同型半胱氨酸与房颤的关联分析——基于如皋衰老队列

Relationship between homocysteine and atrial fibrillation:a cross-section analysis of Rugao Aging Cohort Study

目的 探讨中国老年人群房颤(AF)与Hcy的相关性。方法 数据来源于如皋衰老队列70~89岁人群的第四次随访资料。根据Hcy水平的四分位数及推荐的切点15μmol/L进行分组,即Q1、Q2、Q3、Q4组和Hcy高水平组、Hcy正常水平组。采用Logistic回归模型分析不同水平Hcy与AF的相关性。结果 本研究共纳入1798名研究对象,其中男814例,女984例,平均年龄(79.09±4.38)岁,AF者90例(5.0%),Hcy高水平者867例(48.2%)。AF者与非AF者的年龄、吸烟情况、饮酒情况、Hcy水平、Hcy高水平者比例差异均有统计学意义(P<0.05)。Logistic回归分析显示,与Q1组相比,Q2(OR=2.884,95%CI1.201~6.930)、Q3(OR=3.644,95%CI1.547~8.580)、Q4(OR=6.607,95%CI2.932~14.891)组AF发生风险显著增加;与Hcy正常水平组相比,Hcy高水平组AF发生风险显著增加(OR=2.774,95%CI1.742~4.419);logHcy每增加一个标准差,AF发生风险为原来的1.441(95%CI1.227~1.692)倍;在校正年龄、性别、婚姻状况、BMI、教育、职业、吸烟、饮酒、高血压、糖尿病后,上述差异仍有统计学意义(P<0.05)。结论 中国老年人群Hcy水平升高与AF风险增加相关,提示Hcy可能是AF发生的风险因素。

Objective To explore the relationship between atrial fibrillation(AF)and homocysteine(Hcy)in the Chinese elderly.Methods The data were obtained from the survey of the population aged 70-89 years old in the fourth follow-up of Rugao Aging Cohort Study.According to the quartile level or the recommended cut point(15μmol/L)of Hcy,the subjects were devided into Q1 group,Q2 group,Q3 group and Q4 group or high level of Hcy group and normal level of Hcy group.The relationships between different levels of Hcy and AF were analyzed by Logistic regression model.Results A total of 1798 subjects were included in this study,and the average age was 79.09±4.38 years old.Among them,814 were male and 984 were female;90 cases presented with AF(5.0%),and 867 cases presented with high level of Hcy(48.2%).There were statistically significant differences in age,smoking history,drinking history,Hcy level and the proportion of people with high Hcy level between AF group and non-AF group(P<0.05).Logistic regression analysis showed that,compared with Q1 group,the risk of AF in Q2 group(OR=2.884,95%CI 1.201-6.930),Q3 group(OR=3.644,95%CI 1.547-8.580)and Q4 group(OR=6.607,95%CI 2.932-14.891)were significantly increased;Compared with normal level of Hcy group,the risk of AF in high level of Hcy group was significantly increased(OR=2.774,95%CI 1.742-4.419);For each standard deviation increased in logHcy,the risk of AF was 1.441 times as high as the original one(OR=1.441,95%CI1.227-1.692);The differences were still statistically significant after adjusting for age,gender,marital status,body mass index,education,occupation,smoking,drinking,hypertension and diabetes(P<0.05).Conclusions Elevated Hcy level is correlated with the increased risk of AF in the Chinese elderly,and it suggests that Hcy may be a risk factor for the occurrence of AF.