From the, University Department of Pharmacology, Oxford, UK.
Department Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
J Intern Med. 2021 Oct;290(4):826-854. doi: 10.1111/joim.13279. Epub 2021 Apr 6.
We have reviewed the literature and have identified more than 100 diseases or conditions that are associated with raised concentrations of plasma total homocysteine. The commonest associations are with cardiovascular diseases and diseases of the central nervous system, but a large number of developmental and age-related conditions are also associated. Few other disease biomarkers have so many associations. The clinical importance of these associations becomes especially relevant if lowering plasma total homocysteine by B vitamin treatment can prevent disease and so improve health. Five diseases can at least in part be prevented by lowering total homocysteine: neural tube defects, impaired childhood cognition, macular degeneration, primary stroke, and cognitive impairment in the elderly. We conclude from our review that total homocysteine values in adults of 10 μmol/L or below are probably safe, but that values of 11 μmol/L or above may justify intervention. Homocysteine is more than a disease biomarker: it is a guide for the prevention of disease.
我们查阅了文献，发现有 100 多种疾病或病症与血浆总同型半胱氨酸浓度升高有关。最常见的关联是心血管疾病和中枢神经系统疾病，但大量发育和与年龄相关的疾病也与之相关。很少有其他疾病生物标志物有如此多的关联。如果通过补充 B 族维生素治疗降低血浆总同型半胱氨酸可以预防疾病并改善健康，那么这些关联的临床重要性就变得尤为重要。至少有五种疾病可以通过降低总同型半胱氨酸来部分预防：神经管缺陷、儿童认知障碍、黄斑变性、原发性中风和老年人认知障碍。我们从综述中得出结论，成年人的总同型半胱氨酸值在 10μmol/L 或以下可能是安全的，但 11μmol/L 或以上的水平可能需要进行干预。同型半胱氨酸不仅仅是疾病的生物标志物：它还是预防疾病的指南。
