同型半胱氨酸及尿酸水平与社区人群中国动脉粥样硬化性心血管疾病风险预测关系的研究

Study of the relationship among homocysteine and uric acid levels and risk prediction of atherosclerotic cardiovascular disease in Chinese community population

目的:基于中国动脉粥样硬化性心血管疾病风险预测[prediction for atherosclerotic cardio-vascular disease(ASCVD)risk in China,China-PAR]模型,探讨血同型半胱氨酸(homocysteine,HCY)及UA水平与社区人群心血管病10年风险的关系。方法:以2023年3月至5月,在我中心体检的1699例50~85岁参检者作为对象,收集年龄、性别等基本临床特征,检测HCY、UA等生化指标,采用China-PAR模型进行心血管10年风险评分。按照血HCY及UA是否升高,分为四组:HCY及UA正常组,单纯高HCY组,单纯高UA组,HCY及UA升高组,比较四组间China-PAR评分的差异。结果:HCY及UA正常组,单纯高HCY组,单纯高UA组,HCY及UA升高组的心血管10年风险值中位数分别为:7.6%,11.1%,9.5%,12.9%;各组心血管10年风险高危分布情况分别为:484例(37.8%),78例(54.9%),97例(45.8%),39例(60.0%)。HCY及UA升高组心血管10年风险值中位数、高危占比显著高于前三组(P<0.01)。单因素二元Logistic回归分析显示:BMI、TG、肌酐、FBG、HbAlc、HCY、UA与心血管10年风险高危相关(P<0.01),相关系数分别为:0.158、0.258、0.009、0.715、0.986、0.059、0.003;多因素二元Logistic回归显示:BMI,FBG、HbAlc、HCY对心血管10年风险高危有显著的正向影响关系(P<0.01),相关系数分别为:0.108、0.468、0.433、0.044,UA对心血管10年风险高危无相关(P>0.05)。结论:血HCY及UA水平与社区人群China-PAR心血管10年风险高危正相关,且血HCY的相关性强于血UA。

Objective:To investigate the relationship among blood homocysteine(HCY),Uric Acid(UA)levels and the 10-year risk of cardiovascular disease in community based on China-PAR model.Methods:A total of 1699 participants aged 50 to 85 years who underwent physical examination in our center from March to May 2023 were selected as the study objects.Basic clinical characteristics such as age,gender and so on were collected.Biochemical indexes such as HCY and UA were detected by blood samples.The 10-year cardiovascular risk score was performed by China-PAR model.According to whether blood HCY and UA were elevated,the individuals were divided into four groups:normal HCY and UA group,isolated high HCY group,isolated high UA group,and elevated HCY and UA group.The differences of China-PAR scores among the four groups were compared.Results:The median 10-year cardiovascular risk values of normal HCY and UA group,isolated high HCY group,isolated high UA group,and elevated HCY and UA group were 7.6%,11.1%,9.5%,and 12.9%,respectively.The distribution of 10-year cardiovascular high risk in each group was as follows:484 cases(37.8%),78 cases(54.9%),97 cases(45.8%),39 cases(60.0%).The median 10-year cardiovascular risk and the proportion of high risk in the elevated HCY and UA groups were significantly higher than those three groups(P<0.01).Single-factor binary Logistic regression analysis showed that body mass index,triglyceride,creatinine,fast blood glucose,HbA1c,HCY and UA were associated with 10-year cardiovascular high risk(P<0.01),and the correlation coefficients were 0.158,0.258,0.009,0.715,0.986,0.059,0.003,respectively.Multivariate binary Logistic regression analysis showed that body mass index,fast blood glucose,HbA1c and HCY had significant positive effects on 10-year cardiovascular high risk(P<0.01),and the correlation coefficients were 0.108,0.468,0.433 and 0.044,respectively.UA had no significant effect on 10-year cardiovascular high risk(P>0.05).Conclusions:HCY and UA levels were positively correlated with high risk of the 10-year cardiovascular of China-PAR in community population.The correlation between blood HCY level and the 10-year cardiovascular high risk was stronger than that of blood UA.