Impact of combined elevations of homocysteine and asymmetric dimethylarginine on all-cause death ― The Tanushimaru Study
Impact of combined elevations of homocysteine and asymmetric dimethylarginine on all-cause death ― The Tanushimaru Study
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同型半胱氨酸和不对称二甲基精氨酸联合升高对全因死亡的影响 - Tanushimaru 研究
DOI：
10.1016/j.jjcc.2021.01.011
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发表时间：
2021
影响因子：
2.5
通讯作者：
Fukumoto Yoshihiro
中科院分区：
文献类型：
--
作者：
Toyomasu Kenta;Adachi Hisashi;Enomoto Mika;Fukami Ako;Nakamura Sachiko;Nohara Yume;Morikawa Nagisa;Sakaue Akiko;Hamamura Hitoshi;Yamamoto Maki;Fukumoto Yoshihiro
背景：同型半胱氨酸（Hcy）和不对称二甲基精氨酸（ADMA）均可诱导内皮功能障碍。然而，这两种升高对全因死亡的影响尚不清楚。我们调查了一般人群中Hcy或ADMA升高与全因死亡之间的关系。研究方法：1999年在Tanushimaru进行了一项基于人群的调查，共招募了517名受试者（224名男性，293名女性;平均年龄62.8岁），我们测量了空腹血浆Hcy和ADMA水平。结果：本组病例平均随访17.7年（1.8-20.8年），平均随访时间为20年以上。在此期间，182例受试者死亡（35.2%）。同型半胱氨酸与ADMA呈高度相关（r= 0.194; P< 0.001）。校正年龄和性别后的考克斯回归分析显示，对数转换的Hcy水平升高与全因死亡显著相关（p= 0.028）。当Hcy和ADMA水平分为五分位时，分层模型显示Hcy和ADMA对全因死亡具有协同作用。结论：这是我们首次在该社区居住的日本人中同时测量Hcy和ADMA水平的报告，我们证明了在这项流行病学研究中，Hcy和ADMA的联合升高对全因死亡有很大影响。© 2021由Elsevier Ltd代表日本心脏病学院发表。
Background: Both homocysteine (Hcy) and asymmetric dimethylarginine (ADMA) induce endothelial dysfunction. However, the impact of both elevations on all-cause death is not known. We investigated the association between elevations of Hcy or ADMA and all-cause death in a general population. Methods: A total of 517 subjects (224 men, 293 women; mean age, 62.8 years) were recruited from a population-based survey in 1999 in Tanushimaru, and we measured fasting plasma Hcy and ADMA levels. We followed them up for over 20 years and examined the effect on mortality using Cox proportional hazard regression model.Results: The mean follow-up years were 17.7 (1.8-20.8). In this period, 182 subjects have died (35.2%). The correlation between Hcy and ADMA was high (r= 0.194; p< 0.001). With Cox regression analysis after adjustments for age and sex, elevated log transformed Hcy levels were significantly associated with allcause death (p= 0.028). When Hcy and ADMA levels were divided into quintiles, the hierarchical model showed the synergistic effect of Hcy and ADMA on all-cause death. Conclusions: This is the first report that we have measured Hcy and ADMA levels simultaneously in this community-dwelling Japanese, and we demonstrated that combined elevations of Hcy and ADMA had big impact on all-cause death in this epidemiological study.© 2021 Published by Elsevier Ltd on behalf of Japanese College of Cardiology.