1020名社区人群同型半胱氨酸水平的调查和相关分析

目的描述社区人群血浆同型半胱氨酸(Hcy)在不同年龄和性别间的分布特征,探讨Hcy与血脂水平等之间的相关性,研究高Hcy血症的危险因素及其对脑动脉狭窄的影响。方法从2500名社区人群筛选出1020名无心脑血管病史并可以进行经颅多普勒(TCD)检查的人群为样本,记录吸烟饮酒史、血压、人体测量学和生化资料,采用荧光生化法测定血浆Hcy水平,使用SPSS 12.0软件对检测指标进行处理。结果社区人群中Hcy水平男性(15．0μmol/L±5．8μmol／L)高于女性(12 4μmol／L±3．9μmol／L),差异有统计学意义(P<0．05);Hcy水平随着年龄增长而增高(P< 0．05);高Hcy血症的发生率男性(47．2％)高于女性(23．2％),差异有统计学意义(P<0．05);大脑中动脉狭窄组中Hcy水平(18．3μmol／L±5．3μmol/L)高于非狭窄组(12．9μmol／L±4．6μmol／L); logistic回归分析证实Hcy水平与血脂等之间无相关性,而仅与性别和年龄相关(P<0．05)。结论社区人群中Hcy水平存在性别和年龄的差异,两者是高Hcy血症的独立危险因素,Hcy水平与血脂等诸因素无相关性,高Hcy血症易致脑动脉狭窄。     

西宁地区80例健康人血浆同型半胱氨酸水平调查

目的了解西宁地区健康人群同型半胱氨酸水平。方法采用雅培公司的荧光偏振免疫分析试剂盒,对西宁地区80例健康人的血浆同型半胱氨酸(Hcy)进行检测,同时进行人口学特征、吸烟、饮酒及饮食情况调查。结果研究人群高Hcy血症的检出率较高,为30.7%;血浆Hcy平均水平为10.49μmol/L,年龄越大,血浆Hcy水平越高,男性高于女性。结论西宁地区18岁~24岁健康人群血浆Hcy水平存在年龄、性别差异;高Hcy血症的检出率较高。     

武汉市社区人群血浆同型半胱氨酸分布特征及影响因素的多元逐步回归分析

目的 描述武汉市社区人群血浆同型半胱氨酸(Hcy)在不同性别、不同年龄段分布水平和分布特征及采用多元逐步回归分析方法分析人群Hcy的主要影响因素。方法 以武汉市三个社区的全部人群作为研究对象,对Hcy的分布特征及相关影响因素进行统计学分析。结果 (1)Hcy几何均数男性为14.43μmol/L,女性为10.89μmol/L,男性高于女性,两者差异有显著统计学意义(P<0.001);(2)以年龄分层,每层男性Hcy水平亦高于女性,每层两者差异亦均有统计学意义;(3)武汉市社区人群高Hcy血症患病率为23.94％,男性患病率高于女性,是女性的2.62倍;(4)逐步回归分析显示,性别不同其Hcy的影响因素各不同,男性Hcy的影响因素有:日吸烟量、每周锻炼次数和尿微量白蛋白;女性的影响因素为:每次锻炼时间、体重、甘油三酯含量、高密度脂蛋白胆固醇、尿微量白蛋白和年龄。结论 (1)武汉市社区人群血浆Hcy水平呈偏态分布,存在年龄性别差异;(2)武汉市社区人群高Hcy患病率高于发达国家,亦高于国内其他一些城市;(3)武汉市社区人群血浆Hcy的主要影响因素存在性别差异,与国外报道和与国内其他地区报道有所不同,提示血浆Hcy水平还可能受到环境等有关因素的影响。     

86例同型半胱氨酸与脑梗死相关性分析

探讨脑梗死与血浆同型半胱氨酸（Hcy）水平之间的关系。方法：采用化学发光分析法,检测86例脑梗死患者（观察组）的血浆Hcy;检测同期56例健康体检者（对照组）血浆Hcy的含量,对比分析其与脑梗死的相关性。结果：观察组53例（61.63%）血浆Hcy增高,血浆Hcy含量为（23.16±3.62）μmol/L,对照组5例（8.93%）血浆Hcy增高,血浆Hcy含量为（10.47±3.49）μmol/L,两组比较差异有显著性（P〈0.01）。结论：脑梗死患者血浆Hcy升高,高Hcy血症是引起缺血性卒中的重要因素之一。     

上海某社区35～59岁高血压人群同型半胱氨酸水平及其分布特征

【目的】分析上海某社区35~59岁高血压人群同型半胱氨酸(homocysteine,Hcy)水平及分布特征,了解该人群高同型半胱氨酸血症(hyperhomocysteinemia,HHcy)的患病率及其相关因素。【方法】采用整群随机抽样方法,对2016年上海某社区1 161例35~59岁高血压患者进行体格检查及问卷调查,并测定血浆Hcy水平,采用SPSS 22.0软件分析不同高血压人群Hcy水平及HHcy患病状况,采用非条件logistic回归方法分析HHcy相关危险因素。【结果】1 161例35~59岁高血压患者的Hcy中位数为14.80μmol/L(男性:18.10μmol/L,女性:13.70μmol/L,P0.05)。Hcy水平随年龄递增,不同高血压家族史、糖尿病史、高血压组别以及体质指数(BMI)比较,男、女性Hcy中位数水平差异均有统计学意义(P0.05);人群HHcy检出率为48.06%(男性72.12%,女性27.29%;χ2=232.45,P0.05)。高血压组别是男性HHcy的相关因素,重点组和好转组分别是稳定组的16.94倍及4.43倍;女性重点组及好转组相应OR值(95%CI)分别为42.63(16.13,121.94)及23.74(9.67,61.81);女性HHcy水平还与年龄相关,50岁以上年龄组的危险度是50岁以下组的2倍以上。【结论】Hcy性别差异明显,男性、高血压分组是35~59岁社区高血压人群HHcy的相关因素。     

中老年人群同型半胱氨酸分布特点及其健康教育

目的了解某炼化公司中老年人群血清同型半胱氨酸（homocysteine,Hcy）分布特点,为该地区高同型半胱氨酸血症（hyperhomocysteinemia,HHcy）人群提供健康教育对策。方法整理5113名某炼化公司40岁以上人群体检资料,分析不同性别、年龄段血清Hcy水平和HHcy检出率及与传统心血管疾病主要危险因素的相关关系。结果某炼化公司40岁以上中老年人群的血清Hcy水平为（11.52±7.6）μmol/L,各年龄段男性血清Hcy水平及HHcy检出率均高于女性（P〈0.05）;同性别年龄组之间HHcy检出率随年龄的增加呈增高趋势;男性、年龄、收缩压、体质量指数、高血压病和肌酐清除率与HHcy存在相关性（P〈0.05）。结论某炼化公司40岁以上中老年人群的血清Hcy水平存在有性别与年龄的差异,男性、年龄、收缩压、体质量指数、肌酐清除率和高血压病史是HHcy的危险因素。男性40岁、女性60岁以上人群是本地区实施HHcy健康教育的目标人群。     

轻中度高血压人群中血清肌酐水平及其影响因素

目的 了解中国轻中度高血压人群血清肌酐(serum creatinine,Scr)水平及其影响因素.方法 从哈尔滨、沈阳、北京、西安、上海和南京6个地区入选480例年龄在18～75岁无慢性肾病史的轻中度原发性高血压患者,测定血清肌酐水平,451例患者纳入最终统计分析.结果 总人群平均血清肌酐水平约68 μmol/L,男性77.9μmol/L,女性61 μmol/L,男性高于女性(P＜0.001);在男性和女性人群中Scr均与血浆同型半胱氨酸(homocysteine,Hcy)和尿酸(uric acid,UA)水平呈正相关;其他相关因素具有性别差异,女性人群中血清肌酐水平与高密度脂蛋白(high-density lipoprotein cholesterol,HDL-C)呈负相关,而男性人群中,血清肌酐水平与年龄呈正相关.结论 轻中度高血压人群的血清肌酐水平男性高于女性,且与同型半胱氨酸和尿酸水平独立相关,血清肌酐水平的升高可能是性别、年龄、血浆同型半胱氨酸、尿酸和高密度脂蛋白等因素综合作用的结果.     

232例老人血脂异常发生率及其相关因素分析

目的调查老年人群血脂异常、高血糖及高同型半胱氨酸血症的患病率,为下一步营养干预提供科学资料。方法根据知情同意的原则,选取天津市某区55~89岁老干部232人为研究对象。抽空腹静脉血,全自动生化分析仪测定血脂、血糖和同型半胱氨酸(Hcy)含量。结果血浆胆固醇、甘油三酯、血糖以及Hcy含量均值分别为5.39mmol/L,1.52mmol/L,5.80mmol/L和16.72μmol/L;高胆固醇血症、高甘油三酯血症平均患病率分别为35.34%、25.86%,女性明显高于男性;高血糖平均患病率为21.55%,不同性别之间没有显著性差异;高Hcy血症平均患病率为51.29%,男性明显高于女性。结论老年人群中血脂异常、高血糖及高同型半胱氨酸血症等多种危险因素共同存在并相互作用,是心脑血管疾病发病率增高的重要原因之一。建议从饮食调理、健康教育等方面入手,必要时结合营养干预和药物治疗。     

小儿特发性癫痫血清同型半胱氨酸水平测定的临床意义

目的探讨小儿特发性癫痫与高同型半胱氨酸血症的关系。方法对特发性癫痫患儿与健康对照组儿童采用循环酶法检测血清同型半胱氨酸（Hcy）含量。分析癫痫组和对照组Hdy水平与不同癫痫类型间Hcy的差异。结果110例特发性癫痫患儿血清同型半胱氨酸水平为16．07μmol／L，40例对照组血清同型半胱氨酸水平为7．20μmol／L，2组比较差异有统计学意义。结论小儿特发性癫痫与高同型半胱氨酸血症有关。     

急性脑梗死患者血清同型半胱氨酸水平分析

目的研究急性脑梗死患者血清同型半胱氨酸（Hcy）含量,可望了解其部分发病机理。方法采用化学发光免疫分析法,测定116例已确诊的急性脑梗死患者的血清Hcy的含量,并与55名健康对照者比较。结果①脑梗组血Hcy平均为（28．97±20．96）μmol／L,对照组平均为（12．11±3．80）μmol／L。脑梗组明显高于正常对照组,急性脑梗死组与正常对照组的Hcy含量比较,差异有统计学意义（t=5．912,P=0．000〈0．01）;②男性脑梗组Hcy的水平（30．69±20．90）μmol／h,女性Hcy的水平（25．16±18．43）μmol／L,经比较,差异无统计学意义（t=1．319,P=0．190〉0．05）。结论同型半胱氨酸在急性脑梗死患者升高。     

Risk factors for cardiovascular disease and diet of urban and rural dwellers in northern Nigeria

Over the last 30 years, cardiovascular diseases (CVDs), including stroke and myocardial infarction, have increased in developing countries. Serum lipids and diet of the Fulani, a rural Nigerian population, were previously studied. Despite their consumption of a diet rich in saturated fat, the overall blood lipid profiles of Fulani men and women are generally favourable. However, Fulani males in the same study had mean serum levels of homocysteine, an emerging risk factor for CVD, that exceeded the upper limit of the homocysteine reference range. The authors were interested in knowing if these findings in the Fulani nomads were representative of the biochemical parameters of CVD risk in other ethnic groups in the same region of Nigeria. To address this question, the nutrient content of diets of 55 men, aged 20-75 years, and 77 women, aged 20-70 years, who were inhabitants of a large urban centre in northern Nigeria, was assessed, and their serum levels of total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, and homocysteine were determined. These data were compared with those of the same rural Fulani population studied previously. Urban subjects consumed more calories than rural subjects (men: 2061 vs 1691 kcal; women: 1833 vs 1505 kcal) and had a significantly higher mean body mass index (BMI) and percentage of body fat than rural subjects. Both urban males and females had carbohydrate intakes that were greater than those of Fulani pastoralists (men: 56% vs 33% total calories; women: 51% vs 38% total calories), but had a significantly lower dietary intake of total fat and saturated fat (men: 36% vs 51% of total calories; women: 40% vs 51% of total calories). With the exception of HDL-cholesterol levels, which were significantly lower in the rural population, the blood lipid profiles of rural subjects were more favourable compared to those of urban subjects. Both urban and rural males had homocysteine levels above the upper limit of the reference range for healthy adults (urban males--12.7 micromol/L; rural males-15.2 micromol/L). The dietary intakes of folate and vitamin B12 were lower for rural Fulani subjects, and this was reflected in their significantly lower serum concentrations of these two vitamins. Results of this study suggest that, although the lipid profiles of urban and rural men and women in northern Nigeria indicate a relatively low risk for CVD, their elevated serum homocysteine levels are a cause for concern. The high homocysteine levels among rural men and women could be explained in part at least by their marginal status with respect to folate and vitamin B12.     

北京25～64岁人群1984～1999年体重指数和超重率变化趋势的研究

目的：分析1984－1999年北京地区25－64岁人群平均体重指数（BMI）、超重率的变化趋势。方法：在北京地区心血管病监测人群中，分别进行了5次心血管病危险因素的横断面调查。结果：1984－1999年25－64岁人群平均BMI由23．3增加到24．0，超重率由27．5％增加到35．9％。男性人群超重率由23．5％增加到43．4％。男性各年龄组及城乡地区的超重率均呈增加趋势。女性人群在城乡地区的超重率呈不同变化趋势，城市女性超重率由36．0％下降到23．3％，农村女性超重率由28．4％增加到46．0％。城市人群的超重率由29．1％增加到31．8％，农村人群的超重率由22．1％增加到49．6％。研究早期城市人群的平均BMI和超重率大于农村人群（P＜0．05），到研究后期农村人群的BMI和超重率赶上并超过城市人群（P＜0．05）。结论：城市男性和农村男女两性人群BMI和超重率均呈上升趋势，但农村人群的上升速度较快，且平均BMI和超重率目前已高于城市人群。     

The levels of lycopene, alpha-tocopherol and a marker of oxidative stress in healthy northeast Thai elderly

An imbalance between oxidative stress and antioxidant capacity has been proposed to play an important role in the development and progression of chronic diseases in the elderly. The present study was carried out to investigate correlation between the serum antioxidants (lycopene and alpha-tocopherol) and malondialdehyde (MDA), a marker of oxidative stress in the healthy Thai elderly. The 207 healthy subjects aged 60-91 years old (72 males and 135 females) in Khon Kaen province, Thailand were enrolled in this study. They were interviewed by questionnaires about smoking habit. Serum lycopene and alpha-tocopherol levels were determined by high performance liquid chromatography (HPLC). MDA was measured by thiobarbituric assay. Serum lycopene and alpha-tocopherol levels in the elderly were 0.27 micromol/L (95% CI = 0.23-0.31) and 22.10 micromol/L (95% CI = 20.99-23.22), respectively. Males had significant lower serum lycopene and alpha-tocopherol levels than females (p<0.001). Of 72 males, 31.94% are current smokers whereas 1.4% of 135 females are current smokers. Current smokers had significantly lower serum lycopene (0.17 +/- 0.11 micromol/L) than current non-smokers (0.28 +/- 0.27 micromol/L) (p=0.0439) but level of alpha-tocopherol had non significance (p=0.210). Moreover, the current smokers had higher MDA malondialdehyde level (1.55 +/- 0.10 micromol/L) than the current non-smokers (1.35 +/- 0.04 micromol/L) (p=0.094). Thus, dietary antioxidant supplementation from local fruits and vegetables may have a beneficial role in the prevention of chronic diseases at high-risk oxidative stress such as smoking in these elderly.     

A study of plasma total homocysteine levels in healthy people

Elevated plasma levels of homocysteine have been identified as an independent risk factor for atherosclerosis. AIM: The aim of this study was to determine the reference limits of plasma total homocysteine for Bulgarian population. MATERIALS AND METHODS: We investigated 153 healthy individuals without vitamin deficiency aged from 18 to 65 years. The reference group consisted of 74 males and 79 females with mean age respectively 37.80 +/- 1.36 and 39.32 +/- 1.33 years. Plasma total homocysteine was determined by high performance liquid-chromatography (HPLC) modified and validated in our laboratory. RESULTS: The reference intervals were 7.4-18.5 micromol/l for males and 5.5-14.5 micromol/ 1 for females. The mean levels of plasma homocysteine were significantly higher in males in comparison with females (11.86 +/- 0.33 micromol/l vs. 9.88 +/- 0.27 micromol/l; P < 0.001), without considerable correlation with age. Comparing the values of total homocysteine between the two groups of age - < or = 49 and > or = 50 years showed that the investigated individuals > or = 50 years had higher plasma concentration, and the difference was significant only for the group of females. Hyperhomocysteinemia according to ECAP cut-off value (> 12.1 micromol/l) was registered in 30.7% of healthy volunteers. CONCLUSIONS: The results of our study demonstrated that homocysteine levels depend on sex and, to a lesser degree, on age. We have determined plasma total homocysteine reference intervals for the Bulgarian population. This will help the interpretation of the results and contribute to adequate and efficient prevention of blood vessel diseases.     

Blood pressure,lipids and other risk factors for cardiovascular disease in Aborigines and persons of European descent of southeastern Australia

Abstract: Based on a survey in two country towns of southeastern Australia, cardiovascular risk-factor prevalence data from Aborigines and persons of European descent are presented. The mean diastolic blood pressure in 123 Aboriginal males was 83.2 mmHg, compared with 79.2 mmHg in 272 European males (P= 0.005). In 178 Aboriginal females, mean diastolic pressure was 79.2 mmHg, compared with 76.3 mmHg in 281 European females (P = 0.006). Mean plasma total cholesterol was higher in Europeans (both males and females: 5.7 mmol/L) than in Aborigines (in males 5.2 and females 5.0 mmol/L) (male comparison, P = 0.02, female comparison, P < 0.001). The prevalence in participants aged 25 to 64 years of at least one major risk factor (diastolic blood pressure 95 mmHg or higher, plasma cholesterol 6.5 mmol/L or higher, or smoking more than one cigarette daily) was higher in both these samples of Aborigines (94 per cent in males, 89 per cent in females) and Europeans (70 per cent in males, 59 per cent in females) than in the 1989 urban sample of the National Heart Foundation (47 per cent in males, 36 per cent in females). Multivariate analyses showed statistically significant independent contributions of body mass index and the variable ‘ethnicity’ (unidentified genetic and environmental differences between the groups) to blood pressure and other risk factors. The higher cardiovascular mortality of Aborigines may be explained partly by the higher prevalence of risk factors in this group compared with other Australians. Further, the risk-factor profile may be worse among rural compared with urban Europeans.     

轻中度高血压人群叶酸与同型半胱氨酸水平的相关分析

目的探讨轻中度高血压患者血清叶酸水平与血浆总同型半胱氨酸水平（tHcy）的相关性。方法从哈尔滨、沈阳、北京、西安、上海和南京六城市分析455位28～75岁轻中度原发性高血压患者，测定血清叶酸和血浆同型半胱氨酸水平。结果叶酸水平低于15nmol／L时，叶酸水平越低，tHcy水平越高，高tHcy血症的发生率也越高。结论轻中度高血压患者中，血清叶酸水平与血浆tHcy水平呈负相关。     

Urinary iodine concentrations and thyroid function in adult Zimbabweans during a period of transition in iodine status.

BACKGROUND: In 1993 the compulsory iodization of salt was introduced in Zimbabwe, a country that was previously an area of severe iodine deficiency. OBJECTIVE: The objective of this study was to document urinary iodine excretion and biochemical thyroid function in seemingly healthy, community-dwelling adults after the introduction of iodization. DESIGN: A multistage, random sampling method was used in rural and urban settings to identify households from which the senior household member (aged >35 y) was recruited (alternating male and female recruits). Demographic data were collected for each subject and urinary and venous blood samples were taken. Urinary iodine excretion and serum thyroid hormone status (thyrotropin and total thyroxin) were evaluated according to age, sex, and area of residence. RESULTS: A total of 736 adults were recruited (253 men; mean age: 64 y). Urinary iodine concentrations were high [median (first and third quartiles): 4.41 (2.84, 6.78) micromol/L, or 560 (360, 860) microgram/L] and were significantly higher in rural areas than in urban areas [4.73 (3.07, 7.14) micromol/L, or 600 (390, 906) microgram/L, compared with 3.47 (2.05, 4.73) micromol/L, or 440 (260, 600) microgram/L; P < 0.001]. Urinary iodine excretion declined significantly with increasing age (r = -0.29, P < 0.001). Serum thyroid status suggested that the prevalence of biochemical hyperthyroidism in the study was 3%, with 13 of 415 cases in rural and 3 of 149 cases in urban subjects. CONCLUSION: This study reaffirms the need to continuously monitor iodine replacement programs to ensure efficacy.     

High prevalence of hyperhomocysteinemia in Chinese adults is associated with low folate, vitamin B-12, and vitamin B-6 status

Elevated plasma total homocysteine (tHcy) concentrations are associated with lower folate, vitamin B-12, and vitamin B-6 status and are considered an independent risk factor for cardiovascular disease in developed countries, but data in developing countries are limited. We conducted a cross-sectional study to explore tHcy status and its association with plasma B vitamin status in 2471 Chinese men and women aged 35 to 64 y, living in the urban and rural areas of the northern and the southern regions of China. Blood samples were also collected in 2 seasons (spring and fall). The geometric mean plasma tHcy concentration was significantly higher in the north (adjusted geometric mean, 95% CI; 13.0 micromol/L, 12.6-13.3) than in the south (9.1, 8.9-9.4) after controlling for gender, area (urban and rural), age, and season (spring and fall). Twenty-eight percent of northerners and 7% of southerners had plasma tHcy concentrations>or=16.0 micromol/L, a level used to define hyperhomocysteinemia. Within each region, men had higher plasma tHcy concentrations than women (16.1 vs. 10.6 micromol/L in the north, and 10.7 vs. 7.9 micromol/L in the south) and 40% of the northern men had hyperhomocysteinemia. Generally, individuals living in the urban areas had 30% (95% CI, 1.0-1.6) greater odds of having high tHcy levels (>or=16 micromol/L) than those living in the rural areas. Low plasma concentrations of folate, vitamins B-12 and B-6, older age, being male, and living in urban areas were all independently associated with elevated tHcy, with low folate as the strongest determinant.