呼和浩特地区表观健康成年人群血清同型半胱氨酸水平分析和参考区间建立

Serum Homocysteine Level Analysis and Reference Interval Establishment of Epigenetically Healthy Adult Population in Hohhot,Inner Mongolia

目的分析呼和浩特地区表观健康成年人群血清同型半胱氨酸(homocysteine,Hcy)水平和高同型半胱氨酸血症(hyperhomocysteinemia,hHcy)检出情况,并建立参考区间。方法选取2019年在内蒙古医科大学附属医院体检的25678例成年健康体检者为研究对象,检测Hcy水平,依据性别、年龄、种族分组并比较组间Hcy水平,分析Hcy水平与性别、年龄和种族之间的关系,并建立参考值范围。结果体检者血清Hcy检测数据呈偏态分布(W=0.235,P=0.000)。血清Hcy水平随着年龄的增加而增加,其中男性年龄组间比对(Z=-2.417~4.657,P=0.000~0.269),女性年龄组间比对(Z=1.970~3.896,均P<0.05),各年龄组间男性Hcy水平均高于女性,差异均有统计学意义(Z=-5.704~-2.398,均P<0.05);蒙古族人与汉族人血清Hcy水平[12.28(10.53,15.05)vs 12.25(10.47,14.96)]差异无统计学意义(Z=-1.086,P=0.127)。体检者的血清Hcy水平浓度与性别、年龄因素均呈正相关(r=0.057,0.086,均P<0.05),与种族因素无相关性(r=0.031,P=0.069)。hHcy总检出率随年龄增长而升高(F=4.142,P=0.042),各年龄组间男性hHcy检出率远远高于女性(χ^(2)=7.108~24.375,均P<0.05),蒙古族人hHcy检出率高于汉族人(22.63%vs 21.76%),差异有统计学意义(χ^(2)=46.148,P=0.000)。单因素分析表明hHcy检出率与年龄、性别等相关联(P=0.036,0.000),与种族关联性不大(P=0.124);多因素分析表明年龄、性别因素是hHcy检出的独立影响因素(P=0.021,0.000)。呼和浩特地区男性年龄按21~30,31~40,41~60,61~70,71~80和>80岁分为6组,参考区间分别为7.02~18.63,7.92~21.18,7.85~23.60,7.97~24.00,7.89~24.37和7.88~20.88μmol/L;女性年龄按21~30,31~40,41~50,51~60,61~70,71~80和80岁分为7组,参考区间分别为6.77~17.47,7.24~19.12,7.29~20.07,7.90~21.44,7.86~22.30,7.88~23.03和7.49~17.17μmol/L。结论呼和浩特地区健康成年人群血清Hcy水平受年龄和性别影响,建立呼和浩特地区Hcy的参考区间可以为当地心脑血管相关疾病预防提供一定的参考依据。

Objective To analyze the serum levels of homocysteine(Hcy)and the detection of hyperhomocysteinemia(hHcy)in healthy adult people in Hohhot,and establish reference interval.Methods 25678 adult healthy people who underwent physical examination in the Affiliated Hospital of Inner Mongolia Medical University in 2019 were selected as the research objects.The level of Hcy was detected.They were grouped according to gender,age and race,compared the level of Hcy between the groups,analyzed the relationship between Hcy level and gender,age and race,and established the reference value range.Results The serum Hcy detection data were skewed(W=0.235,P=0.000).Serum Hcy levels increased with age,with male age groups(Z=-2.417~4.657,P=0.000~0.269),female age groups(Z=1.970~3.896,all P<0.05),male Hcy levels were higher than women,the differences were statistically significant(Z=-5.704~-2.398,all P<0.05).No Hcy difference between Mongolian and Han[12.28(10.53,15.05)vs 12.25(10.47,14.96)],the difference was statistically significant(Z=-1.086,P=0.127).The serum Hcy level concentration of physical examination was significantly positively correlated with gender and age(r=0.057,0.086,all P<0.05),but not with race(r=0.031,P=0.069).The total detection rate of hHcy increased with age(F=4.142,P=0.042),and the detection rate of hHcy was much higher among men than women,the differences were statistically significant(χ^(2)=7.108~24.375,all P<0.05),and the detection rate of hHcy in Mongolian was higher than that in Han(22.63%vs 21.76%)(χ^(2)=46.148,P=0.000),and the differences were statistically significant,respectively.Univariate analysis showed that the detection rate of hHcy was correlated with age and gender(P=0.036,0.000),but not with race(P=0.124).Mulitivariate analysis showed that age and gender were independent influencing factors for hHcy detection(P=0.021,0.000).Men in Hohhot were divided into 6 groups according to their ages of 21~30,31~40,41~60,61~70,71~80 and>80 year old,and the reference interval was 7.02~8.63,7.92~21.18,7.85~23.60,7.97~24.007.89~24.37 and 7.88~20.88μmol/L,respectively.Female ages were divided into 7 groups according to 21~30,31~40,41~50,51~60,61~70,71~80 and>80 years old,and the reference interval was 6.77~17.47,7.24~19.12,7.29~20.07,7.90~21.44,7.86~22.30,7.88~23.03 and 7.49~17.17μmol/L,respectively.Conclusion The serum Hcy level of healthy adult people in Hohhot was affected by age and gender.The establishment of the reference interval of Hcy in Hohhot can provide some reference basis for the prevention of local cardiovascular and cerebrovascular-related diseases.