Plasma homocysteine and parental myocardial infarction in young adults in Jerusalem
Plasma homocysteine and parental myocardial infarction in young adults in Jerusalem
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DOI：
10.1161/01.cir.0000017360.99531.26
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发表时间：
2002-06-11
期刊：
影响因子：
37.8
通讯作者：
Selhub, J
中科院分区：
文献类型：
--
作者：
Kark, JD;Sinnreich, R;Selhub, J
背景——血浆同型半胱氨酸（tHcy）轻度升高与心血管疾病的因果关系尚未确定。为了解决该关系的前因后果方向性这一尚未解决的问题，我们评估了以色列年轻男性和女性中 tHcy 与父母心肌梗死 (MI) 的家族关联。我们还将冠心病 (CHD) 发病率较高的耶路撒冷的 tHcy 浓度与美国第三次全国健康和检查调查 (NHANES III) 进行了比较。 方法和结果 - 1976 年至 1979 年间，耶路撒冷共有 8646 名 17 岁青少年和 6952 名父母接受了检查。在 28 至 32 岁之间，对在 10 年随访期间经历过记录的 MI 的父母的后代（n = 133 名男性，62 名女性；72% 的反应）和无 CHD 的父母的后代（n = 389 名男性，208 名女性；71% 的反应）进行了重新检查。 tHcy 水平由同一实验室测定 25 至 34 岁的 NHANES 非西班牙裔白人群体 (n=379) 和耶路撒冷人口样本 (n=858)。来自耶路撒冷的男性（而非女性）的 tHcy 水平明显高于来自美国的样本（第 90 个百分位数，23 微摩尔/升与 14 微摩尔/升）。这种差异主要归因于以色列人群血浆维生素 B,2 水平较低。雄性病例后代的调整后 tHcy 高于对照 (1.9 mumol/L, P=0.002)。 Logistic 模型显示，在后代 tHcy 的五分位数中，父母 MI 的风险呈分级增加，第五个五分位数的调整后优势比为 2.7（趋势 P=0.0026）。结论 - 父母患有 CHD 的年轻男性后代的 tHcy 较高，表明 tHcy 升高先于 CHD 表现。男性人群 tHcy 升高可能导致以色列 CHD 发病率高。
Background-A causal role for mildly elevated plasma homocysteine (tHcy) in cardiovascular disease remains undetermined. To address the unresolved issue of the antecedent-consequent directionality of the relationship, we assessed the familial association of tHcy with parental myocardial infarction (MI) in young Israeli men and women. We also compared tHcy concentrations in Jerusalem, where rates of coronary heart disease (CHD) are high, with the United States Third National Health and Examination Survey (NHANES III).Methods and Results-A total of 8646 17-year-olds and 6952 parents were examined from 1976 to 1979 in Jerusalem. At ages 28 to 32 years, offspring of parents who experienced a documented MI during a 10-year follow-up (n=133 men, 62 women; 72% response) and offspring of CHD-free parents (n=389 men, 208 women; 71% response) were reexamined. tHcy levels were determined by the same laboratory for the NHANES non-Hispanic white population aged 25 to 34 years (n=379) and the Jerusalem population sample (n=858). Men from Jerusalem, but not women, had clearly higher tHcy levels than the sample from the United States (90th percentile, 23 versus 14 mumol/L). This difference was largely attributable to lower plasma vitamin B,2 levels in the Israeli population. Male case offspring had higher adjusted tHcy than did controls (1.9 mumol/L, P=0.002). Logistic modeling revealed a graded increase in risk of parental MI across quintiles of offspring tHcy, with an adjusted odds ratio of 2.7 in the 5th quintile (P=0.0026 for trend).Conclusions-The higher tHcy in young male offspring of parents with CHD suggests that elevated tHcy precedes manifestation of CHD. The elevated population tHcy in men may contribute to the high incidence of CHD in Israel.