00-4.56). Similarly, each 1 mol/L increase in the serum tHcy concentration was associated with a 4% higher risk of TAAAs (adjusted OR, 1.04; 95% confidence interval, 1.00-1.07). Subgroup analyses indicated that HHcy tended to be associated with a greater risk of TAAAs in all stratified subgroups (adjusted ORs > 1). Furthermore, the interaction analyses revealed no interactive role in the association between HHcy and TAAAs.

CONCLUSIONS

The present case-control study suggests that HHcy is an independent risk factor for TAAAs. Larger prospective cohort studies are warranted to validate these findings.

摘要

目的

探讨高同型半胱氨酸血症(HHcy)与胸主动脉瘤和腹主动脉瘤(TAAAs)之间的关系。

方法

本研究为 2013 年 7 月至 2017 年 3 月期间在中国人民解放军总医院就诊并接受胸腹主动脉磁共振血管造影或计算机断层扫描血管造影的患者进行的病例对照研究。共纳入 73 例 TAAA 患者作为病例组,219 例性别匹配的无 TAAA 患者作为对照组。采用 logistic 回归模型及亚组和交互分析,探讨 HHcy 与 TAAA 的关系。

结果

TAAA 患者血清总同型半胱氨酸(tHcy)浓度和 HHcy 比例明显高于无 TAAA 患者(<0.001)。多变量 logistic 回归模型显示,HHcy 患者 TAAA 的发病风险是血清 tHcy 水平正常患者的 2.14 倍(校正优势比(OR)2.14,95%置信区间 1.00-4.56)。同样,血清 tHcy 浓度每增加 1 μmol/L,TAAA 的发病风险增加 4%(校正 OR 1.04,95%置信区间 1.00-1.07)。亚组分析显示,HHcy 与 TAAA 的相关性在所有分层亚组中均倾向于呈正相关(校正 OR>1)。交互分析显示,HHcy 与 TAAA 之间无交互作用。

结论

本病例对照研究提示 HHcy 是 TAAA 的独立危险因素。需要更大的前瞻性队列研究来验证这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eca9/7407013/b32b8563a069/BMRI2020-4691026.001.jpg

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