PLASMA HOMOCYST(E)INE, FOLATE, AND VITAMIN-B12 CONCENTRATIONS AND RISK FOR EARLY-ONSET CORONARY-ARTERY DISEASE
PLASMA HOMOCYST(E)INE, FOLATE, AND VITAMIN-B12 CONCENTRATIONS AND RISK FOR EARLY-ONSET CORONARY-ARTERY DISEASE
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DOI：
10.1093/ajcn/59.4.940
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发表时间：
1994-04-01
影响因子：
7.1
通讯作者：
ROSEMAN, JM
中科院分区：
文献类型：
--
作者：
PANCHARUNITI, N;LEWIS, CA;ROSEMAN, JM
高血浆同囊(e)线（Hcy）浓度可能是冠状动脉疾病（CAD）的决定因素。叶酸和维生素B-12是降低Hcy浓度的主要代谢途径所必需的。在一项病例对照研究中，研究人员对101名年龄在30-50岁、血管造影证实为冠心病的白人男性和108名年龄相仿、与患者生活在同一社区的白人男性进行了Hcy和这两种维生素辅助因子的相互关系。与对照组相比，血浆Hcy浓度每增加四分位数，冠心病的优势比（OR）为1.6 （95% CI: 1.3, 2.1）。在年龄、HDL和LDL胆固醇、体重指数、吸烟、高血压和糖尿病控制后，Hcy仍然是一个独立的危险因素（OR: 1.4; 95% CI: 1.0, 2.0）。叶酸浓度每增加四分位数的OR变化为0.8 （95% CI: 0.6, 1.0）。经Hcy调整后，该差异减小（OR: 0.9; 95% CI: 0.7, 1.2）。患者与对照组维生素B-12浓度几何平均值均为5.8 nmol/L，差异无统计学意义。然而，在控制Hcy和其他CAD危险因素后，维生素B-12浓度每四分位数增加的OR为1.5 （95% CI: 1.0, 1.8）。通过增加血浆叶酸浓度的干预来降低血浆Hcy可能会降低冠心病的风险。
High plasma homocyst(e)ine (Hcy) concentrations may be a determinant of coronary artery disease (CAD). Folate and vitamin B-12 are required for the primary metabolic pathway to reduce Hcy concentrations. The interrelationships of Hcy and these two vitamin cofactors were investigated in a case-control study of 101 white males aged 30-50 y with angiographically demonstrated CAD, and 108 white male, similarly aged, control subjects living in the same community as the patients. The odds ratio (OR) of CAD per quartile increase of plasma Hcy concentration based on control values was 1.6 (95% CI: 1.3, 2.1). After age, HDL and LDL cholesterol, body mass index, smoking, hypertension, and diabetes were controlled for, Hcy remained an independent risk factor (OR: 1.4; 95% CI: 1.0, 2.0). The OR change per quartile increase of folate concentration was 0.8 (95% CI: 0.6, 1.0). This difference was reduced (OR: 0.9; 95% CI: 0.7, 1.2) after Hcy adjustment. No difference in the geometric mean of vitamin B-12 concentration was found between patients and control subjects, both 5.8 nmol/L. However, after Hcy and the other CAD risk factors were controlled for, the OR per quartile increase in vitamin B-12 concentration was 1.5 (95% CI: 1.0, 1.8). Reduction in plasma Hcy by interventions to increase plasma folate concentration may decrease CAD risk.