高同型半胱氨酸血症与代谢综合征及其组分相关性的研究
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摘要
目的探讨代谢综合征(MS)及其各主要组分与高同型半胱氨酸血症(HHcy)之间的相关性。方法采取随机、整体抽样的方法,选取广西南宁市某高校社区职工603人进行横断面流行病学研究。对纳入对象进行问卷调查,收集个人基本信息(性别、年龄等)、个人嗜好(吸烟、饮酒、运动等)、既往病史及家族史、药物服用情况等;体格检查:包括身高、体重、腰围、血压的测量;生化指标测定:包括高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、空腹血糖(FBG)和餐后血糖(PBG)、同型半胱氨酸(HCY)等。采用logistic回归分析对高同型半胱氨酸血症与代谢综合征及其主要组分(肥胖、高血糖或糖尿病、血脂异常、高血压)的相关性进行评估。结果在控制性别、年龄、吸烟、饮酒和运动这些与Hcy升高有关的因素后,MS、HDL-C降低和腹型肥胖组发生HHcy的概率显著高于正常组,且具有统计学意义(P均<0.05),高甘油三酯、高血压组发生HHcy的概率显著高于正常组,但结果无统计学意义(P均>0.05)。结论同型半胱氨酸与代谢综合征及其各主要组分(除血糖外)具有相关性,应重视对代谢综合征患者同型半胱氨酸的检测,为心血管疾病的预防和早期诊断提供依据。
Objective To investigate the relationship of hyperhomocysteine(HHcy) with metabolic syndrome(MS) and its main components. Methods 603 community workers from a university in Nanning, Guangxi, were selected for cross-sectional epidemiological study. Questionnaire survey was conducted for the included subjects to collect basic personal information(gender, age, etc.), personal hobbies(smoking, drinking, sports, etc.), previous medical history, family history and medication use, etc. Physical examination: including measurement of height, weight, waist circumference and blood pressure; Biochemical indexes: including high density lipoprotein cholesterol(HDL-C), triglycerides(TG), fasting blood glucose(FBG), postprandial blood glucose(PBG), homocysteine(HCY), etc. Logistic regression analysis was used to evaluate the correlation of hyperhomocysteine with metabolic syndrome and its major components(obesity, hyperglycemia or diabetes, dyslipidemia, hypertension). Results After control of gender, age, smoking, drinking and exercise which associated with increased Hcy, the incidence of HHcy is significantly higher than normal group in MS, low HDL-C and abdominal obesity group, with statistical significance(P < 0.05), the incidence of HHcy in high triglycerides, high blood pressure group is significantly higher than normal group, but the result has no statistical significance(P>0.05). Conclusion Hyperhomocysteine is related to metabolic syndrome and its main components(except blood glucose),the detection of homocysteine in patients with metabolic syndrome should be paid more attention, so as to provide a basis for the prevention and early diagnosis of cardiovascular diseases.
Objective To investigate the relationship of hyperhomocysteine(HHcy) with metabolic syndrome(MS) and its main components. Methods 603 community workers from a university in Nanning, Guangxi, were selected for cross-sectional epidemiological study. Questionnaire survey was conducted for the included subjects to collect basic personal information(gender, age, etc.), personal hobbies(smoking, drinking, sports, etc.), previous medical history, family history and medication use, etc. Physical examination: including measurement of height, weight, waist circumference and blood pressure; Biochemical indexes: including high density lipoprotein cholesterol(HDL-C), triglycerides(TG), fasting blood glucose(FBG), postprandial blood glucose(PBG), homocysteine(HCY), etc. Logistic regression analysis was used to evaluate the correlation of hyperhomocysteine with metabolic syndrome and its major components(obesity, hyperglycemia or diabetes, dyslipidemia, hypertension). Results After control of gender, age, smoking, drinking and exercise which associated with increased Hcy, the incidence of HHcy is significantly higher than normal group in MS, low HDL-C and abdominal obesity group, with statistical significance(P < 0.05), the incidence of HHcy in high triglycerides, high blood pressure group is significantly higher than normal group, but the result has no statistical significance(P>0.05). Conclusion Hyperhomocysteine is related to metabolic syndrome and its main components(except blood glucose),the detection of homocysteine in patients with metabolic syndrome should be paid more attention, so as to provide a basis for the prevention and early diagnosis of cardiovascular diseases.
引文
[1]金文胜,译,潘长玉,校.代谢综合征—促进心血管疾病流行的祸首[J].中华内分泌代谢杂志,2005,21(4).
[2]钟惠娟,张立建,陈瑞,等.代谢综合征患者血浆同型半胱氨酸、内皮素与颈动脉内膜中层厚度的相关研究[J].当代医学,2011,17(20):18-20.
[3]Sreckovic B, Sreckovic VD, Soldatovic I, et al. Homocysteine is amarkerformetabolicsyndromeandatherosclerosis.Diabetes Metab Syndr.2017,11(3):179-182.
[4]Sengwayo D,Moraba M,Motaung S.Association of homocysteinaemiawithhyperglycaemia,dyslipidaemia,hypertension and obesity. Cardiovasc J Afr.2013 24(7):265-269.
[5]RobertsonJ,IemoloF,StablerSP,etal.VitaminB12,homocysteineandcarotidplaqueintheeraoffolicacid fortificationofenrichedcerealgrainproducts.CMAJ.2005172(12):1569-1573.
[6]薛莉,陈树兰,张建荣.高同型半胱氨酸血症对急性冠状动脉综合征患病的作用及其机制探讨[J].中国循环杂志,2002,17(3):183-185.
[7]王清涛,秦晓光.同型半胱氨酸的检测和临床应用[J].中华检验医学杂志,2006,29(3):193-195.
[8]Wald DS, Law M, Morris JK. Homocysteine and cardiovascular disease:evidence on causality fromameta-analysis.BMJ.2002;325(7374):1202.
[9]李响,李淑红,李琳.成人血清同型半胱氨酸水平与代谢综合征及各组分的关系[J].中华临床营养杂志,2016,24(3):139-143.
[10]中华医学会糖尿病分会.中国2型糖尿病防治指南(2017年版).中国实用内科杂志,2018,38(4):4-67.
[11]Wang WM,JinHZ.Homocysteine:APotentialCommonRoute for Cardiovascular Risk and DNA Methylation in Psoriasis.Chin Med J(Engl).2017,130(16):1980-1986.
[12]MollS,VargaEA.HomocysteineandMTHFRmutations.Circulation 2015;132:e6-9.
[13]何莉.高同型半胱氨酸血症与高血压发病机制的研究进展[J].心血管病学进展,2015,36(3):283-287.
[14]隋丰秋.吉林省德惠地区居民血同型半胱氨酸与代谢综合症相关性研究[D].吉林:吉林大学,2015.
[15]刘思波.血浆同型半胱氨酸水平与代谢综合征及其各相关因子的相关性研究[J].中国医药指南,2016,10(17):510-511.
[16]刘璐璐,魏金婴,魏雪,等.德惠地区居民高同型半胱胺酸血症水平与危险因素的相关性研究[J].中华临床医师杂志,2015,9(16):3133-3135.
[17]李宗锋,李洪臣.中老年高脂血症患者同型半胱氨酸与维生素B12及叶酸水平调查[J].中华实用诊断与治疗杂志,2014,28(5):516-517.
[2]钟惠娟,张立建,陈瑞,等.代谢综合征患者血浆同型半胱氨酸、内皮素与颈动脉内膜中层厚度的相关研究[J].当代医学,2011,17(20):18-20.
[3]Sreckovic B, Sreckovic VD, Soldatovic I, et al. Homocysteine is amarkerformetabolicsyndromeandatherosclerosis.Diabetes Metab Syndr.2017,11(3):179-182.
[4]Sengwayo D,Moraba M,Motaung S.Association of homocysteinaemiawithhyperglycaemia,dyslipidaemia,hypertension and obesity. Cardiovasc J Afr.2013 24(7):265-269.
[5]RobertsonJ,IemoloF,StablerSP,etal.VitaminB12,homocysteineandcarotidplaqueintheeraoffolicacid fortificationofenrichedcerealgrainproducts.CMAJ.2005172(12):1569-1573.
[6]薛莉,陈树兰,张建荣.高同型半胱氨酸血症对急性冠状动脉综合征患病的作用及其机制探讨[J].中国循环杂志,2002,17(3):183-185.
[7]王清涛,秦晓光.同型半胱氨酸的检测和临床应用[J].中华检验医学杂志,2006,29(3):193-195.
[8]Wald DS, Law M, Morris JK. Homocysteine and cardiovascular disease:evidence on causality fromameta-analysis.BMJ.2002;325(7374):1202.
[9]李响,李淑红,李琳.成人血清同型半胱氨酸水平与代谢综合征及各组分的关系[J].中华临床营养杂志,2016,24(3):139-143.
[10]中华医学会糖尿病分会.中国2型糖尿病防治指南(2017年版).中国实用内科杂志,2018,38(4):4-67.
[11]Wang WM,JinHZ.Homocysteine:APotentialCommonRoute for Cardiovascular Risk and DNA Methylation in Psoriasis.Chin Med J(Engl).2017,130(16):1980-1986.
[12]MollS,VargaEA.HomocysteineandMTHFRmutations.Circulation 2015;132:e6-9.
[13]何莉.高同型半胱氨酸血症与高血压发病机制的研究进展[J].心血管病学进展,2015,36(3):283-287.
[14]隋丰秋.吉林省德惠地区居民血同型半胱氨酸与代谢综合症相关性研究[D].吉林:吉林大学,2015.
[15]刘思波.血浆同型半胱氨酸水平与代谢综合征及其各相关因子的相关性研究[J].中国医药指南,2016,10(17):510-511.
[16]刘璐璐,魏金婴,魏雪,等.德惠地区居民高同型半胱胺酸血症水平与危险因素的相关性研究[J].中华临床医师杂志,2015,9(16):3133-3135.
[17]李宗锋,李洪臣.中老年高脂血症患者同型半胱氨酸与维生素B12及叶酸水平调查[J].中华实用诊断与治疗杂志,2014,28(5):516-517.