Nygård O, Refsum H, Ueland P M, Vollset S E
Department of Public Health and Primary Health Care, University of Bergen, Norway.
Am J Clin Nutr. 1998 Feb;67(2):263-70. doi: 10.1093/ajcn/67.2.263.
We report on the location and skewness of the distribution of plasma total homocysteine (tHcy) according to lifestyle indexes in 11,941 apparently healthy participants of the Hordaland Homocysteine Study. Most subjects were in two age groups: 9165 subjects were aged 40-42 y and 2351 subjects were aged 65-67 y. The remaining 425 subjects were of intermediate ages. In multivariate analysis, sex, age, folate intake, smoking status, and coffee consumption were the strongest determinants of tHcy concentration. The combined effect of the three modifiable factors was larger than the effect from each factor alone. A lifestyle profile characterized by low folate intakes, smoking, and coffee consumption was associated with a high median tHcy concentration and a pronounced skewness toward high tHcy values. In subjects characterized by a contrasting lifestyle profile [high folate intakes, nonsmoking status, and low coffee consumption (< 1 cup/d)], tHcy values were almost normally distributed and the median concentration was 3.0-4.8 micromol/L lower. Among all 40-42-y-old subjects, the 95% reference ranges based on geometric mean tHcy concentrations were 5.1-16.5 micromol/L for women and 6.2-18.7 micromol/L for men. The corresponding ranges for subjects characterized by high folate intakes, nonsmoking status, and low or moderate coffee consumption (< 5 cups/d) were 4.8-12.8 micromol/L and 6.2-14.7 micromol/L. These findings are relevant for establishing adequate reference ranges for tHcy and emphasize folate intake, smoking status, and coffee consumption as major acquired determinants of tHcy concentration in this general population.
我们报告了在卑尔根同型半胱氨酸研究中11941名表面健康参与者的血浆总同型半胱氨酸（tHcy）分布的位置和偏度，这些参与者的生活方式指数各不相同。大多数受试者分为两个年龄组：9165名受试者年龄在40 - 42岁，2351名受试者年龄在65 - 67岁。其余425名受试者年龄处于中间阶段。在多变量分析中，性别、年龄、叶酸摄入量、吸烟状况和咖啡摄入量是tHcy浓度的最强决定因素。这三个可改变因素的综合作用大于每个因素单独的作用。以低叶酸摄入量、吸烟和咖啡摄入为特征的生活方式与高tHcy中位数浓度以及向高tHcy值的明显偏度相关。在以相反生活方式为特征的受试者中（高叶酸摄入量、不吸烟状态和低咖啡摄入量（<1杯/天）），tHcy值几乎呈正态分布，中位数浓度低3.0 - 4.8微摩尔/升。在所有40 - 42岁的受试者中，基于几何平均tHcy浓度的95%参考范围，女性为5.1 - 16.5微摩尔/升，男性为6.2 - 18.7微摩尔/升。以高叶酸摄入量、不吸烟状态和低或中度咖啡摄入量（<5杯/天）为特征的受试者的相应范围为4.8 - 12.8微摩尔/升和6.2 - 14.7微摩尔/升。这些发现对于确定tHcy的适当参考范围具有重要意义，并强调叶酸摄入量、吸烟状态和咖啡摄入量是该普通人群中tHcy浓度的主要后天决定因素。
