Hyperhomocysteinemia confers an independent increased risk of atherosclerosis in end-stage renal disease and is closely linked to plasma folate and pyridoxine concentrations
Hyperhomocysteinemia confers an independent increased risk of atherosclerosis in end-stage renal disease and is closely linked to plasma folate and pyridoxine concentrations
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DOI：
10.1161/01.cir.94.11.2743
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发表时间：
1996-12-01
期刊：
影响因子：
37.8
通讯作者：
Jacobsen, DW
中科院分区：
文献类型：
--
作者：
Robinson, K;Gupta, A;Jacobsen, DW
高水平的血浆同型半胱氨酸是动脉粥样硬化的危险因素，而动脉粥样硬化是肾功能衰竭死亡的重要原因。我们评估了这作为终末期肾脏疾病血管并发症的危险因素的作用。方法和结果176例透析患者（男性97例，女性79例，平均年龄56.3+/-14.8岁）记录了空腹血浆同型半胱氨酸及其他危险因素。测定叶酸、维生素B-12和磷酸吡哆醛的浓度。通过与正常参考人群的比较确定高总同型半胱氨酸值的患病率，并通过多元逻辑回归估计相关血管并发症的风险。患者的总同型半胱氨酸浓度高于正常人群（26.6+/-1.5 vs 10.1+/-1.7 mu mol/L；对照组的p95百分位数为16.3 mu mol/L）， 149例（85%）终末期肾病患者（P27.8 mu mol/L）血管并发症的独立优势比为2.9 （CI, 1.4 ~ 5.8； P= 0.007）。有血管并发症的患者的B族维生素水平低于没有血管并发症的患者。维生素Bg缺乏症在患者中比在正常参考人群中更常见(18%比2%；P
Background A high level of total plasma homocysteine is a risk factor for atherosclerosis, which is an important cause of death in renal failure. We evaluated the role of this as a risk factor for vascular complications of end-stage renal disease.Methods and Results Total fasting plasma homocysteine and other risk factors were documented in 176 dialysis patients (97 men, 79 women; mean age, 56.3+/-14.8 years). Folate, Vitamin B-12, and pyridoxal phosphate concentrations were also determined. The prevalence of high total homocysteine Values was determined by comparison with a normal reference population, and the risk of associated Vascular complications was estimated by multiple logistic regression. Total homocysteine concentration was higher in patients than in the normal population (26.6+/-1.5 versus 10.1+/-1.7 mu mol/L; P95th percentile for control subjects, 16.3 mu mol/L) were seen in 149 patients (85%) with end-stage renal disease (P27.8 mu mol/L) had an independent odds ratio of 2.9 (CI, 1.4 to 5.8; P=.007) of vascular complications. B vitamin levels were lower in patients with vascular complications than in those without. Vitamin Bg deficiency was more frequent in patients than in the normal reference population (18% versus 2%; P