Effect of advanced age on plasma homocysteine levels and its association with ischemic stroke in non-valvular atrial fibrillation.
Effect of advanced age on plasma homocysteine levels and its association with ischemic stroke in non-valvular atrial fibrillation.
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高龄对非瓣膜性心房颤动血浆同型半胱氨酸水平的影响及其与缺血性卒中的关系
DOI：
10.11909/j.issn.1671-5411.2017.12.004
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发表时间：
2017-12
期刊：
影响因子：
--
通讯作者：
Shang MS
中科院分区：
文献类型：
--
作者：
Yao Y;Gao LJ;Zhou Y;Zhao JH;Lv Q;Dong JZ;Shang MS
研究背景高同型半胱氨酸（homocysteine，Hcy）与心房颤动（atrial fibrillation，AF）患者心血管事件的发生有关，但血浆Hcy的年龄相关性表达模式尚不清楚。本研究旨在探讨高龄对非瓣膜性房颤患者血浆同型半胱氨酸水平的影响及其与缺血性卒中的关系。方法将2562例非瓣膜性房颤患者和535例对照者分为6个年龄组。分析不同年龄组血浆Hcy水平，探讨高龄对Hcy的影响。结果65岁以下各年龄组间血浆Hcy水平无显著性差异，65-74岁组及75岁以上组血浆Hcy水平明显升高（15.7 ± 4.6 μmol/L，17.1 ± 4.9 μmol/L，均与前4个年龄组比较P < 0.01）。房颤组Hcy水平明显高于同年龄组对照组（均P < 0.05）。高同型半胱氨酸血症的发生率随年龄的增长而逐渐增加，在6个年龄组中分别为32.3%、29.2%、31.2%、32.4%、45.9%、51.4%。房颤合并缺血性脑卒中患者血浆Hcy浓度随年龄增长而进行性升高，且高于同年龄无脑卒中者。Logistic回归分析显示，年龄65-74岁[OR：1.742，95% CI：1.223-2.482，P = 0.002]和年龄≥ 75岁（OR：2.637，95% CI：1.605-4.335，P < 0.001）是血浆Hcy水平升高的独立预测因素。结论高龄房颤患者血浆Hcy水平升高，可能是老年房颤患者缺血性脑卒中发病率进行性增加的原因之一。
Background Elevated homocysteine (Hcy) has been reported to be associated with cardiovascular events in atrial fibrillation (AF) patients, while the age-related expression pattern of plasma Hcy in AF remains unknown. The study was aimed to investigate the effect of advanced age on plasma Hcy levels and its association with ischemic stroke in non-valvular AF patients. Methods A total of 2562 consecutive patients with non-valvular AF and 535 controls were enrolled and divided into six age groups. Plasma Hcy levels were analyzed among different age groups, and the effect of advanced age on Hcy was investigated. Results Plasma Hcy levels did not show any difference among groups aged below 65 years, while it increased sharply in patients aged 65–74 years and aged over 75 years (15.7 ± 4.6 µmol/L, 17.1 ± 4.9 µmol/L, both P < 0.01 compared with the first four age groups). Hcy was much higher in AF patients than in controls at the same age group (all P < 0.05). The proportion of patients with hyperhomocysteinemia increased gradually with age from 32.3%, 29.2%, 31.2%, 32.4%, 45.9%, to 51.4% in six age groups. The concentration of Hcy in AF patients with ischemic stroke increased progressively with age, and was higher than those without stroke at the same age. Logistic regression analysis demonstrated that age 65–74 years [odds ratios (OR): 1.742, 95% confidence interval (CI): 1.223–2.482, P = 0.002] and age ≥ 75 years (OR: 2.637, 95% CI: 1.605–4.335, P < 0.001) were significantly independent predictors of elevated plasma Hcy levels. Conclusions Advanced age was significantly associated with elevated Hcy levels, which may provide a possible explanation for the progressive increase in ischemic stroke especially in elderly AF patients.
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影响因子：
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37.8
作者：
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American Heart Association Statistics Committee and Stroke Statistics Subcommittee