同型半胱氨酸水平与心血管疾病危险因素的关联性分析

An analysis on the relationship between Homocysteine levels and risk factors of cardiovascular diseases

目的了解中老年职工同型半胱氨酸（Hcy）血清分布特点,为防治高同型半胱氨酸血症（HHcy）提供依据。方法选择某炼化公司40岁以上的体检职工5 113人,分析不同性别、年龄血清Hcy水平和HHcy检出率及HHcy与心血管疾病危险因素的关联性。结果各年龄组男性血清Hcy水平及HHcy检出率均明显高于女性,差异有统计学意义（P〈0.01）;男女HHcy检出率均随年龄增加呈增高趋势（P〈0.01）;Logistic回归分析显示,男性（OR=3.99,95%CI：3.12~5.10）、年龄大（OR=1.02,95%CI：1.01~1.03）、有高血压（OR=2.56,95%CI：2.04~3.22）、收缩压高（OR=1.01,95%CI：1.01~1.02）和BMI值大（OR=1.40,95%CI：1.04~1.89）是HHcy独立危险因素;而肌酐清除率高（OR=0.39,95%CI：0.31~0.49）是保护因素。结论年龄大、收缩压高、BMI值大和肌酐清除率低与Hcy水平有关联。

Objective To understand the distribution of serum Homocysteine（ Hcy） among the middle- aged and the elderly in a refining and chemical company and to provide suggestions for prevention and control of hyperhomocysteinemia（ HHcy）. Methods A total of 5 113 employees aged over 40 who received annual physical examination in our medical center in 2013 were enrolled in this study. Serum Hcy levels and HHcy positive rate were analyzed by gender and age. The relationship between HHcy and major risk factors of cardiovascular diseases were also analyzed. Results Serum Hcy levels and HHcy positive rate among male were higher than female in each phase of age The difference was statistically significant（ P〈0. 01）. Within the same gender group,HHcy positive rate increased significantly with age（ P〈0. 01）. Linear correlation and logistic regression showed that male（ OR = 3. 99,95% CI = 3. 12- 5. 10）,age（ OR = 1. 02,95% CI =1. 01- 1. 02）,history of hypertension（ OR = 2. 56,95% CI = 2. 04- 3. 22）,systolic pressure（ OR = 1. 01,95% CI = 1. 01- 1. 02） and body mass index（ OR = 1. 40,95% CI = 1. 04- 1. 89） were independent risk factors of HHcy,while creatinine clearance（ OR = 0. 39,95% CI = 0. 31- 0. 49） was protective factor. Conclusion The age,systolic pressure,body mass index and creatinine clearance was related to Hcy levels.