德清县农村社区糖调节异常人群2型糖尿病发病风险预测

目的构建农村社区糖调节异常(IGR)人群2型糖尿病(T2DM)发病风险预测模型,为T2DM的预防提供理论依据和评估工具。方法收集2006-2014年浙江德清县农村社区28 251名非糖尿病成人健康数据,筛选出基线调查中5 656例IGR作为本研究队列人群,并按2:1随机分为建模队列(n=3 803)和验证队列(n=1 853)。采用SPSS 22.0软件进行统计分析,计数资料组间比较采用χ~2检验,基于建模队列采用Cox回归分析筛查T2DM相关危险因素,构建发病风险预测模型,根据纳入模型的危险因素系数β建立风险评分表,以受试者工作特征(ROC)曲线下面积(AUC)评价模型的预测能力。在验证队列中进一步验证,评价模型预测能力。结果最终纳入模型的变量有年龄、体质指数(BMI)、高血压史、蔬菜摄入量和食物偏好。建模队列的AUC=0.71(95%CI:0.66~0.77),验证队列的AUC=0.65(95%CI:0.58~0.73)。风险评分提示,总评分≥5分的对象发展为T2DM的风险显著增加。结论所构建的T2DM发病风险预测模型在农村社区IGR人群中有较好的预测能力,而且简单、使用方便,具备很好的应用价值。     

中国台湾省35～74岁健检人群慢性肾病5年发病风险预测模型

目的构建中国台湾省35～74岁健检人群慢性肾病(CKD)5年发病风险(个体化)预测模型。方法选择1996～2006年初次参加台湾省美兆健检的35～74岁人群19 987人,将其中基线未患CKD者18 275人分为建模队列(用于建立5年发病预测模型)和验证队列(用于评估模型外部效度)。采用logistic回归构建预测模型,以ROC曲线下面积(AUC)评价拟合优度,并将人群的预测风险概率进行风险等级划分。结果去除基线患者后CKD5年发病率为5.24%(958/18275)。纳入5年发病风险预测模型的变量包括年龄、教育程度、糖尿病、高血压、低密度脂蛋白胆固醇、甘油三酯和血肌酐水平7个指标。建模队列建立的预测模型的ROC曲线下面积(AUC)约为0.734(95%CI:0.714～0.754),验证队列外部效度验证结果AUC=0.768(95%CI:0.734～0.801)。将建模队列划分为4个风险等级后,显示中危(占14.1%)和高危(占5.4%)的个体5年内发生CKD的危险分别比一般人群高2.0倍和4.8倍。结论利用中国台湾省美兆健检纵向数据建立的CKD 5年个体风险预测模型效应与信度均较高,且简单实用,对于今后CKD风险个体评价及群体监测均有较大的应用价值。     

台湾地区35～74岁健康体检人群代谢综合征发病风险预测模型的建立

目的 构建台湾地区35～74岁健康体检人群代谢综合征5年发病风险(个体化)预测模型。方法在1997-2006年初次参加台湾美兆自动化健康体检机构(美兆健检)的35～74岁人群中,将随访满5年基线时无代谢综合征13 973人作为随访队列,并分为建模队列(用于建立5年发病预测模型)和验证队列(用于评估模型外部效度),采用logistic回归构建预测模型。以ROC曲线下面积(AUC)评价拟合优度,并将人群的预测风险概率进行风险等级划分。结果 去除基线患者后研究人群5年代谢综合征患病率为11．7％。纳入发病风险预测模型变量有年龄、糖尿病家族史、收缩压、空腹血糖、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、总胆固醇、体重指数和血尿酸,建模队列建立预测模型的AUC为0．827(95％CI：0．814～0．839),验证队列的AUC分别为0．813(O．789～0．837)、0．826(0．800～0．852)、0．794(0．768～0．820)。将建模队列划分为4个风险等级后,提示个体发病概率≥17．6％者为中危人群,发病概率≥59．0％者为高危人群。结论 由美兆健检纵向数据库建立的5年代谢综合征个体风险预测模型有较高的验证效度,对于体检人群5年代谢综合征发病预测具有实用、可行的特点,预测模型对评估代谢综合征个体发病和群体监测均有较高应用价值。     

台湾地区30～59岁健康体检人群肥胖5年发病风险预测模型

目的 构建台湾地区30 ～ 59岁健康体检人群肥胖5年发病风险(个体化)预测模型.方法 选择1998 -2006年首次参加台湾美兆健康体检的30～59岁人群15 085人,剔除基线患肥胖者91 8人共计14 167人.将4个体检中心分为建模队列(台北中心,n=8104)和验证队列(另3个中心,n=6063).按建模队列5年后是否发生肥胖为因变量、基线指标为自变量进行单变量分析,并建立多元逐步logistic回归模型,以ROC曲线下面积(AUC)为判定预测模型拟合优度的主要指标,用验证队列对模型的外部效度进行评估.建模后再将人群预测风险概率正态化转为可实际应用操作的4个风险等级.结果 4个体检中心基线时正常体重、超重和肥胖人群的比例分别为50.00％～ 60.00％、26.47％ ～ 31.11％和5.76％～7.24％.剔除基线患者后,全部受检者5年肥胖发病率为2.73％(386/14 167),4个中心肥胖发病率为2.66％～2.91％.多变量logistic回归构建的预测模型包括年龄、性别、糖尿病家族史、近3个月体重变化≥4kg和腰围5个指标.建模队列建立的预测模型AUC约为0.898(95％CI:0.884～ 0.912),验证队列外部效度验证结果为AUC=0.881(95％C1:0.862 ～ 0.900).将建模队列划分为4个风险等级后,显示中危(16 0％)和高危(2.9％)的个体5年内发生肥胖的危险分别比一般人群高7.8倍和16.6倍.结论 利用台湾美兆健康体检纵向数据资料建立的肥胖5年个体风险预测模型,其效度和信度均较高,且评价标准简单实用,无论对个体自身肥胖风险评价还是对社区人群肥胖监测均具有应用价值.     

老年男性保健人群六年累计缺血陛心血管病发病率及其危险因素的前瞻陛研究

目的 研究老年保健人群6年累计缺血性心血管病(ICVD)的发病率及其相关危险因素.方法 基线人群为2003年5月某医院数据库记录在案的、出生于1938年1月1日前(即年龄＞65岁)的所有老年保健对象,剔除基线时已患有ICVD者.收集的危险因素有:基线时年龄、性别、体重指数、收缩压、血总胆固醇浓度、血甘油三酯浓度、血高密度脂蛋白胆固醇(HDL-C)浓度、血肌酐浓度、血载脂蛋白A1浓度、糖尿病、吸烟,以人年作为观察时间,计算基线危险因素不同分期水平下的人年发病率及累计发病率,进行单因素分析.使用Cox比例风险回归模型进行多因素分析.结果 基线人群为2271名男性老年人,6年内ICVD累计发病率为23.56%,人年发病率达到了45.41‰.单因素分析表明,与ICVD事件正相关的变量是:收缩压、体重指数、血总胆固醇水平、血甘油三酯水平、血载脂蛋白A1水平、糖尿病、吸烟;与ICVD事件负相关的变量是:血HDL-C浓度、血肌酐浓度;多元Cox比例风险模型的分析结果显示:收缩压、糖尿病、血总胆固醇、体重指数是最主要的危险因素,血HDL-C是主要的保护因素.结论 老年保健人群ICVD发病率较高.控制血压、血糖,提高血HDL-C水平可能是降低未来ICVD事件最为有效的措施.     

中国台湾35~74岁健检人群高尿酸血症5年发病风险预测模型

目的构建中国台湾35~74岁健检人群高尿酸血症5年发病风险预测模型。方法选择随访刚满5年且基线无高尿酸血症的健康体检人员21 190人,分为建模队列和验证队列,采用多因素逐步回归logistic分析构建模型,以ROC曲线下面积(AUC)评价拟合优度。结果研究人群5年高尿酸血症发病率为12.64%。纳入预测模型变量有性别、舒张压、血尿酸、总胆固醇、LDL-C、甘油三酯、教育,其OR值(95%CI)分别为0.397(0.334~0.472)、1.021(1.015~1.027)、1.018(1.016~1.020)、0.763(0.651~0.894)、1.416(1.261~1.591)、1.304(1.194~1.424)和0.877(0.830~0.927)。预测模型ROC曲线下面积(AUC)为0.766(95%CI,0.753~0.779),验证队列为0.764(0.752~0.776)。结论由研究数据库建立的高尿酸血症风险预测模型有较高验证效度,对于该健康体检人群高尿酸血症预测具有实用、可行的特点,对评估发病风险有一定应用价值。     

中国台湾地区35～74岁健检人群2型糖尿病患病率以及5年发病风险预测模型

目的构建2型糖尿病（type 2 diabetes mellitus,T2DM）5年发病风险（个体化）预测模型。方法选择1997-2006年首次参加中国台湾美兆自动化健检机构（简称美兆健检）的35～74岁人群24 220人,将基线未患T2DM者23 180人分为建模队列（用于建立5年发病预测模型）和验证队列（用于评估模型外部效应）。采用Logis-tic回归构建预测模型,以受试者工作特征（receiver operating characteristic,ROC）曲线下面积（area under roc curve,AUC）评价拟合优度并将人群的预测风险概率进行风险等级划分。结果去除基线患者后T2DM 5年发病率为3.25%（753/23 180）。纳入5年发病风险预测模型的变量包括年龄、有无T2DM家族史、身高、腰围、空腹血糖、甘油三酯、高密度脂蛋白胆固醇7个指标。建模队列建立的预测模型的ROC曲线下面积（AUC）约为0.873（95%CI：0.851～0.893）,验证队列外部效度验证结果：桃园、台中、高雄3个体检中心的AUC依次为0.823、0.850和0.819。将建模队列划分为4个风险等级后,显示中危（占13.4%）和高危（占4.3%）的个体5年内发生T2DM的危险分别比一般人群高5.9倍和29.8倍。结论利用中国台湾美兆健检纵向数据资料建立的T2DM 5年个体风险预测模型效应与信度均较高,且简单实用,对于今后T2DM风险个体评价及群体监测均有较大的应用价值。     

血清尿酸对2型糖尿病预测价值的分析

目的 分析成都地区1992年中年居民血清尿酸水平对2007年该人群2型糖尿病患病的预测价值.方法 1992年进行代谢综合征研究时共纳入1061人,其中年龄45 ～ 60岁且血糖正常者共71 1人,并依据血清尿酸水平分为尿酸正常组及增高组,采用x2检验和logistic回归分析1992年高尿酸血症与2007年该人群(711人)2型糖尿病患病率的相对危险度(RR).结果 (1)1992年血尿酸增高人群在2007年时空腹血糖(FBG)皆高于尿酸正常人群,t检验示组间FBG的差异有统计学意义.2007年糖尿病患病率亦呈类似FBG的特点,为尿酸增高组高于尿酸正常组,经X2检验,组间糖尿病患病率差异有统计学意义.(2)根据该队列人群1992年血尿酸增高与否,计算2007年2型糖尿病患病,RR=3.749,P=0.000,95％CI:2.387 ～ 5.890.(3)使用logistic回归模型分析1992年基线血尿酸对2007年2型糖尿病患病的影响,在调整了其他危险因素后,高尿酸血症RR=1.426,P=0.003,95％CI:1.173～1.705.结论 尿酸异常与血糖代谢异常关系密切,高尿酸血症可预测2型糖尿病的发生.     

海南省居民高血压患病风险预测模型建立与验证

目的分析海南省成人居民高血压患病的危险因素，建立个体化高血压患病风险预测模型。方法 2021年7月—2022年1月，通过多层多阶段随机抽样的方法，随机抽取海南省4个市（县）≥18岁的常住居民进行问卷调查、体格检查、血生化及尿液常规检验等资料的收集。按7∶3的比例随机分为建模组和验证组，经过单因素分析及LASSO回归初步筛选，再经过多因素分析确定预测变量，构建高血压患病列线图模型并应用C指数、受试者工作特征（receiver operating characteristic,ROC）曲线、校准曲线和决策曲线分析法（decision curve analysis,DCA）对预测模型进行评价。结果 调查4 606人，高血压患病率为32.50%。年龄、文化程度、吸烟、体质量指数、高血压病家族史、糖尿病、三酰甘油、血尿酸、尿肌酐及尿微量白蛋白为海南省成人居民高血压患病的独立危险因素（均P<0.05）。高血压患病风险预测模型在建模组和验证组C指数分别为0.858 5和0.853 0,ROC曲线下面积（area under ROC curve,AUC）分别为0.858和0.845，校准曲线表现...     

造影术后肌酐水平和各危险因素的相关性研究

目的 探讨术后肌酐峰值和基线各危险因子的相关性.方法 选取行心血管造影的2型糖尿病并轻-中度肾功能不全的患者54例,收集术前基线资料(性别、基线肌酐、体重、身高等)和术后48 h和72 h肌酐水平,分别对基线Scr和术后48 h和72 h进行配对分析,寻找Scr峰值.利用SIMCA-P软件,运用偏最小二乘回归方法(partial least-squares regression,PLS)分析各术前危险因素和Scr峰值的相关性.结果 配对资料分析显示术后72 h Scr跟基线Scr相比增高3％ (P=0.012; 97.37±20.06 vs.94.99±20.27) μmol/1,差异有统计学意义,考虑为Scr峰值.PLS显示术前Scr、年龄、心衰、SBP、DBP、服用ACEI、服用ARB、对比剂剂量、基线血糖、BUN、ALT、使用NSAIDS与术后72 h Scr正相关,女性、体重、水化、血红蛋白、基线胆固醇与术后72 h Scr负相关.对危险因素重要性的VIP分析,术前Scr与术后72 h Scr关系最显著,其次是性别、体重、身高和使用ACEI.建立PLS回归方程.预测建模分析显示,模型的拟合效果是令人满意的.结论 对于轻中度肾功能不全伴2型糖尿病患者,术后72 h Scr最高,而基线Scr是预测术后Scr增高的最重要的危险因子.     

不同级别医院医护人员缺血性心血管疾病发病风险评估

目的调查广西柳州市三级及社区医院医护人员心血管疾病及危险因素的流行情况,分析并比较两者未来10年缺血性心血管病(ICVD)的发病风险及危险因素评估。方法入选在广西柳州市某医院进行体检的年龄≥35岁医护人员2423例。对受检者进行问卷调查及生化检查,采用"国人ICVD10年发病危险度评估表"评估35~59岁人群10年ICVD发病风险。定义ICVD发病风险>10%为发病人群,采用广义多因素降维法(GMDR)分析各危险因素间的交互作用及多元logistics回归分析各危险因素与发病风险的相关性。结果三级医院医护人员的体质量,BMI,收缩压,舒张压,TC,FBG及10年患病危险度水平,高胆固醇血症,高血压患病率及相对危险度超过10%占比均高于社区人员(P<0.001)。调整性别后,GMDR分析发现全部医护人员最佳交互模型为年龄和收缩压,测试集精确度为0.8825,交叉一致性为9/10(P<0.001);三级医院医护人员最佳交互模型为年龄和收缩压,测试集精确度为0.8714,交叉一致性为9/10(P=0.004);社区医院医护人员最佳交互模型为体质量指数和收缩压,测试集精确度为0.9386,交叉一致性为10/10(P<0.004)。logistics回归分析交互效应的贡献程度。全部医护人员收缩压升高发病风险增加(OR=1.32,95%CI=0.84~1.56,P<0.05),年龄及血压均升高发病风险增加(OR=1.55,95%CI=1.03~2.27,P<0.001);三级医院医护人员年龄及血压均升高时,发病风险增加(OR=1.31,95%CI=1.01~2.12,P<0.001);社区医院医护人员收缩压升高发病风险增加(OR=1.17,95%CI=0.82~1.47,P<0.05),体质量指数及血压均升高发病风险增加(OR=1.89,95%CI=1.08~2.74,P<0.001)。结论收缩压升高是医院医护人员10年ICVD发病风险的重要贡献因素,需加强干预。     

A stroke prediction score in the elderly: validation and Web-based application.

The objective of this study was to construct a prediction model for predicting stroke in an elderly U.S. population, and to assess the accuracy in this population of other previously published prediction models. The subjects were participants in the Cardiovascular Health Study: 2,495 men and 3,393 women age 65 years and older at baseline, and followed for 6.3 years. Among 5,711 participants free of baseline stroke, 399 strokes occurred. Sex-specific prediction equations were constructed using study variables that were most importantly related to incident stroke: age, systolic blood pressure, diabetes, ECG diagnosis of atrial fibrillation or left ventricular hypertrophy, confirmed history of cardiovascular disease, diabetes, time to walk 15 ft, and serum creatinine. The prediction rule was implemented as a risk score and in a Web-based interactive Java applet. Overall, the model predicted 5-year stroke risks ranging from less than 1 to 59%. The 20% of subjects in the highest predicted risk group had a 5-year actual stroke incidence rate of 15%, while the 20% lowest risk group had a 1% incidence. Risk scores from two other studies performed well in these study participants. Effective discrimination between low and high stroke risk in the elderly was possible in this cohort with data that are easy to obtain. Evaluation of the generalizability and clinical usefulness of this prediction model requires further research.     

Prediction of stroke, coronary heart disease, cardiovascular disease, cancer, and total death based on results of annual health checkups

OBJECTIVE: We aimed to predict mortality rate from the findings of annual health checkups for men and women. METHOD: The subjects were 31,053 men and 61,224 women who were living in Ibaraki prefecture (Japan), aged 40 to 79 years, without history of any stroke and coronary heart disease, and who participated in annual health checkups in 1993. They were followed until the end of 2001, with a systemic review of resident registration and death certificates. The Cox's proportional hazards model with step-down procedure was used to estimate predictive model. RESULTS: During the 8.0 years follow-up, there were 5260 deaths (710 from stroke, 389 from coronary heart disease and 2,322 from cancer). The predictive factors for all causes were advanced age, high systolic blood pressure, medication for hypertension, low serum HDL cholesterol, high or low serum creatinine, high AST or ALT, diabetes, low body mass index, current smoking, heavy drinking, and urinary protein among men. The predictive factors for cardiovascular disease were advanced age, high systolic blood pressure, medication for hypertension, low or high serum total cholesterol, low serum HDL cholesterol, high serum creatinine, diabetes, low body mass index, current smoker, and urinary protein, and those for cancer were advanced age, medication for hypertension, low serum HDL cholesterol, low serum creatinine, high AST or ALT, diabetes, low body mass index, current smoking, heavy drinking and urinary protein. Furthermore, those for stroke were advanced age, high systolic blood pressure, medication for hypertension, low serum HDL cholesterol, high serum creatinine, high AST or ALT, low body mass index, current smoking, while for coronary heart disease they were advanced age, high systolic blood pressure, high serum total cholesterol, low serum HDL cholesterol, diabetes, current smoking, and urinary protein among men. For women, similar predictive factors were obtained, although some of them did not reach statistical significance. CONCLUSION: We could construct predictive models for 5-year mortality rate from results of annual health checkups. These findings should prove useful for computerized health education on the prevention of stroke, coronary heart disease, and cancer.     

Serum hepatocyte growth factor and cancer mortality in an apparently healthy Japanese population

Background: In patients with cancer, hepatocyte growth factor (HGF) is elevated and is a predictor of prognosis. We investigated whether serum HGF was a predictive marker for cancer death in a population of community-dwelling Japanese.Methods: We studied 1492 apparently healthy Japanese adults who underwent health examinations in 1999. Those who reported a history of liver disease or malignancy on a baseline questionnaire were excluded, and plasma HGF was measured in the remaining 1470 participants, who were followed periodically for 10 years. Multivariate proportional hazards regression was used to estimate cancer mortality.Results: A total of 169 participants died during follow-up (61 from cancer, 32 from cerebrocardiovascular disease, and 76 from other diseases). Mean HGF at baseline was significantly higher among decedents than among survivors (0.26 ± 0.11 vs 0.23 ± 0.09 ng/ml, respectively; P < 0.01). The Cox proportional hazards model showed that age, systolic blood pressure, HGF (hazard ratio, 1.27; 95% CI, 1.06-1.52; P = 0.009), albumin level, smoking status, and creatinine were independent predictors of all-cause death. Age, HGF (hazard ratio, 1.31; 95% CI, 1.04-1.65; P = 0.02), and total cholesterol were independent predictive markers for cancer death.Conclusions: Serum HGF was a predictor of cancer death in an apparently healthy population of community-dwelling Japanese.     

Coronary heart disease risk factors and attributable risks in African-American women and men: NHANES I epidemiologic follow-up study.

OBJECTIVES: This study assessed associations of risk factors with coronary heart disease incidence in African Americans. METHODS: The participants in the NHANES I Epidemiologic Follow-Up Study included in this analysis were 1641 Black and 9660 White persons who were aged 25 to 74 years when examined and who did not have a history of coronary heart disease. Average follow-up for survivors was 19 years. RESULTS: Significant, independent risk factors for coronary heart disease were age, systolic blood pressure, and smoking in Black women and age, systolic blood pressure, serum cholesterol, low education, and low family income in Black men. In this cohort, 19% of incident coronary heart disease in Black women and 34% in Black men might be prevented if systolic blood pressure were below 140 mm Hg. In Black men, attributable risk for low education (46%) was even higher than that for elevated blood pressure. CONCLUSIONS: Elevated systolic blood pressure and smoking were predictive of coronary heart disease incidence in African Americans. Estimates of population attributable risk were highest for elevated systolic blood pressure in women and education less than high school in men. Further studies of serum lipids, education, and coronary heart disease in Black women are needed.     

non-HDL-C与缺血性心血管病10年发病风险相关性研究

目的  评估非高密度脂蛋白胆固醇(non-high density lipoprotein cholesterol, non-HDL-C)与10年缺血性心血管病(ischemic cerebrovas-cular disease, ICVD)发病风险的相关性。方法  从2017―2020年度国家心血管病高危人群队列研究中,筛选出安徽省年龄≥35岁人群100 893例,记录其基本信息、血压、血脂等,并计算血清non-HDL-C值。利用中国人10年ICVD发病危险度的简易评估模型预测入选者10年内ICVD患病风险,采用多因素logistic回归分析模型和趋势分析方法探究non-HDL-C对ICVD发病风险的意义,同时绘制森林图。结果  研究对象平均年龄(57.52±9.94)岁,其中男性40 931人占40.57%,女性59 962人占59.43%。男性高危发病风险人群占16.94%,高于女性(8.45%),且发病风险随non-HDL-C值、年龄的增加而上升,随教育和收入水平的提高而降低(P＜0.001)。non-HDL-C为未来10年ICVD发病风险的独立危险因素(P < 0.001)。结论  相比传统指标,non-HDL-C对预测未来10年ICVD发病风险有一定意义,且由于其无须考虑禁食状态等独特优势,non-HDL-C在一定程度上优于LDL、TG等传统指标。     

高血压患者高尿酸血症的发病风险预测[*基金项目：北京市教委实培计划项目(2017-11-08-246)。 ①首都医科大学公共卫生学院 北京 100069 ②首都医科大学公共卫生学院 北京 100069 # 通讯作者]*

目的 研究高血压患者高尿酸血症的发病水平及危险因素,构建发病风险预测模型及风险评分表。方法 收集2011—2016年北京小汤山医院体检中心1 198例高血压患者的体检资料,采用广义估计方程进行多因素分析,并通过回归系数构建高血压患者未来5年高尿酸血症的发病风险预测模型和风险评分表,以ROC曲线下面积(AUC)评价模型及评分表的预测能力。结果 研究人群高尿酸血症5年累积发病率为15.5%。纳入预测模型的变量有性别、体质指数、甘油三酯、血肌酐、尿素氮、谷丙转氨酶、空腹血糖和体检时间,其RR值(95%CI)分别为0.673(0.513~0.883)、2.409(1.699~3.415)、1.775(1.389~2.268)、2.504(1.723~3.639)、1.790(1.354~2.366)、1.405(1.012~1.948)、0.646(0.468~0.893)和1.256(1.201~1.314)。预测模型及评分表的AUC分别为0.709(95%CI: 0.690~0.727)和0.711(95%CI: 0.692~0.730)。结论 肥胖、血脂紊乱、肝肾功能减退和低血糖等均是高血压患者发生高尿酸血症的危险因素,由上述指标建立的高血压患者高尿酸血症发病风险预测模型具有较强的预测能力。     

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。     

Determinants of plasma homocysteine levels and carotid intima-media thickness in Japanese

Although hyperhomocysteinemia is considered to be a key risk factor for atherosclerosis, especially in Western countries, its role in the Asian population is still controversial. In this study, we evaluated the determinants of homocysteine and carotid intima-media thickness, a clinical marker for the detection of atherosclerosis, in Japanese. In 289 Japanese adults (age 37-86 yrs), we screened plasma total homocysteine by high performance liquid chromatography and evaluated maximum carotid intima-media thickness by ultrasound. Other blood chemistry values were also measured. Total homocysteine levels were higher in men than in women and increased with age. In multiple regression analysis, adjusted for age and sex, serum creatinine was a powerful determinant of homocysteine (beta = 3.3, p < 0.01). Maximum carotid intima-media thickness was higher in men than in women and increased with age. When adjusted for age and sex, systolic blood pressure was independently correlated with maximum carotid intima-media thickness (beta = 0.001, p < 0.01). Our current results support previous findings that in addition to age and sex, serum creatinine and systolic blood pressure are independent determinants of homocysteine and carotid intima-media thickness, respectively.