Hyperhomocysteinemia in patients with cardiovascular disease
Hyperhomocysteinemia in patients with cardiovascular disease
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DOI：
10.5604/17322693.1102340
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发表时间：
2014-05-14
影响因子：
0.3
通讯作者：
Kopczynski, Zygmunt
中科院分区：
文献类型：
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作者：
Baszczuk, Aleksandra;Kopczynski, Zygmunt
同型半胱氨酸（Hcy）是一种内源性非结构蛋白，是蛋氨酸和半胱氨酸途径中出现的一种含硫氨基酸，积极参与多种生化反应。健康人血浆中同型半胱氨酸的总浓度较低，用高效液相色谱法测定其水平在5.0-15.0μmol/l之间，用免疫测定方法测定其水平在5.0-12.0μmol/l之间。血液中这种氨基酸浓度较高称为高同型半胱氨酸血症。高同型半胱氨酸血症与心血管疾病及其并发症（心脏病发作和中风）显着相关。据认为，高同型半胱氨酸血症会损害内皮细胞，降低血管的灵活性，并对止血过程产生不利影响。此外，高同型半胱氨酸血症会增强高血压、吸烟、葡萄糖、脂质和脂蛋白代谢受损等危险因素的不利影响，并促进炎症的发展。补充叶酸和维生素B-12和B-6可有效降低同型半胱氨酸浓度。然而，过去十年进行的干预研究并未证实维生素疗法降低心血管疾病患者血液中同型半胱氨酸水平的临床益处。此外，遗传学研究尚无明确证据表明MTFHR多态性677C>T基因的存在也与心血管疾病的发生有关，MTFHR多态性677C>T是高同型半胱氨酸血症的最常见原因之一。这些结果促使研究人员讨论同型半胱氨酸在心血管疾病发生和治疗中的作用以及对此问题进行进一步研究的必要性。
Homocysteine (Hcy) is an endogenous, non-structural protein, a sulfur-containing amino acid emerging on the pathway of methionine and cysteine, actively involved in numerous biochemical reactions.Total concentration of homocysteine in plasma of healthy humans is low and its level is between 5.0 and 15.0 mu mol/l, assessed with the use of HPLC, or 5.0-12.0 mu mol/l, using immunoassay methods. Higher concentration of this amino acid in blood is called hyperhomocysteinemia. Hyperhomocysteinemia is significantly correlated with cardiovascular disease and its complications: heart attacks and strokes. It is believed that hyperhomocysteinemia damages endothelial cells, reduces the flexibility of vessels, and adversely affects the process of hemostasis. In addition, hyperhomocysteinemia enhances the adverse effects of risk factors such as hypertension, smoking, and impaired glucose, lipid and lipoprotein metabolism, as well as promoting the development of inflammation.The concentration of homocysteine can be effectively lowered by supplementation with folic acid and vitamins B-12 and B-6. However, intervention studies conducted in the past decade did not confirm the clinical benefit of vitamin therapy lowering the level of homocysteine in blood of patients with cardiovascular disease. Moreover, there is not clear evidence from genetic studies that the presence of the gene for MTFHR polymorphism 677C>T, which is one of the most common causes of hyperhomocysteinemia, is also associated with the development of cardiovascular disease.These results led the researchers to discuss the role of homocysteine in the development and treatment of cardiovascular disease as well as the need for further research on this issue.