Elevated Total Plasma Homocysteine Levels are Associated with Type 2 Diabetes in Women with Hypertension

升高的血浆同型半胱氨酸水平在女性高血压患者中与2型糖尿病的关系

Changyi Wang ； Qunhong Wu ； Lina Zhang ； Yanhua Hao ； Rui Fan ； Xiaolin Peng ； Shengyuan Liu ； Zhongwei Chen ； Tao Zhang ； Sihan Chen ； Jianping Ma ； Shiwei Duan ； Liyuan Han

《Asia Pacific Journal of Clinical Nutrition》 24卷4期 (2015/12) Pp. 683-691

https://doi.org/10.6133/apjcn.2015.24.4.09

摘要

背景与目的：在高血压患者中针对同型半胱氨酸水平与2型糖尿病之间关系的研究较少。方法与研究设计：该研究对深圳市南山区60个社区的5935名原发性高血压患者进行了调查。病例组为高血压患者伴发糖尿病，对照组为高血压患者无糖尿病。采用标准方法对其人口学特征及生化指标进行调查。采用多变量分析方法分析同型半胱氨酸水平与2型糖尿病的关系。结果：该研究一共纳入5241例对照（男／女：2716／2625）与594例病例（男／女：291／303）。在女性高血压患者中，同型半胱氨酸水平与2型糖尿病之间呈剂量反应关系。在控制了相应的混杂因素之后，同型半胱氨酸水平每升高5 μmol/L，在原始模型中，比值比及95%可信区间为1.11（1.07－1.16），在模型1中，比值比及95%可信区间为1.05（1.01－1.11），在模型2中，比值比及95%可信区间为1.07（1.02－1.13）。在高血压患者中，未发现高Hcy血症分级（≥15 μmol/L vs ＜15μmol/L）与2型糖尿病存在关联。结论：当将同型半胱氨酸水平按照四分位数进行分级时，女性高血压患者同型半胱氨酸水平与2型糖尿病之间存在关联。然而并未发现高Hcy血症分级（≥15 μmol/L vs ＜15 μmol/L）与2型糖尿病存在关联。

關鍵字

同型半胱氨酸 ； 糖尿病 ； 高血压 ； 交互 ； 以人群为基础的研究

並列摘要

Background and Objectives: There is only limited available evidence of a relationship between total plasma homocysteine (tHcy) levels and type 2 diabetes in hypertensive subjects. Methods and Study Design: A total of 5,935 Chinese essentially hypertensive subjects were recruited by cluster sampling from 60 communities. The cases had diabetes, whereas the controls did not. Anthropometric indices and biochemical parameters were assessed using standard procedures. A multivariable analysis was performed to analyze the association of tHcy and type 2 diabetes susceptibility in hypertensive subjects. Results: The 5,241 controls (women/men: 2,716/2,625) and 594 cases (women/men: 291/303) were recruited consecutively. The level of tHcy was dose- dependently associated with type 2 diabetes in the hypertensive women subjects. After controlling for corresponding confounding factors, a significant trend was only noted in the women subjects, with odds ratios per 5 μmol/L tHcy of 1.11 (95% confidence interval (CI), 1.07-1.16) in the crude model, 1.05 (95% CI, 1.01-1.11) in model 1, and 1.07 (95% CI, 1.02-1.13) in model 2. However, no significant result was found for levels of tHcy ≥15 μmol/L vs ＜15 μmol/L in the men, women and all hypertensive subjects. Conclusions: When the level of tHcy was divided into quartiles, tHcy was positively associated with type 2 diabetes in hypertensive women subjects. However, when the level of tHcy was separated into hyperhomocysteinemic (≥15 μmol/L) and normal (＜15 μmol/L), no significant results were observed.

並列關鍵字

tHcy ； type 2 diabetes ； hypertension ； interaction ； population-based study