补充多种维生素制剂对动脉硬化性疾病患者同型半胱氨酸水平的影响

Effect of Multivitamine Supplementation on Plasma Homocysteine and Prevalence of Atherosclerotic Diseases

目的通过本院干部体检资料的分析,探讨补充多种维生素对血浆同型半胱氨酸(Hcy)及动脉硬化性疾病患病率的影响。方法1999年度本院干部体检1220人和1999年4月～2000年10月部分住院患者358人,共1578人,其中男1403人,女175人;年龄39～99岁,平均(70.32±10.04)岁。空腹抽血并分离血浆,用酶联免疫法测定血浆Hcy浓度,同时调查其是否服用多种维生素和服用年数,以及是否患有动脉硬化性疾病(包括冠心病、缺血性脑卒中、高血压)和糖尿病。结果(1)正常组610人,男536人,女74人(无心、脑、肾疾病史、高血压、糖尿病及血栓性疾病史者);Hcy的血浆水平为(11.71±4.80)μmol/L,男性血浆Hcy水平高于女性,为(11.93±4.91)μmol/Lvs(10.14±3.57)μmol/L,P<0.01。(2)动脉硬化性疾病组968人,Hcy水平明显高于正常组,为(13.68±7.60)μmol/Lvs(11.71±4.80)μmol/L,P<0.01。(3)服用多种维生素者的血浆Hcy水平明显低于未曾服用者,为(11.59±4.84)μmol/Lvs(13.57±7.37)μmol/L,P<0.01。且服用年限越长,Hcy浓度越低,r=-0.139,P<0.01。(4)服用多种维生素者动脉硬化性疾病的患病率低于未服用者,30.4%vs69.6%,P=0.051,差异接近显著。结论Hcy是动脉硬化性疾病和糖尿病的一种新的危险因素,其浓度随年龄、性别有所不同。

Objective To investigate the effect of plasma homocysteine(Hcy)and prevalence of atheroscle-rotic disease after multivitamine supplementation.Methods Total1578cases observed,1403males and175females at39～99y(70.32±10.04y).Medical histories and multivitamin supplementation status(types,doses and duration of supplementation)were obtained by questionnaire;plasma Hcy level were measured using microplate enzyme immunoassay.Results(1)Plasma Hcy in normal group(74who are free from coronary artery disease,hypertension,strok,dibetes mellitus(DM),and renal disease)was(11.71±4.80)μmol/L,and plasma Hcy level in male was higher than that in female,(11.93± 4.91)μmol/L vs(10.14±3.57)μmol/L,P=0.002;(2)Plasma Hcy level in atherosclerosis diseases group(n=968)was higher than that in normal group(n=610),(13.67±7.56)μmol/L vs(11.71±4.80)μmol/L,P=0.000;(3)Plasma Hcy level in multivitamins supplement group was lower than that in non multivitamins supplement group,(11.59±4.84)μmol/L vs(13.57±7.37)μmol/L,P=0.000,there was a negative correlation between duration of multivitamins supple-mentation and plasma Hcy level(r=-0.139,P=0.000);(4)Prevalence of atherosclerotic disease and DM in persons with multivitamine supplemen tation was lower than non multivitamine supplement group(21.4%vs39.9%),but there was no sign ificant difference,it might be due to the sample size was not large enough.Conclusions Homoc ysteine is a novel risk factor as atherosclerosis diseases and dibetes.The concentrations of Hcy are different with age,sex,and serum folate,VitB 12 concentration.Prolong multivitamins supp lementation can prevent heperhomocysteinemia and reduce prevalent of atherosclerotic disease.It should be confirmed by prospective studies in greater cases and multi clinical center study,if it is recom mened to be used in clinic.