成人血清同型半胱氨酸水平与代谢综合征及各组分的关系

Association of serum homocysteine levels with metabolic syndrome and its components in adults

目的：探讨成人血清同型半胱氨酸水平和代谢综合征及其各组分的相关性。方法采用定点连续抽样方法选取2012年9至12月在北京阜外医院进行健康体检的成人为研究对象，共594人入选，其中160人存在代谢综合征、434名无代谢综合征。入选者均检测血同型半胱氨酸水平及其他生化指标并收集人体测量学指标，采用Binary Logistic回归分析对同型半胱氨酸水平和代谢综合征及其各组分的相关性进行评价。结果代谢综合征组和非代谢综合征组的血同型半胱氨酸水平差异无统计学意义[（12.2±7.0）μmol／L 比（12.6±8.4）μmol／L， P＞0.05]；高同型半胱氨酸血症者（≥15μmol／L）和正常者（＜15μmol／L）相比，代谢综合征和其各代谢异常的发生率（代谢综合征27.3％比26.9％；血压异常27.3％比19.6％；高三酰甘油50.0％比48.3％；高密度脂蛋白胆固醇异常39.8％比36.6％；血糖异常30.7％比32.6％；腹型肥胖31.8％比31.2％）差异均无统计学意义（P均＞0.05）；存在不同代谢组分数量（0～5）的受检者间同型半胱氨酸水平[（12.3±7.4）μmol／L；（12.4±6.7）μmol／L；（13.2±11.2）μmol／L；（12.5±7.8）μmol／L；（11.2±2.7）μmol／L；（12.4±4.3）μmol／L]差异均无统计学意义（P均＞0.05）。校正年龄、性别、体质量指数、总胆固醇、低密度脂蛋白胆固醇和超敏C反应蛋白等混杂因素后，代谢综合征及其各组分对高同型半胱氨酸血症的预测均无统计学意义（ P均＞0.05）。结论在无明确冠状动脉性心脏病证据的人群中，高同型半胱氨酸血症与代谢综合征及其代谢异常组分间无相关性，二者可能存在不同的致心血管疾病的机制。

Objective To explore the relationship of serum homocysteine （ Hcy） level with metabolic syndrome （MS） and its components.Methods A cross-sectional study was conducted in 594 adults consec-utively sampled from people visiting Fuwai Hospital for physical examination between September and Decem-ber 2012, including 160 MS participants （MS group） and 434 without MS participancs （without MS group）. Serum Hcy levels, serum biochemical parameters, and anthropometric measurements of all the participants were collected.Binary logistic regression was used to assess the association of serum Hcy levels with MS and its components.Results No significant difference in Hcy levels was observed comparing the MS group and the without MS group [（12.2 ±7.0） μmol/L vs.（12.6 ±8.4） μmol/L, P〉0.05].Between participants with and without hyperhomocysteinemia （≥15 μmol/L vs.〈15 μmol/L） , no statistically significant differ-ences were observed in prevalence of MS and its metabolic disorders （ MS 27.3% vs.26.9%; high blood pressure 27.3% vs.19.6%; high triglycerides 50.0% vs.48.3%; high-density lipoprotein cholesterol 39.8%vs.36.6%; dysglycemia 30.7% vs.32.6%; abdominal obesity 31.8% vs.31.2%; all P 〉0.05）.Among participants having 0 to 5 metabolic abnormalities, there were no significant differences in ser-um Hcy levels [ （12.3 ±7.4） μmol/L; （12.4 ±6.7） μmol/L; （13.2 ±11.2） μmol/L; （12.5 ± 7.8） μmol/L; （11.2 ±2.7） μmol/L; （12.4 ±4.3） μmol/L; all P〉0.05].In a binary logistic re-gression model adjusted for age, gender, body mass index, total cholesterol, low-density lipoprotein choles-terol, and high-sensitivity C-reactive protein, neither MS nor its components were independent predictors of serum Hcy levels （ all P〉0.05 ） .Conclusions Elevated serum Hcy levels are not associated with MS or its components in people without evident cardiovascular diseases .MS and elevated serum Hcy levels may cause cardiovascular diseases via different mechanisms .