Woo K S, Chook P, Lolin Y I, Cheung A S, Chan L T, Sun Y Y, Sanderson J E, Metreweli C, Celermajer D S
Department of Medicine, The Chinese University of Hong Kong.
Circulation. 1997 Oct 21;96(8):2542-4. doi: 10.1161/01.cir.96.8.2542.
Hyperhomocyst(e)inemia is associated with premature peripheral vascular, cerebrovascular, and coronary artery disease. Because homocysteine has been found to be damaging to endothelial cells in animal and cell culture studies, we evaluated the association between hyperhomocysteinemia and arterial endothelial dysfunction (a marker of early atherosclerosis) in asymptomatic adult subjects.
Using high-resolution ultrasound, we measured endothelium-dependent flow-mediated dilation (EDD) and endothelium-independent nitroglycerin-induced dilation (GTN) of the brachial artery in 14 prospectively defined hyperhomocysteinemic (mean plasma homocysteine, 34.8+/-8.5 micromol/L), nonsmoking, healthy subjects aged 53+/-9 years and 14 control subjects with low plasma homocysteine levels (9.9+/-3.2 micromol/L). The two groups were well matched for age; sex; body mass index; blood pressure, blood cholesterol, folate, and vitamin B12 levels; and vessel diameter. EDD was significantly lower in hyperhomocysteinemic subjects (6.5+/-1.7%) than in subjects with low homocysteine levels (10.8+/-1.7%) (P<.001). GTN responses were similar in the two subject groups (P=.90). Multivariate analysis confirmed homocysteine level as the strongest predictor for impaired EDD, independent of age, sex, body mass index, or blood pressure, folate, vitamin B12, and cholesterol levels.
Hyperhomocysteinemia is an independent risk factor for arterial endothelial dysfunction in healthy middle-aged adults.
高同型半胱氨酸血症与外周血管、脑血管及冠状动脉疾病的过早发生相关。由于在动物和细胞培养研究中发现同型半胱氨酸会损害内皮细胞，我们评估了无症状成年受试者中高同型半胱氨酸血症与动脉内皮功能障碍（早期动脉粥样硬化的一个标志物）之间的关联。
我们使用高分辨率超声，测量了14名前瞻性定义的高同型半胱氨酸血症（平均血浆同型半胱氨酸水平为34.8±8.5微摩尔/升）、不吸烟、年龄在53±9岁的健康受试者以及14名血浆同型半胱氨酸水平较低（9.9±3.2微摩尔/升）的对照受试者肱动脉的内皮依赖性血流介导的舒张功能（EDD）和非内皮依赖性硝酸甘油诱导的舒张功能（GTN）。两组在年龄、性别、体重指数、血压、血胆固醇、叶酸和维生素B12水平以及血管直径方面匹配良好。高同型半胱氨酸血症受试者的EDD（6.5±1.7%）显著低于同型半胱氨酸水平较低的受试者（10.8±1.7%）（P<0.001）。两组受试者的GTN反应相似（P = 0.90）。多变量分析证实，同型半胱氨酸水平是EDD受损的最强预测因素，独立于年龄、性别、体重指数或血压、叶酸、维生素B12和胆固醇水平。
高同型半胱氨酸血症是健康中年成年人动脉内皮功能障碍的独立危险因素。
