Israelsson B, Brattström L E, Hultberg B L
Department of Medicine, University of Lund, Malmö General Hospital, Sweden.
Atherosclerosis. 1988 Jun;71(2-3):227-33. doi: 10.1016/0021-9150(88)90147-5.
Five (24%) subjects out of a group of 21 men, 48-58 years old (mean 54), who had suffered their first myocardial infarction (MI) before the age of 55 and with a low risk profile vis-à-vis conventional risk factors in a health screening preceding the MI, had abnormally high total plasma homocysteine values in the fasting state when investigated within 1-7 years (mean 3) after their MI. The patient group was exactly matched with 36 control subjects for sex, age, diastolic blood pressure, smoking, and serum concentrations of cholesterol and triglycerides. Total plasma homocysteine was negatively correlated to both erythrocyte folate and serum vitamin B12, and vitamin concentrations below the median of the normal distribution were found in the five with high plasma homocysteine content, indicating a possible involvement of reduced remethylation of plasma homocysteine to methionine. After methionine loading, in 3 of the patient group (14%) homocysteine levels exceeded mean +2 SD for controls, which may indicate heterozygosity for homocystinuria. Results are consistent with the hypothesis that a high plasma homocysteine content may be a risk factor for MI.
在一组年龄为48 - 58岁（平均54岁）的21名男性中，有5名（24%）在55岁之前首次发生心肌梗死（MI），并且在心肌梗死之前的健康筛查中相对于传统危险因素具有低风险特征，在心肌梗死后1 - 7年（平均3年）内进行调查时，他们在空腹状态下的血浆总同型半胱氨酸值异常高。患者组在性别、年龄、舒张压、吸烟以及胆固醇和甘油三酯的血清浓度方面与36名对照受试者进行了精确匹配。血浆总同型半胱氨酸与红细胞叶酸和血清维生素B12均呈负相关，并且在血浆同型半胱氨酸含量高的5名患者中发现维生素浓度低于正态分布的中位数，这表明血浆同型半胱氨酸向蛋氨酸的再甲基化减少可能参与其中。在给予蛋氨酸负荷后，患者组中有3名（14%）的同型半胱氨酸水平超过了对照组的均值 +2标准差，这可能表明存在同型胱氨酸尿症的杂合性。结果与血浆同型半胱氨酸含量高可能是心肌梗死的危险因素这一假设一致。
