Selhub J, Jacques P F, Bostom A G, D'Agostino R B, Wilson P W, Belanger A J, O'Leary D H, Wolf P A, Rush D, Schaefer E J, Rosenberg I H
Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA.
J Nutr. 1996 Apr;126(4 Suppl):1258S-65S. doi: 10.1093/jn/126.suppl_4.1258S.
Recent studies demonstrated associations between occlusive vascular disease and hyperhomocysteinemia of both genetic and nutritional origin. In the present study we analyzed plasma samples from the 20th biannual examination of the Framingham Heart Study cohort to determine distribution of plasma homocysteine concentrations with emphasis on relationships to B vitamins and prevalence of carotid artery stenosis. Results showed that homocysteine exhibited strong inverse association with plasma folate and weaker associations with plasma vitamin B-12 and pyridoxal-5'-phosphate (PLP). Homocysteine was also inversely associated with intakes of folate and vitamin B-6, but not vitamin B-12. Prevalence of high homocysteine (>14 micromol/l) was 29.3% in this cohort, and inadequate plasma concentrations of one or more B vitamins appear to contribute to 67% of the cases of high homocysteine. Prevalence of stenosis > or = 25% was 43% in men and 34% in women with an odds ratio of 2.0 for individuals in the highest homocysteine quartile (> or = 14.4 micromol/l) compared with those in the lowest quartile (< or = 9.1 micromol/l), after adjustment for sex, age, high density lipoprotein cholesterol, systolic blood pressure and cigarette smoking (Ptrend < 0.001). Plasma concentrations of folate and pyridoxal-5'-phosphate and folate intake were inversely associated with extracranial carotid stenosis after adjustment for age, sex and other risk factors.
近期研究表明，无论是遗传性还是营养性高同型半胱氨酸血症均与闭塞性血管疾病有关。在本研究中，我们分析了弗雷明汉心脏研究队列第20次半年检查的血浆样本，以确定血浆同型半胱氨酸浓度的分布情况，重点关注其与B族维生素的关系以及颈动脉狭窄的患病率。结果显示，同型半胱氨酸与血浆叶酸呈强负相关，与血浆维生素B12和磷酸吡哆醛（PLP）呈较弱的相关性。同型半胱氨酸还与叶酸和维生素B6的摄入量呈负相关，但与维生素B12的摄入量无关。该队列中高同型半胱氨酸（>14微摩尔/升）的患病率为29.3%，一种或多种B族维生素血浆浓度不足似乎导致了67%的高同型半胱氨酸病例。在对性别、年龄、高密度脂蛋白胆固醇、收缩压和吸烟进行调整后，男性颈动脉狭窄≥25%的患病率为43%，女性为34%，同型半胱氨酸最高四分位数（≥14.4微摩尔/升）的个体与最低四分位数（≤9.1微摩尔/升）的个体相比，优势比为2.0（Ptrend<0.001）。在对年龄、性别和其他危险因素进行调整后，血浆叶酸、磷酸吡哆醛浓度和叶酸摄入量与颅外颈动脉狭窄呈负相关。
