西南地区各族人群血清同型半胱氨酸水平分析及参考范围的建立

Serum Homocysteine Level Analysis and the Reference Range Establishment Among Ethnic Groups in Southwest China

目的分析西南地区各族人群血清同型半胱氨酸（HCY）水平,建立基于循环酶法的西南主要民族血清HCY参考区间,并初步探讨海拔对血清HCY水平影响。方法用循环酶法试剂检测体检健康的汉族人群4021名（包括平原汉族3581名、高原汉族440名）、藏族人群680名、彝族人群369名血清HCY水平,根据性别、年龄、种族、生活海拔进行分层分组统计分析。结果藏族人群血清HCY水平均高于彝族及汉族同性别同年龄阶段组（P〈0.01）,而彝族人群均高于汉族同性别同年龄阶段组（P〈0.01）;汉、彝族各年龄阶段男性血清HCY水平均显著高于女性（P〈0.05）;藏族人群性别间血清HCY水平差异无统计学意义（P〉0.05）;彝族、藏族所有年龄组间血清HCY水平差异均无统计学意义（P〉0.05）,而汉族男性和女性各年龄组间血清HCY水平不完全一致（P=0.001,0.005）,两两分别比较发现,汉族男性和女性在〉70岁组、61-70岁组与其他各组差异均有统计学意义（P〈0.01）,而〈60岁各组间差异无统计学意义（P〉0.05）。民族年龄性别分层分析可将所有受试者分为汉族男性21-60岁、61-70岁、〉70岁、女性21-60岁、61-70岁、〉70岁、彝族男性、女性、藏族人群九个小组,血清HCY水平参考区间分别为6.87-22.18μmol/L、7.33-27.69μmol/L、9.81-31.03μmol/L、4.39-17.36μmol/L、5.68-20.90μmol/L、7.11-26.33μmol/L、8.65-27.11μmol/L、6.92-25.37μmol/L、10.26-36.66μmol/L。根据生活海拔分层分析,高原汉族组血清HCY水平显著高于平原汉族组（P〈0.001）。结论健康人群血清HCY水平与性别、年龄、种族、生活海拔密切相关,我们基于循环酶法根据不同因素分别建立的西南地区各组人群血清HCY参考区间,对本地区临床实验室有重要借鉴意义。

Objective To analyze the levels of serum homocysteine（HCY） in ethnic groups in southwest of China,establish the reference range,and preliminarily explore the effect of altitude on serum HCY level.Methods A total of 4021 cases of healthy Han（including 3581 at flatland and 440 cases at high altitude）,369 cases of healthy Yi,680 cases of healthy Tibetan were included in the study.Serum HCY was detected by enzymatic cycling assay.The stratified analysis was conducted based on gender,age,race and the altitude of live.Kruskal-Wallis H test was used to compare between groups,Nemenyi test was used in two group comparison,and Mann-Whitney U test was used to compare between different sex and different altitude.Ninety five percent reference range was calculated by X2.5%and X97.5%.Results The serum HCY level in the Tibetan population was higher than that of Yi and Han population in the same age group（P〈0.01）,while Yi was higher than that of Han population in the same age group（P〈0.01）.The levels of serum HCY in male was significantly higher than the female in both Yi and Han population（P〈0.05）.There were no differences among gender in the Tibetan population（P〈0.05）.The levels of serum HCY in Han increased gradually with age（P = 0.001,0.005）.The stratified analysis of age and gender can be divided into 21-60 years,61-70 years, 70 years,female 21-60 years,61-70 years, 70 years in Han male,Yi male,female,Tibetan.The reference range of their serum HCY were 6.87-22.18μmol/L,7.33-27.69μmol/L,9.81-31.03μmol/L,4.39-17.36μmol/L,5.68-20.90μmol/L,7.11-26.33μmol/L,8.65-27.11μmol/L,6.92-25.37μmol/L,10.26-36.66μmol/L,respectively.In terms of analysis of the altitude of living,the serum HCY level at high altitude of Han was significantly higher than those living at flatland（P〈 0.001）.Conclusion Serum HCY level in healthy people is closely related to gender,age,race and the altitude of live.We have established the reference range of serum HCY in different ethnic groups with different factors based on enzymatic cycling assay,which provides important value for the clinical laboratory in the local region.