Hyperhomocysteinaemia and Vitamin B12 Deficiency: The Long-Term Effects in Cardiovascular Disease
Hyperhomocysteinaemia and Vitamin B12 Deficiency: The Long-Term Effects in Cardiovascular Disease
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DOI：
10.1159/000093746
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发表时间：
2006-06
期刊：
影响因子：
1.9
通讯作者：
M. V. van Oijen;F. Vlemmix;R. Laheij;L. Paloheimo;J. Jansen;F. Verheugt
中科院分区：
文献类型：
--
作者：
M. V. van Oijen;F. Vlemmix;R. Laheij;L. Paloheimo;J. Jansen;F. Verheugt
背景：血浆同型半胱氨酸水平升高是心血管疾病的既定危险因素。维生素B12在同型半胱氨酸代谢中起着关键作用，也可能是导致心血管疾病的主要因素。目的：本研究的目的是评估维生素B12缺乏或高同型半胱氨酸血症是否与复发性心血管事件相关。方法：从1998年2月至5月，共招募了211例从我们的冠心病监护室出院的患者。测定空腹血中血清维生素B12和血浆同型半胱氨酸水平。从医疗档案中评估患者特征、医疗信息和心血管风险因素。随访5年，收集心血管病死亡率和发病率。结果如下：在810人年的随访期内，48例（21%）患者经历了非致命性复发性心血管事件，另有14例（7%）死于心血管原因。在出院时患有缺血性心脏病的患者中，与血浆同型半胱氨酸水平正常的患者相比，低水平（16 µ mol/l）患者的复发性心血管事件风险增加（p = 0.05），在生存率方面没有差异（校正风险比为2.22（95% CI：1.40 - 3.04））。结论：总之，高血浆同型半胱氨酸浓度，而不是低血清维生素B12浓度，增加缺血性心脏病患者的心血管发病率和死亡率的风险。
Background: An elevated plasma homocysteine level is an established risk factor for cardiovascular disease. Vitamin B12 plays a key role in homocysteine metabolism and could be the main factor in causing cardiovascular disease as well. Objectives: The aim of this study was to assess whether vitamin B12 deficiency or hyperhomocysteinaemia is associated with recurrent cardiovascular events. Methods: Overall, 211 patients discharged alive from our Coronary Care Unit were recruited from February till May 1998. Serum vitamin B12 and plasma homocysteine levels were measured in fasting blood samples. Patient characteristics, medical information and cardiovascular risk factors were assessed from medical files. Patients were followed for 5 years and the prevalence of cardiovascular mortality and morbidity was collected. Results: In the follow-up period of 810 person-years, 48 (21%) of the patients experienced a nonfatal recurrent cardiovascular event and another 14 (7%) died of a cardiovascular cause. Among those with ischaemic heart disease at discharge, no difference in survival was found between the patients with a low (16 µmol/l), an increased risk of a recurrent cardio vascular event (p = 0.05) in comparison to those with normal plasma homocysteine levels was proven (adjusted hazard ratio of 2.22 (95% CI: 1.40–3.04). Conclusions: In conclusion, high plasma homocysteine concentration, but not a low serum vitamin B12 concentration, increases the risk of cardiovascular morbidity and mortality in patients with ischaemic heart disease.