Plasma homocysteine concentrations and risk of coronary heart disease in UK Indian Asian and European men
Plasma homocysteine concentrations and risk of coronary heart disease in UK Indian Asian and European men
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DOI：
10.1016/s0140-6736(99)93019-2
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发表时间：
2000-02-12
期刊：
影响因子：
168.9
通讯作者：
Kooner, JS
中科院分区：
文献类型：
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作者：
Chambers, JC;Obeid, OA;Kooner, JS
背景：英国印度裔亚洲人冠心病（CHD）死亡率增加的原因尚不清楚。在这项研究中，我们测试的假设，血浆同型半胱氨酸浓度升高是印度亚洲人冠心病的危险因素，并解释他们的冠心病风险增加的一部分，与European.Methods相比，我们进行了两个平行的病例对照研究，一个在欧洲人和一个在印度亚洲人。我们招募了551名男性病例（294名欧洲人，257名印度亚洲人）和1025名健康男性对照（507名欧洲人，518名印度亚洲人）。空腹和甲硫氨酸负荷后同型半胱氨酸，维生素B-12和叶酸浓度，和传统的冠心病危险因素进行了测量，结果空腹同型半胱氨酸浓度高8%（95%CI 3-14）的情况下，与对照组相比，在两个种族。空腹血浆同型半胱氨酸水平升高5 μ mol/L，冠心病的比值比在欧洲人中为1.3（1.1-1.6），在印度亚洲人中为1.2（1.0-1.4）。空腹血浆同型半胱氨酸与冠心病之间的关联在两个种族中均独立于传统的冠心病危险因素。与对照组相比，病例组负荷后同型半胱氨酸浓度无显著差异。在对照组中，印度亚洲人的空腹同型半胱氨酸浓度比欧洲人高6%（2-10）。根据结果，我们估计，与欧洲人相比，高同型半胱氨酸可能导致印度亚洲人冠心病死亡人数的两倍。两个种族之间同型半胱氨酸浓度的差异可以通过亚洲人较低的维生素B-12和叶酸水平来解释。解释血浆同型半胱氨酸是印度亚洲人CHD的一个新的和独立的危险因素，并且可能有助于他们增加CHD风险。印度亚洲人升高的同型半胱氨酸浓度可能与他们降低的维生素B-12和叶酸水平有关，这意味着在这组中增加的CHD风险可能通过膳食维生素补充剂来降低。
Background Reasons for the increase in mortality due to coronary heart disease (CHD) in UK Indian Asians are not well understood. In this study, we tested the hypotheses that elevated plasma homocysteine concentrations are a risk factor for CHD in Indian Asians, and explain part of their increased CHD risk, compared with Europeans.Methods We undertook two parallel case-control studies, one in Europeans and one in Indian Asians. We recruited 551 male cases (294 European, 257 Indian Asian) and 1025 healthy male controls (507 European, 518 Indian Asian). Fasting and post-methionine load homocysteine, vitamin B-12 and folate concentrations, and conventional CHD risk factors were measured,Findings Fasting homocysteine concentrations were 8% higher (95% CI 3-14) in cases compared with controls, in both ethnic groups. The odds ratio of CHD for a 5 mu mol/L increment in fasting plasma homocysteine was 1.3 (1.1-1.6) in Europeans and 1.2 (1.0-1.4) in Indian Asians. The association between fasting plasma homocysteine and CHD was independent of conventional CHD risk factors in both ethnic groups. Post-load homocysteine concentrations were not significantly different in cases compared with controls. Among the controls, fasting homocysteine concentrations were 6% (2-10) higher in Indian Asians than in Europeans. From the results we estimate that elevated homocysteine may contribute to twice as many CHD deaths in Indian Asians, compared with Europeans. The differences in homocysteine concentrations between the two ethnic groups were explained by lower vitamin B-12 and folate levels in Asians.Interpretation Plasma homocysteine is a novel and independent risk factor for CHD in Indian Asians, and may contribute to their increased CHD risk, Raised homocysteine concentrations in Indian Asians may be related to their reduced vitamin B-12 and folate levels, implying that the increased CHD risk in this group may be reduced by dietary vitamin supplementation.