东营地区4109例城乡人群血浆同型半胱氨酸及合并心血管危险因素的调查分析

The distribution of serm homocysteine and associated with cardiovascular risk factors in a population of 4109 subjects between dongying urban and rural areas

目的研究东营地区城市和农村人群中的高同型半胱氨酸血症(HHcy)现患率的差异,同时比较HHcy患者合并不同心血管病危险因素时现患率的城乡分布。方法以东营地区2个社区和2个农村40~79岁的中老年知情同意者4109人作为研究对象,进行问卷调查,并测量身高、体质量、BP、体质量指数(BMI),采集清晨空腹静脉血检测空腹血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血同型半胱氨酸(Hcy)。结果 (1)总体人群中HHcy的现患率为35.57%,40~50岁(包含50岁)人群现患率为28.1%,51~60岁(包含60岁)为32.76%,61~70岁(包含70岁)为41.45%,>70岁为55.35%,男性占50.40%,女性占28.82%,性别间差异具有统计学意义(OR=0.398,95%CI:0.350~0.453,P<0.01)。农村HHcy现患率明显高于城市(P<0.001)。(2)合并危险因素分析,HHcy合并有高血压者最多,占71.92%,城市HHcy合并高血压现患率(60.03%)明显低于农村(81.41%)(P<0.05),其次为合并有血脂异常,占60.88%,合并吸烟占36.34%,合并肥胖占21.77%。结论高血压是HHcy人群中最主要合并的危险因素,其次是和血脂异常。农村HHcy合并高血压的居民应是重点干预对象,城市HHcy合并吸烟、肥胖等危险因素的现患率高于农村。合并血脂异常、糖代谢异常的HHcy患者,城乡之间差异不明显。

Objective To investigate the differences of prevalence ofserm of hyperhomocystinemia（ HHcy） as well as the differences of cardiovascular risk factors in HHcy patients between urban and rural areas. Methods People from 40-79 years old who were signed the informed consent were selected of two urban areas and two rural areas in Dongying. They were studied by questionnaires,height,weight,BP and body mass index were measured.Overnight fasting blood sample were collected to detect fasting glucose,total cholesterol,triglycerides,low-density lipoprotein,high-density lipoprotein,homocysteine（ Hcy）. Results（ 1） The overall prevalence of HHcy status was 35. 57%,40-50 years old population prevalence rate was 28. 1%,51-60 years old population prevalence rate was 32. 76%,61-70 years old population prevalence rate was 41. 45%,more than 70 years old population prevalence rate was 55. 35%,including a prevalence of 50. 40% in male and 28. 82% in female which showed statistical differences（ OR = 0. 398,95% CI： 0. 350-0. 453,P 0. 01）. The prevalences of HHcy in urban areas were significantly higher than that in rural areas（ P 0. 001）.（ 2） When HHcy combined the risk factors,hypertension showed the highest prevalence（ 71. 92%）. The HHcy population accompanied with hypertension was significantly lower in urban areas（ 60. 03%） than in rural areas（ 81. 41%）（ P 0. 05）. The HHcy population accompanied with abnormal blood lipid level was 60. 88%,with smoke was 36. 34%,with obesity was 21. 77%. Conclusions Hypertensive is the most commonly risk factor for HHcy population,followed by dyslipidemia. HHcy combined with hypertensive in rural area is the most important intervention object. The HHcy population accompained with smoke or obesity are higher in urban than rural. There are no significant differences in HHcy combined with dyslipidemia or abnormal carbohydrate metabolism between urban area and rural area.