体检人群同型半胱氨酸水平与心血管疾病的关系

Correlation between homocysteine levels and cardiovascular diseases in physical examination population

目的探讨体检人群同型半胱氨酸(Hcy)水平与心血管疾病之间的关系。方法采用分层随机抽样的方法,华东疗养院2015年体检人群中,随机抽取20~80岁人群共7 296人为研究对象,收集研究对象的病史、腰围、身高、体重、血压、血脂、血清肌酐、尿酸、空腹血糖、血清胰岛素、Hcy等资料。利用Logistic回归分析Hcy水平与心血管疾病间的关系。结果体检人群Hcy水平的升高与冠心病、糖尿病及高血压病发病率的增加有关,与脑血管病发病率无关。Hcy水平与入选者的年龄、体质指数、腰围、收缩压、舒张压、胰岛素、HOMA指数、肌酐、TG、LDL-C及尿酸水平呈正相关,而与入选者的HDL-C、Lp(a)水平呈负相关。Logistic回归分析显示,Hcy水平与冠心病的发生相关(风险比∶1.036,95%CI∶1.001~1.072,P=0.042),与糖尿病的发生也相关(风险比∶1.020,95%CI∶1.007~1.033,P=0.002)。结论体检人群高Hcy水平与更高的冠心病、糖尿病的发病率相关。

Objective To investigate the correlation between homocysteine（ Hcy） levels and cardiovascular diseases in physical examination population. Methods The stratified random sampling method was used to randomly collect 7296 subjects aged 20 ~ 80 years in physical examination population in Shanghai Huadong sanatorium in 2015. The detail medical history,waist circumference,height,body mass,blood pressure,blood lipid,serum creatinine,uric acid,blood glucose,insulin and homocysteine were cellected and analyzed. Morever the correlation between Hcy levels and cardiovascular disease was analyzed by Logistic regression methods. Results The increase of Hcy levels of the subjects was related with an increase of incidence rate of coronary heart disease,diabetes and hypertension,however,which was not correlated with that of cerebrovascular disease. The Hcy levels were positively correlated with the subject ＇s age,body mass index,waist circumference,systolic blood pressure,diastolic blood pressure,insulin,HOMA index,triglyceride,low density lipoprotein cholesterol,serum creatinine and uric acid,however,which were negativelt correlated to high density lipoprotein cholesterol and lipoprotein a. The Logistic regression analysis showed Hcy levels were associated with the incidence of coronary heart disease（ OR： 1. 036,95% CI： 1. 001 ~ 1. 072,P〈0. 05）,which were also associated with the incidence of diabetes（ OR：1. 020,95% CI： 1. 007 ~ 1. 033,P〈0. 01）. Conclusion The higher Hcy levels are associated with higher incidence rate of coronary heart disease and diabetes in physical examination population.