Plasma homocysteine as a risk factor for atherothrombotic events in systemic lupus erythematosus
Plasma homocysteine as a risk factor for atherothrombotic events in systemic lupus erythematosus
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DOI：
10.1016/s0140-6736(96)03032-2
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发表时间：
1996-10-26
期刊：
影响因子：
168.9
通讯作者：
Rosenberg, IR
中科院分区：
文献类型：
--
作者：
Petri, M;Roubenoff, R;Rosenberg, IR
背景 本研究的目的是评估血浆同型半胱氨酸是否是系统性红斑狼疮 (SLE) 患者中风和其他血栓事件的危险因素，这种情况已知与过早动脉粥样硬化血栓并发症相关。在这项前瞻性研究中，我们调查了霍普金斯狼疮队列研究中 337 名 SLE 患者的同型半胱氨酸与中风和血栓事件风险之间的关联，并对 1619 名患者进行了随访。人年（平均 4 . 8 [SD 1 . 7] 年），每位患者每年进行四次随访评估，以获得有关血栓形成和冠状动脉疾病的既定危险因素的信息。前瞻性定义的终点是 1987 年至 1995 年间中风和动脉或静脉血栓事件的发生情况。在研究开始时从禁食患者中采集血样。测量血浆同型半胱氨酸、叶酸、维生素 B12 和 5'-磷酸吡哆醛 (PLP) 浓度。同型半胱氨酸浓度升高定义为超过 14 。 1 mu mol/L。结果显示，93% 的研究人群为女性，54% 为非洲裔美国人，45% 为白人。参与者的平均年龄为 34 岁。 9 (SD 11 . 7) 年。随访期间，有 29 例中风病例和 31 例动脉血栓事件。 51 名 (15%) 系统性红斑狼疮患者的同型半胱氨酸浓度升高。对数转换的总同型半胱氨酸浓度与血清叶酸相关(r=0.31，p=0.0001)。在单变量分析中，同型半胱氨酸浓度升高与中风（比值比 2 . 24 [95% CI 1 . 22-4 . 13]，p=0 . 01）和动脉血栓事件（3 . 74 [1 . 96-7 . 13]，p=0 . 0001）显着相关。对已确定的危险因素进行调整后，血浆总同型半胱氨酸浓度仍然是中风 (2 . 44 [1 . 04-5 . 75]，p=0 . 04) 和动脉血栓 (3 . 49 [0 . 97-12 . 54]，p=0 . 05) 的独立危险因素。 解释 同型半胱氨酸是卒中和血栓事件的潜在可改变的独立危险因素。系统性红斑狼疮患者。
Background The aim of this study was to asses whether plasma homocysteine is a risk factor for stroke and other thrombotic events in patients with systemic lupus erythematosus (SLE)-a condition known to be associated with premature atherothrombotic complications.Methods in this prospective study, we investigated the association between homocysteine and risk of stroke and thrombotic events in 337 SLE patients in the Hopkins Lupus Cohort Study, with follow-up of 1619 person-years (mean 4 . 8 [SD 1 . 7] years), Each patient had four follow-up assessments per year to obtain information about established risk factors for thrombosis and coronary artery disease. The prospectively defined endpoints were occurrence of stroke and arterial or venous thrombotic events between 1987 and 1995. Blood samples were taken at study entry from fasting patients. Plasma homocysteine, folate, vitamin B12, and pyridoxal 5'-phosphate (PLP) concentrations were measured. Raised homocysteine concentrations were defined as more than 14 . 1 mu mol/L.Findings 93% of the study population were women, 54% African American, and 45% white. The mean age of participants was 34 . 9 (SD 11 . 7) years. During follow-up there were 29 cases of stroke and 31 arterial thrombotic events. Raised homocysteine concentrations were found in 51 (15%) SLE patients. The log-transformed total homocysteine concentrations correlated with serum folate (r=0 . 31, p=0 . 0001). In univariate analyses, raised homocysteine concentrations were significantly associated with stroke (odds ratio 2 . 24 [95% CI 1 . 22-4 . 13], p=0 . 01) and arterial thrombotic events (3 . 74 [1 . 96-7 . 13], p=0 . 0001). After adjustment for established risk factors, total plasma homocysteine concentrations remained an independent risk factor for stroke (2 . 44 [1 . 04-5 . 75], p=0 . 04) and arterial thromboses (3 . 49 [0 . 97-12 . 54], p=0 . 05).Interpretation Homocysteine is a potentially modifiable, independent risk factor for stroke and thrombotic events in patients with SLE.