血homocysteine作为血管疾病的危险因素. 欧洲协调行动项目 欧洲协调行动项目
I M Graham1, L E Daly, H M Refsum
1Department of Cardiology, Adelaide Hospital, Trinity College, Dublin, Ireland.
血homocysteine的升高是血管疾病的独立风险因素,类似于吸烟. 高水平的homocysteine显著放大与吸烟和高血压相关的风险,这表明维生素干预可能是有益的.
科学领域:
- 心血管医学 心血管医学
- 营养科学 营养科学
- 流行病学 流行病学
背景情况:
- 血homocysteine的升高是动脉样硬化血管疾病的已知的危险因素.
- 这种风险的确切程度及其与其他常规风险因素的相互作用仍然不完全理解.
研究的目的:
- 量化与血同型半氨酸水平升高相关的血管疾病风险.
- 为了研究高水平homocysteine与吸烟和高血压等已确定的危险因素之间的潜在相互作用.
主要方法:
- 一项多中心病例控制研究,涉及9个欧洲国家750例动脉样性血管疾病和800例对照病例.
- 血总同型半氨酸在禁食条件下测量,并在进行 metionin 负荷测试后进行测量.
- 评估还包括其他危险因素:血可巴胺,醇5'-酸盐,红细胞叶酸,血清胆固醇,吸烟状况和血压.
主要成果:
- 与最低水平相比,在最高水平的同等氨酸四分位数中观察到血管疾病的风险增加了2.2倍.
- 显而易见的是,同类半氨酸水平和血管风险之间存在剂量反应关系.
- 高水平的同类氨酸显示出协同作用,显著放大吸烟者和高血压患者的风险,超出了个别风险因素的附加效应.
结论:
- 血总同型半氨酸的增加代表了一个独立的血管疾病风险,与吸烟和高脂血症相当.
- 同类氨酸在吸烟和高血压患者中强烈加剧风险.
- 需要进行随机对照试验,评估降低同类氨酸水平的维生素治疗对预防血管疾病的疗效.
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