同型半胱氨酸在绝经后女性心血管疾病中的研究进展

Research Progress of Homocysteine in Cardiovascular Diseases in Postmenopausal Women

绝经意味着女性卵巢功能衰竭,性激素水平改变导致女性出现一系列绝经相关症状,近期可出现血管舒缩症状如潮热、盗汗,神经精神症状等,远期危害可出现心血管疾病(cardiovascular disease,CVD)、骨质疏松、糖脂代谢紊乱、泌尿生殖道萎缩等全身各器官系统退行性病变。绝经后女性CVD发病风险升高,是中老年女性致死、致残的重要原因。同型半胱氨酸(homocysteine,Hcy)是一种含巯基的氨基酸,是甲硫氨酸循环的中间代谢产物,与CVD的发生发展密切相关,被认为是CVD的独立危险因素。近年来相关研究表明绝经后女性Hcy水平及高同型半胱氨酸血症(hyperhomocysteinemia,HHcy)发生率均高于绝经前女性。绝经后升高的Hcy水平与CVD发生风险具有关联,Hcy可能在绝经后CVD中发挥重要作用。人体内Hcy水平可能受雌激素等性激素调控,绝经激素治疗(menopause hormone therapy,MHT)可降低女性Hcy水平,对降低绝经后CVD的发生风险有积极作用。

Menopause means ovarian failure and changes in sex hormone levels,which lead to a series of menopauserelated symptoms,including short-term vasomotor symptoms such as hot flashes,night sweats,neuropsychiatric symptoms,etc.Menopause also results in degenerative diseases in main organs and systems including cardiovascular diseases(CVD),osteoporosis,disorders of glucose and lipid metabolism,and urogenital atrophy.Postmenopausal women have an increased risk of CVD,which is the leading cause of mortality and an important cause of disability in middle-aged and old women.Homocysteine is a sulfhydryl-containing amino acid and an intermediate metabolite of the methionine cycle.It is closely related to the occurrence and development of CVD and is considered as an independent risk factor of CVD.In recent years,studies have shown that Hcy levels and the incidence of hyperhomocysteinemia(HHcy)are higher in postmenopausal women than in premenopausal women.The elevated Hcy level after menopause is associated with higher risks of CVD,and Hcy may play an important role in postmenopausal CVD.Serum Hcy levels may be regulated by sex hormones such as estrogen.Menopausal hormone therapy(MHT)can reduce Hcy levels in women and may have a positive effect on decreasing the risks of postmenopausal CVD.