探討健康成年人B-維生素 (葉酸、維生素B-12及B-6) 的營養狀況與高同半胱胺酸血症的相關性

To investigate the association between B-vitamins status (folate, vitamin B-12 and B-6) and hyperhomocysteinemia in healthy adult population

陳芳霈(Fang-Pei Chen)

指導教授 ： 黃怡嘉

中山醫學大學/健康管理學院/營養學研究所/碩士(2007年)

https://doi.org/10.6834/CSMU.2007.00051

摘要

本研究是以健康成年人為研究對象，目的是探討禁食與甲硫胺酸負荷試驗後血漿同半胱胺酸濃度與B-維生素（葉酸、維生素B-12及維生素B-6）之間的相關性。研究設計方法則是以橫斷方式進行。受試者是由台中榮民總醫院體檢科募集199位31-50歲的健康男女性（男：100人，女：99人），依受試者禁食血漿同半胱胺酸濃度分為高同半胱胺酸組（血漿同半胱胺酸濃度³ 12 mmol/L，共54人）及正常同半胱胺酸組（血漿同半胱胺酸濃度< 12 mmol/L，共145人）。另外抽取受試者空腹及甲硫胺酸負荷試驗後的血液，檢測血漿同半胱胺酸濃度及B-維生素（血清葉酸、血清維生素B-12及血漿磷酸比哆醛）的營養狀況及臨床血液生化值。研究結果顯示正常組的女性禁食及甲硫胺酸負荷試驗後同半胱胺酸濃度皆顯著低於男性。正常同半胱胺酸組的血清葉酸及維生素B-12濃度顯著高於高同半胱胺酸組；但是負荷試驗後同半胱胺酸濃度則顯著較低。血漿磷酸比哆醛濃度兩組間並無顯著差異。血清葉酸濃度與禁食同半胱胺酸濃度呈顯著負相關 (β = -0.162, p = 0.002)；而在正常組中維生素B-12對於甲硫胺酸負荷試驗後同半胱胺酸濃度有顯著負相關 (β = -0.002, p = 0.027)。回歸分析結果顯示血清葉酸 (OR = 0.784, p < 0.001) 能顯著降低高同半胱胺酸血症的危險對比值。本研究結果顯示健康中年族群的高血清葉酸濃度為高同半胱胺酸血症的保護因子。

關鍵字

高同半胱胺酸血症 ； 葉酸 ； 維生素B-12 ； 維生素B-6 ； 甲硫胺酸負荷試驗

並列摘要

To provide more information on B-vitamins (folate, vitamin B-12 and vitamin B-6) in relation to fasting and post methionine loading (PML) homocysteine (Hcy) concentrations, we examined folate, vitamin B-12, B-6 and PML homocysteine in normo-homocysteinemia (N-Hcy, <12 mmol/L) and hyperhomocysteinemia (H-Hcy, ³ 12mmol/L) adults. One hundred and ninety-nine 31-50 years old healthy men (n = 100) and women (n = 99) were recruited from the community and assigned to either the N-Hcy (n = 145) or H-Hcy (n = 54) group. Fasting and PML Hcy, hematological parameters were measured. Fasting and PML Hcy of women in N-Hcy were significant lower than men. Subjects in the N-Hcy group had significantly higher serum folate and vitamin B-12 and lower PML homocysteine concentrations than H-Hcy subjects did. There was no significant difference in vitamin B-6 values between groups. However, serum folate (β = -0.153, p = 0.002) was strongly inversely associated with fasting plasma homocysteine; vitamin B-12 was inversely correlated with PML homocysteine (β = -0.002, p = 0.027). High serum folate concentration (OR = 0.784, p < 0.001) significantly decreased the risk of fasting hyperhomoycsteinemia. High serum folate concentration might be a protective factor of hyperhomocysteinemia in the healthy adult population.

並列關鍵字

hyperhomocysteinemia ； folate ； vitamin B-12 ； vitamin B-6 ； post methionine loading test

參考文獻

Ueland PM, Refsum H, Stabler SP, Malinow MR, Andersson A, Allen RH. Total homocysteine in plasma or serum: methods and clinical applications. Clin Chem 1993; 39: 1764-1779.

Lee BJ, Lin PT, Liaw YP, Chang SJ, Cheng CH, Huang YC. Homocysteine and risk of coronary artery disease: Folate is the important determinant of plasma homocysteine concentration. Nutr 2003; 19: 577-583.

Araki A, Sako Y. Determination of free and total homocysteine in human plasma by high-performance liquid chromatography with fluorescence detection. J Chromatogr 1987; 422: 43-52.

Bostom AG, Jacques PF, Nadeau MR, Williams RR, Ellison RC, Selhub J. Post-methionine load hyperhomocysteinemia in persons with normal fasting total plasma homocysteine: initial results from the NHLBI Family Heart Study. Atherosclerosis 1995; 116: 147–151.

Bostom AG, Gohh RY, Beaulieu AJ, Nadeau MR, Hume AL, Jacques PF, Selhub J, Rosenberg IH. Treatment of hyperhomocysteinemia in renal transplant recipients. A randomized, placebo-controlled trial. Ann Intern Med 1997; 127: 1089–1092.