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近期小剂量叶酸对高同型半胱氨酸血症冠心病患者脂蛋白相关磷脂酶 A2 和收缩压变异性的影响:一项单中心前瞻性队列研究。

The recent effects of small dose of folic acid on lipoprotein-associated phospholipase A2 and systolic blood pressure variability in coronary heart disease patients with hyperhomocysteinemia: A single-center prospective cohort study.

机构信息

Department of Cardiology.

Department of Physical Diagnostics, Yue Bei People's Hospital Affiliated to Shantou University, Shaoguan, Guangdong, China.

出版信息

Medicine (Baltimore). 2020 Dec 18;99(51):e23573. doi: 10.1097/MD.0000000000023573.

Abstract

To Investigate the recent effects of small dose of folic acid on lipoprotein-associated phospholipase A2 (LP-PLA2) and systolic blood pressure variability in coronary heart disease (CHD) patients with hyperhomocysteinemia.In this prospective cohort study, a total of 167 CHD patients with hyperhomocysteinemia were consecutively enrolled, and they were divided into Group A (without folic acid intervention, n = 99), Group B (with 0.4 mg of folic acid intervention, n = 34), Group C (0.8 mg of folic acid intervention, n = 34). General information, fasting blood glucose, and blood lipid, folic acid, homocysteine, Lp-PLA2, and blood pressure variability were compared among 3 groups. The above indicators were reviewed after 3 months of treatment.There were no statistically significant differences of age, gender, blood pressure, incidence of type 2 diabetes mellitus, fasting blood glucose, folic acid, homocysteine, Lp-PLA2, total cholesterol, 3 acyl glycerin, apolipoprotein B, lipoprotein (a), high density lipoprotein cholesterol, and low density lipoprotein cholesterol were found among 3 groups (P > .05); however, after being treated for 3 months, there was statistically significant difference in folic acid among 3 groups (P < .05), there was statistically significant difference in apolipoprotein A between Group A and Group B (t = 0.505, P = .039), and also between Group A and Group C (t = 0.052, P = .017). There were statistically significant differences in Lp-PLA2 (t = 24.320, P = .016) and systolic blood pressure variability (t = 0.154, P = .018) between Group A and Group C.For CHD patients with hyperhomocysteinemia, the higher dose (0.8 mg) of folic acid supplement was beneficial for increasing the apolipoprotein A, reducing the Lp-PLA2, and improving the systolic blood pressure variation, which might help to improve the prognosis in these patients.

摘要

研究小剂量叶酸对高同型半胱氨酸血症冠心病患者脂蛋白相关磷脂酶 A2(LP-PLA2)和收缩压变异性的近期影响。

在这项前瞻性队列研究中,连续纳入了 167 例高同型半胱氨酸血症的冠心病患者,将其分为 A 组(无叶酸干预,n=99)、B 组(0.4mg 叶酸干预,n=34)和 C 组(0.8mg 叶酸干预,n=34)。比较三组的一般资料、空腹血糖和血脂、叶酸、同型半胱氨酸、LP-PLA2 和血压变异性。治疗 3 个月后复查上述指标。

三组间年龄、性别、血压、2 型糖尿病发病率、空腹血糖、叶酸、同型半胱氨酸、LP-PLA2、总胆固醇、三酰甘油、载脂蛋白 B、脂蛋白(a)、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇差异均无统计学意义(P>0.05);然而,治疗 3 个月后,三组间叶酸差异有统计学意义(P<0.05),A 组与 B 组间载脂蛋白 A 差异有统计学意义(t=0.505,P=0.039),A 组与 C 组间载脂蛋白 A 差异亦有统计学意义(t=0.052,P=0.017)。A 组与 C 组间 LP-PLA2 差异有统计学意义(t=24.320,P=0.016),收缩压变异性差异有统计学意义(t=0.154,P=0.018)。

对于高同型半胱氨酸血症的冠心病患者,补充较高剂量(0.8mg)的叶酸有利于增加载脂蛋白 A,降低 LP-PLA2,改善收缩压变异性,这可能有助于改善此类患者的预后。

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