上海市洞泾社区中老年人群同型半胱氨酸水平及其影响因素分析

Levels of serum homocysteine in middle-aged and elderly people in Dongjing community of Shanghai and their influence factors

目的探讨上海市洞泾社区中老年人群血清同型半胱氨酸(Hcy)水平及其影响因素。方法选取洞泾社区≥55岁的体检者2 336名,检测血压、血清Hcy、血脂、血糖(Glu)等水平。以年龄、性别、收缩压、舒张压、体重指数(BMI)分别对其分组。根据有无患病分为高血压组和无高血压组、糖尿病组和无糖尿病组、心脏病组和无心脏病组,根据各生化指标检测结果分为正常组和异常组。对血清Hcy水平及其相关影响因素进行分析。结果男性高Hcy血症的阳性率(23.0%)明显高于女性(8.1%,P<0.01)。不同年龄组间Hcy水平随年龄增长呈递增趋势,且高Hcy血症阳性率差异均有统计学意义(P<0.01)。收缩压<15.96 k Pa组、15.96~18.49 k Pa组和≥18.62 k Pa组高Hcy血症的阳性率分别为11.5%、14.8%和17.1%,各组间差异均有统计学意义(P<0.05)。心脏病组和无心脏病组高Hcy血症阳性率分别为18.0%和13.1%,2个组间差异有统计学意义(P<0.01)。肌酐(Cr)异常组、尿酸(UA)异常组和尿素异常组高Hcy血症阳性率分别为44.1%、24.6%和24.2%,分别高于Cr正常组(12.9%)、UA正常组(12.3%)和尿素正常组(14.2%)(P<0.01)。总胆固醇(TC)异常组高Hcy血症阳性率(12.8%)低于TC正常组(16.3%,P<0.05)。Glu正常组与Glu异常组之间、TG正常组与TG异常组之间、不同BMI各组之间、不同舒张压各组之间、有糖尿病组与无糖尿病组之间、有高血压组与无高血压组之间高Hcy血症的阳性率差异均无统计学意义(P>0.05)。二元逐步回归分析显示心脏病、男性及UA、Cr、收缩压异常是影响老年人Hcy水平的危险因素。结论男性、心脏病及UA、Cr、收缩压异常是导致中老年人高Hcy血症的危险因素。

Objective To investigate the influence factors for the levels of serum homocysteine(Hcy)inmiddle-aged and elderly people in Dongjing community of Shanghai.Methods A total of2336healthy subjects≥55years old were enrolled from Dongjing community.Their blood pressure,serum Hcy,blood lipid,glucose(Glu)and so on were determined.According to age,sex,systolic blood pressure,diastolic blood pressure andbody mass index(BMI),they were classified into hypertension group and non-hypertension group,diabetesmellitus group and non-diabetes mellitus group,heart disease group and non-heart disease group,respectively.According to biochemical indices,results were classified into normal and abnormal groups.The levels of serum Hcyand the influence factors were evaluated.Results The prevalence rate of hyperhomocysteinemia in males(23.0%)was higher than that in females(8.1%,P<0.01).Serum Hcy levels increased with ages,while the prevalencerate of hyperhomocysteinemia had statistical significance(P<0.01).In different systolic blood pressure groups of<15.96,15.96-18.49and≥18.62kPa,the prevalence rates of hyperhomocysteinemia were11.5%,14.8%and17.1%(P<0.05).The prevalence rates of hyperhomocysteinemia in heart disease and non-heart disease groupswere18.0%and13.1%(P<0.01).The prevalence rates of hyperhomocysteinemia in abnormal creatinine(Cr),uric acid(UA)and urea groups(44.1%,24.6%and24.2%)were higher than those in normal Cr,UA and urea groups(12.9%,12.3%and14.2%,P<0.01).In abnormal total cholesterol(TC)group,the prevalence rateof hyperhomocysteinemia was lower than that in normal TC group(12.8%and16.3%,P<0.05).The prevalencerates of hyperhomocysteinemia had no statistical significance in groups with normal and abnormal Glu,triglyceride(TG),BMI and systolic blood pressure,and there was no statistical significance for diabetes mellitus andhypertension or not(P>0.05).Bivariate logistic regression analysis showed that heart disease,male,UA,Cr andsystolic blood pressure were influence factors for the levels of Hcy.Conclusions Male,heart disease,UA,Cr andsystolic blood pressure are risk factors of hyperhomocysteinemia among middle-aged and elderly people.