Reis R P, Azinheira J, Reis H P, Pereira M, Baptista A, Crepo M, Pina J E, Ferreira N C, Luis A S
Serviços de Medicina, Hospital de S. José. Faculdade d Ciências Médicas da Universidad Nova de Lisboa, Lisboa.
Acta Med Port. 1996 Jan;9(1):15-20.
To evaluate importance of homocysteinemia as risk factor of thrombotic cerebrovascular disease, in terms of age and homocysteinemia levels.
A group of patients under 55 years old (n = 35, 21 males) that had suffered a stroke 3 months to 1 year before the study, defined by clinical criteria and the presence of cerebral infarction confirmed by tomography, without history or predisponents to embolic disease. The patients were matched with a group of controls without vascular pathology of a check-up program, in terms of age and sex. Patients and controls with history of alcoholism, signs or laboratory of renal or hepatic insufficiency or with history of recent ingestion of vitamins of the group B were excluded since these conditions could influence homocysteinemia levels. We measured to patients and controls the plasmatic basal homocysteinemia and homocysteinemia 6 hours after methionine overload of 0.1 g/Kg body weigh. We estimated case-control odds ratio of hyperhomocysteinemia globally and by age groups, and odd ratio of different levels of homocysteinemia.
Hyperhomocysteinemia case-control global odds ratio was 5.7, being higher in younger patients (8.8 below and 3.5 after the age of 45 years). Homocysteinemia as a risk factor of cerebrovascular disease presented as a continuous effect: low homocysteinemia was protective, and the higher the homocysteinemia, the higher the cerebrovascular risk proved to be. In these circumstances, heterozygozyty of cysthationine beta synthase deficiency, refered as the more important cause of hyperhomocysteinemia, cannot account for most of the cases of hyperhomocysteinemia.
从年龄和高同型半胱氨酸血症水平方面评估高同型半胱氨酸血症作为血栓性脑血管疾病危险因素的重要性。
一组55岁以下的患者（n = 35，男性21名），在研究前3个月至1年发生过中风，根据临床标准和断层扫描证实的脑梗死确诊，无栓塞性疾病病史或易患因素。根据年龄和性别，将这些患者与一组无血管病变的体检项目对照组进行匹配。排除有酗酒史、肾脏或肝脏功能不全体征或实验室检查异常或近期摄入过B族维生素的患者和对照组，因为这些情况可能影响同型半胱氨酸血症水平。我们测量了患者和对照组的血浆基础同型半胱氨酸血症水平以及给予0.1 g/Kg体重蛋氨酸负荷6小时后的同型半胱氨酸血症水平。我们估计了总体和按年龄组划分的高同型半胱氨酸血症的病例对照优势比，以及不同同型半胱氨酸血症水平的优势比。
高同型半胱氨酸血症的总体病例对照优势比为5.7，年轻患者中更高（45岁以下为8.8，45岁及以上为3.5）。同型半胱氨酸血症作为脑血管疾病的危险因素呈现出连续效应：低同型半胱氨酸血症具有保护作用，同型半胱氨酸血症水平越高，脑血管风险越高。在这种情况下，作为高同型半胱氨酸血症更重要原因的胱硫醚β合酶缺乏杂合子不能解释大多数高同型半胱氨酸血症病例。
