Hyperhomocysteinemia as a risk factor for deep-vein thrombosis
Hyperhomocysteinemia as a risk factor for deep-vein thrombosis
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DOI：
10.1056/nejm199603213341203
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发表时间：
1996-03-21
影响因子：
158.5
通讯作者：
Rosendaal, FR
中科院分区：
文献类型：
--
作者：
denHeijer, M;Koster, T;Rosendaal, FR
背景。先前的研究表明，高同型半胱氨酸血症可能是静脉血栓形成的危险因素，为了评估与高同型半胱氨酸血症相关的静脉血栓形成的风险，我们研究了首次发生深静脉血栓形成的患者和正常对照受试者的血浆同型半胱氨酸水平。我们测量了 269 名客观诊断的首次深静脉血栓形成患者的血浆同型半胱氨酸水平，以及根据年龄和性别与患者匹配的 269 名健康对照者的血浆同型半胱氨酸水平，高同型半胱氨酸血症定义为对照组血浆同型半胱氨酸水平高于第 95 个百分位（18.5 μmol/L）。结果。在 269 名患者中，28 名患者（10%）的血浆同型半胱氨酸水平高于对照的第 95 个百分位数，而对照者中有 13 名患者（匹配优势比为 2.5；95% 置信区间为 1.2 至 5.2），同型半胱氨酸水平升高与静脉血栓形成之间的关联在女性中比男性更强，并且随着年龄的增长而增加，排除具有其他已确定的血栓形成危险因素的受试者 （例如，蛋白 C、蛋白 S 或抗凝血酶缺乏；对活化蛋白 C 的抵抗；怀孕或最近分娩；或口服避孕药的使用）不会对风险估计产生重大影响。结论。高血浆同型半胱氨酸水平是普通人群深静脉血栓形成的危险因素。 (C) 1996 年，马萨诸塞州医学会。
Background. Previous studies have suggested that hyperhomocysteinemia may be a risk factor for venous thrombosis, To assess the risk of venous thrombosis associated with hyperhomocysteinemia, we studied plasma homocysteine levels In patients with a first episode of deep-vein thrombosis and in normal control subjects.Methods. We measured plasma homocysteine levels in 269 patients with a first, objectively diagnosed episode of deep-vein thrombosis and in 269 healthy controls matched to the patients according to age and sex, Hyperhomocysteinemia was defined as a plasma homocysteine level above the 95th percentile in the control group (18.5 mu mol per liter).Results. Of the 269 patients, 28 (10 percent) had plasma homocysteine levels above the 95th percentile for the controls, as compared with 13 of the controls (matched odds ratio, 2.5; 95 percent confidence interval, 1.2 to 5.2), The association between elevated homocysteine levels and venous thrombosis was stronger among women than among men and increased with age, The exclusion of subjects with other established risk factors for thrombosis (e.g., a deficiency of protein C, protein S, or antithrombin; resistance to activated protein C; pregnancy or recent childbirth; or oral-contraceptive use) did not materially affect the risk estimates.Conclusions. High plasma homocysteine levels are a risk factor for deep-vein thrombosis in the general population. (C) 1996, Massachusetts Medical Society.