同半胱胺酸血症與心血管疾病危險預估之相關性研究－以北部某醫學中心員工為例

The Relation between Homocysteine and Cardiovascular Disease Risk Estimate

梁倪嘉(Ni-Chia Liang) ； 黃麗卿(Lee-Ching Hwang) ； 黃偉新(Wei-Hsin Huang)

《中華職業醫學雜誌》 19卷1期 (2012/01) Pp. 49-58

https://doi.org/10.30027/CJOM.201201.0006

摘要

背景及目的：心血管疾病影響國人之健康甚鉅。文獻顯示部分發生心血管疾病的病人不存在有傳統的心血管疾病危險因子；而同半胱胺酸則為一新興的心血管疾病危險指標。本文目的在探討同半胱胺酸與心血管疾病風險預測之間的關連性。材料與方法：收集某北部醫學中心30歲以上接受院內體檢的員工，且身體質量指數（BMI）大於等於24kg/m2 之331人參與本研究，以問卷填寫方式登錄個案基本資料和抽菸習慣，並測量身高、體重、腰臀圍、與血壓，血液檢查包含空腹血糖值、膽固醇、血清高敏感C反應蛋白及同半胱胺酸等檢查，探討其與佛來明罕危險分數所計算出之心血管疾病危險預估值之關係。結果：男性之10年冠狀動脈心臟病風險預估值明顯高於女性，但在10年腦血管疾病風險預估值則無此現象。此外，血中同半胱胺酸值高低與各個心血管危險因子例如血壓、膽固醇值或是血糖皆無相關性，但是發現女性之同半胱胺酸會隨著年齡之增加而增加。在多變項線性迴歸統計方法之下，控制身體質量指數與血清高敏感C反應蛋白之後，發現女性之同半胱胺酸值與預測十年冠狀動脈心臟病及腦血管疾病發生率預測值呈現正相關，但在男性則沒有此關聯性。結論：同半胱胺酸血症與年齡、性別有關，且此生化指標對於女性之冠狀動脈心臟病以及腦血管疾病危險預估值有正相關，但是在男性身上則無此相關性。

並列摘要

Background: Cardiovascular disease has strongly affected our people's health. Some studies revealed that a number of patients with coronary heart disease lack the conventional risk factors, but homocysteine level was found to be a novel risk factor of cardiovascular disease. This article is aimed at discussing the relation between homocysteine and cardiovascular disease risk estimate.Methods: Participants were recruited from the employees of a northern general hospital for routine health examination, and composed of 331 participants who were overweight or obese with a body mass index (BMI) larger than 24kg/m2. Medical history, life style, physical examination, body weight, body height, waist circumference, blood pressure and laboratory tests including fasting glucose, lipid profile, hs-CRP and homocysteine were assessed. The Framingham Risk Score of each participant was calculated.Results: The 10-year coronary heart disease risk estimate was found to be significantly higher in male participants, while the 10-year cerebral vascular disease risk estimate did not differ between the two genders.. Serum homocysteine level did not correlate to the conventional cardiovascular (disease) risk factors such as blood pressure, lipid profile or fasting glucose. However, we found that homocysteine level increased with age in female participants. Multiple linear regression analyses were performed using interactions between BMI, hs-CRP, homocysteine and the 10-year risk estimate. We found that homocysteine level in our female participants significantly related to their 10-year Framingham Risk score.Conclusion: Homocysteine was found to be related to one's gender and age, and it is a factor that positively correlates to 10-year coronary and cerebral vascular disease risk estimate in females, but not in males.

並列關鍵字

homocysteine ； BMI ； cardiovascular disease ； Framingham risk score