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同型半氨酸与慢性病死亡率之间的关系

Vandana Menon1, Mark J Sarnak, Tom Greene

  • 1Division of Nephrology, Department of Medicine, Tufts-New England Medical Center, Boston, MA, USA.

Circulation
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PubMed
概括

总同类半氨酸 (tHcy) 水平似乎不会增加慢性病阶段3-4的患者的死亡风险. 这项研究发现,在该人群中,高THC与全因或心血管疾病死亡率之间没有关联.

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科学领域:

  • 腎臟病學 (nephrology) 是一種醫學專業.
  • 心血管医学 心血管医学
  • 临床化学 临床化学

背景情况:

  • 在患有慢性病 (CKD) 3-4期的患者中,总同型氨酸 (tHcy) 的预后值仍未得到充分研究.
  • 升高的THcy是一般人群中心血管疾病 (CVD) 的已知危险因素.

研究的目的:

  • 调查tHcy水平与CKD3-4阶段患者的死亡结果之间的关联.
  • 确定 tHcy 是否是一个独立的风险因素,对所有原因和心血管疾病死亡率在这个患者群体.

主要方法:

  • 从病饮食修改研究 (MDRD) 的数据分析,这是一个随机对照试验.
  • 血清tHcy在804名患有CKD3-4阶段的患者的基线测量.
  • 所有原因和心血管疾病死亡率在使用国家死亡指数的10年中位随访期间进行了评估.

主要成果:

  • 在单变量分析中,在tHcy的最高三位数和全因或心血管疾病死亡率之间没有发现显著的关联.
  • 调整以估计的膜过率 (eGFR) 进一步减弱了任何观察到的关联.
  • 作为连续变量分析的tHcy也没有显示与全因或心血管疾病死亡率的关联.

结论:

  • 超homocysteinemia似乎不是一个显著的风险因素,所有原因或心血管疾病的死亡率在患有CKD阶段3-4的患者.
  • 以前的研究可能高估了tHcy与心血管疾病风险之间的关联,原因是功能调整不足.