Alfthan G, Pekkanen J, Jauhiainen M, Pitkäniemi J, Karvonen M, Tuomilehto J, Salonen J T, Ehnholm C
Department of Nutrition, National Public Health Institute, Helsinki, Finland.
Atherosclerosis. 1994 Mar;106(1):9-19. doi: 10.1016/0021-9150(94)90078-7.
The relation of serum total homocysteine and lipoprotein(a) (Lp(a)) with the incidence of atherosclerotic disease was investigated among 7424 men and women aged 40-64 years free of atherosclerotic disease at baseline in 1977. During the 9-year follow-up, 134 male and 131 female cases with either myocardial infarction or stroke were identified. For each case a control subject was selected belonging to the same sex and 5-year age group. Serum samples collected in 1977 were stored at -20 degrees C and analyzed in 1991. The mean serum homocysteine concentration of male cases and controls was 9.99 mumol/l and 9.82 mumol/l at baseline and that of female cases and controls 9.58 mumol/l and 9.24 mumol/l, respectively. The median serum Lp(a) concentration of male cases and controls was 73 mg/l and 108 mg/l and that of female cases and controls 113 mg/l and 91 mg/l, respectively. The differences between cases and controls were not statistically significant. There was also no significant association between either homocysteine or Lp(a) and atherosclerotic disease, myocardial infarction or stroke in logistic regression analyses. The odds ratios varied from 1.00 to 1.26 for homocysteine and from 0.81 to 1.06 for Lp(a). The results of this prospective population-based study do not support the hypotheses that serum homocysteine or Lp(a) are risk factors for atherosclerotic disease. The lack of association between serum homocysteine and atherosclerotic disease may be due to the exceptionally low gene frequency predisposing to homocysteinemia in Finland.
1977年，在7424名年龄在40 - 64岁、基线时无动脉粥样硬化疾病的男性和女性中，研究了血清总同型半胱氨酸和脂蛋白(a) [Lp(a)]与动脉粥样硬化疾病发病率的关系。在9年的随访期间，确定了134例男性和131例女性发生心肌梗死或中风。为每例病例选择一名属于相同性别和5岁年龄组的对照对象。1977年采集的血清样本保存在-20℃，并于1991年进行分析。男性病例组和对照组在基线时的血清同型半胱氨酸平均浓度分别为9.99μmol/L和9.82μmol/L，女性病例组和对照组分别为9.58μmol/L和9.24μmol/L。男性病例组和对照组的血清Lp(a)中位数浓度分别为73mg/L和108mg/L，女性病例组和对照组分别为113mg/L和91mg/L。病例组和对照组之间的差异无统计学意义。在逻辑回归分析中，同型半胱氨酸或Lp(a)与动脉粥样硬化疾病、心肌梗死或中风之间也无显著关联。同型半胱氨酸的比值比在1.00至1.26之间，Lp(a)的比值比在0.81至1.06之间。这项基于人群的前瞻性研究结果不支持血清同型半胱氨酸或Lp(a)是动脉粥样硬化疾病危险因素的假设。血清同型半胱氨酸与动脉粥样硬化疾病之间缺乏关联可能是由于芬兰导致高同型半胱氨酸血症的基因频率异常低。
