ASSOCIATION BETWEEN PLASMA HOMOCYSTEINE CONCENTRATIONS AND EXTRACRANIAL CAROTID-ARTERY STENOSIS
ASSOCIATION BETWEEN PLASMA HOMOCYSTEINE CONCENTRATIONS AND EXTRACRANIAL CAROTID-ARTERY STENOSIS
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DOI：
10.1056/nejm199502023320502
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发表时间：
1995-02-02
影响因子：
158.5
通讯作者：
ROSENBERG, IH
中科院分区：
文献类型：
--
作者：
SELHUB, J;JACQUES, PF;ROSENBERG, IH
背景流行病学研究已经确定高同型半胱氨酸血症是动脉粥样硬化的一个可能的危险因素。我们确定了颈动脉粥样硬化的风险与血浆同型半胱氨酸浓度和高同型半胱氨酸血症的营养决定因素的关系。我们对1041名来自Frachial Heart研究的老年受试者（418名男性和623名女性;年龄范围，67至96岁）进行了一项横断面研究。我们研究了颅外颈动脉最大狭窄程度（超声检查）与血浆同型半胱氨酸浓度，以及血浆同型半胱氨酸代谢相关维生素（包括叶酸、维生素B-12和维生素B-6）浓度和摄入量之间的关系。根据两条颈动脉血管病变程度的不同，将受试者分为两类：狭窄0 - 24%和狭窄25 - 100 mm。颈动脉狭窄小于或等于25%的患病率在男性中为43%，女性为34%。狭窄大于或等于25%的优势比为2.0血浆同型半胱氨酸浓度最高的受试者（95%置信区间，1.4 - 2.9）（大于或等于14.4 μ mol/L）与最低浓度相比在调整性别、年龄、血浆高密度脂蛋白胆固醇浓度、收缩压和吸烟状况后，（小于或等于9.1 μ mol/L），
Background. Epidemiologic studies have identified hyperhomocysteinemia as a possible risk factor for atherosclerosis. We determined the risk of carotid-artery atherosclerosis in relation to both plasma homocysteine concentrations and nutritional determinants of hyperhomocysteinemia.Methods. We performed a cross-sectional study of 1041 elderly subjects (418 men and 623 women; age range, 67 to 96 years) from the Framingham Heart Study. We examined the relation between the maximal degree of stenosis of the extracranial carotid arteries (as assessed by ultrasonography) and plasma homocysteine concentrations, as well as plasma concentrations and intakes of vitamins involved in homocysteine metabolism, including folate, vitamin B-12, and vitamin B-6. The subjects were classified into two categories according to the findings in the more diseased of the two carotid vessels: stenosis of 0 to 24 percent and stenosis of 25 to 100 percent.Results. The prevalence of carotid stenosis of less than or equal to 25 percent was 43 percent in the men and 34 percent in the women. The odds ratio for stenosis of greater than or equal to 25 percent was 2.0 (95 percent confidence interval, 1.4 to 2.9) for subjects with the highest plasma homocysteine concentrations (greater than or equal to 14.4 mu mol per liter) as compared with those with the lowest concentrations (less than or equal to 9.1 mu mol per liter), after adjustment for sex, age, plasma high-density lipoprotein cholesterol concentration, systolic blood pressure, and smoking status (P