Distribution of and Factors Associated with Plasma Homocysteine Levels in Wuhan Residents: A Stepwise Multiple Regression Analysis

HOMOCYSTEINE, an amino acid with a sulfhy-dryl group, is an important intermediate product inthe metabolism of methionine and cysteine.Homocysteine itself, however, does not participatein the synthesis of protein products.1 Epidemiologicstudies by Wilcken et al. were the first to charac-terize homocysteine (Hcy) as an independent riskfactor for cardiovascular disease.2 This observationhas been confirmed by subsequent studies whichhave correlated Hcy levels and the risk of acutemyocardial infarction, stroke,...     

叶酸对血浆同型半胱氨酸和血管内皮功能的影响

研究报道，同型半胱氨酸(homocysteine，Hcy)是冠心病的独立危险因子。叶酸参与Hcy的代谢过程，所以叶酸可对冠心病的发生及转归产生影响。本研究旨在观察叶酸补充对冠心病患者Hcy和血管内皮功能的影响。     

High Plasma Homocysteine Increases Risk of Metabolic Syndrome in 6 to 8 Year Old Children in Rural Nepal

Little attention has been given to the association of plasma homocysteine (Hcy) and metabolic syndrome (MetS) in children. We have evaluated the risk of MetS with plasma Hcy in a cohort of 6 to 8 year old rural Nepalese children, born to mothers who had participated in an antenatal micronutrient supplementation trial. We assessed Hcy in plasma from a random selection of n = 1000 children and determined the relationship of elevated Hcy (>12.0 μmol/L) to MetS (defined as the presence of any three of the following: abdominal adiposity (waist circumference ≥ 85th percentile of the study population), high plasma glucose (≥85th percentile), high systolic or diastolic blood pressure (≥90th percentile of reference population), triglyceride ≥ 1.7 mmol/L and high density lipoprotein < 0.9 mmol/L.) and its components. There was an increased risk of low high-density lipoproteins (HDL), [odds ratios (OR) = 1.77, 95% confidence intervals (CI) = 1.08–2.88; p = 0.020], high blood pressure [OR = 1.60, 95% CI = 1.10–2.46; p = 0.015] and high body mass index (BMI) [OR = 1.98, 95% CI = 1.33–2.96; p = 0.001] with elevated Hcy. We observed an increased risk of MetS (OR = 1.75, 95% CI = 1.06–2.90; p = 0.029) with elevated Hcy in age and gender-adjusted logistic regression models. High plasma Hcy is associated with increased risk of MetS and may have implications for chronic disease later in life.     

青岛市成人双生子吸烟饮酒遗传度分析

目的分析遗传因素对双生子吸烟、饮酒的影响。方法以青岛地区自愿参加本研究的年龄≥24周岁的双生子为对象，在卵型鉴定的基础上。采用Holzinger方法分析其吸烟、饮酒的遗传度。结果估计吸烟的遗传度为（66．5±5．53）％，重度吸烟的遗传度为（43．0±5．75）％。男性同卵双生子在吸烟行为上Kappa一致性检验K=0．453，P〈0．001。异卵双生于K=0．307，P=0．005；饮酒的遗传度为（60．8±7．79）％，大量饮酒的遗传度为（22．2±9．80）％。男性同卵双生于在饮酒行为上Kappa一致性检验K=0．518。P〈0．001，异卵双生子K=0．160，P=0．224。结论吸烟、饮酒受遗传因素影响较大；重度吸烟、大量饮酒受遗传因素影响较小。男性同卵双生子在吸烟、饮酒行为上呈现中度一致性．男性异卵双生子、女性双生子一致性差异无统计学意义。     

儿童缺血性脑血管病急性期血清同型半胱氨酸水平变化研究

目的探讨儿童缺血性脑血管病血清同型半胱氨酸(Hcy)的水平变化。 方法选择2007年1月至2011年8月于本院儿科就诊的儿童缺血性脑血管病急性期患儿30例为研究对象纳入研究组。随机选择同期在本院健康体检的健康儿童30例纳入对照组。对两组受试儿童采用循环酶法测定儿童缺血性脑血管病急性期Hcy水平,并进行统计学分析(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象本人的知情同意,并与之签署临床研究知情同意书)。两组受试者年龄、性别等临床资料比较,差异均无统计学意义(P>0.05)。 结果研究组男性与女性儿童的血清Hcy水平分别显著高于对照组同性别儿童[(28.11±10.98) μmol/L vs. (11.36±5.43)μmol/L; (22.96±11.26) μmol/L vs.(12.15±4.33)μmol/L],差异有统计学意义(t＝12.87,10.67;P<0.01);两组受试者血清Hcy异常检出率比较,差异亦有统计学意义(χ²＝12.319,P<0.01)。 结论儿童缺血性脑血管病急性期血清Hcy水平显著升高、异常检出率较高。Hcy水平变化可能在该病的发生发展中起重要作用。     

脑卒中患者血浆同型半胱氨酸水平变化及临床意义

目的：探讨脑卒中患者血浆同型半胱氨酸（Hcy）水平及影响Hcy的因素。方法：选取2013年1月-2014年3月在本院住院治疗的脑卒中和同期体检的健康人作为研究对象,分为脑出血组、脑梗死组和对照组,比较三组人群Hcy、叶酸等指标的水平差异,探讨脑卒中发病、神经缺损程度与Hey的关系。结果：脑出血组和脑梗死组的Hcy水平高于对照组,叶酸、维生素B12：水平低于对照组,差异均有统计学意义（P〈0．05）;脑卒中患者体内的Hey水平与叶酸和维生素B12水平呈负相关;Hcy每上升1μmol／L,发生脑卒中的风险上升11．8％;Hev每上升1μmol／L,神经功能缺损程度评分上升3．124分。结论：高Hcy水平是脑卒中的独立危险因素,Hcv水平与叶酸、维生素B12呈负相关,能反映神经功能缺损程度。     

妊娠期高血压疾病及妊娠期糖尿病患者的血浆同型半胱氨酸测定及临床意义的研究

目的对高同型半胱氨酸血浆与妊娠期高血压疾病、糖尿病发病的相关性进行探讨。方法选择2011年1月至2013年1月,我院检查患有妊娠期高血压（HDCP）患者113例,妊娠期糖尿病（GDM）患者87例以及正常怀孕的孕妇100例。对三组妇女血浆中同型半胱氨酸的浓度进行检测,调查不良妊娠反应。结果血浆中同型半胱氨酸测量的浓度在妊娠期高血压疾病组、妊娠期糖尿病组、正常组存在差异,P〈0．05;跟踪三组的妊娠不良结局,差异具有统计意义,P〈0．05。结论HDCP与GDM组患者的血浆同型半胱氨酸浓度上升可能与胰岛素抵抗相关,但这并不是导致妊娠不良后果的唯一因素。     

Methionine-Loading Rapidly Impairs Endothelial Function,by Mechanisms Independent of Endothelin-1: Evidence for an Association of Fasting Total Homocysteine with Plasma Endothelin-1 Levels

Objective: Homocysteinemia is associated with elevated oxidative stress and impaired endothelial function. In the present study we examined the impact of oxidative stress in the development of endothelial dysfunction in both chronic and acute (methionine-induced) homocysteinemia in humans. We also examined the role of endothelin-1 (ET-1) in the development of endothelial dysfunction in these two conditions.

Methods: In this double-blind placebo controlled study, 28 subjects of both genders (14 with homocysteinemia and 14 healthy controls) underwent methionine-loading (100mg/Kg body weight) in a standard juice, containing vitamins C (2g) plus E (800IU) (n = 14) or no vitamins (placebo group, n = 14). Forearm vasodilatory response to reactive hyperemia, plasma total homocysteine (tHcy), oxidized LDL (ox-LDL), ET-1 and soluble vascular cell adhesion molecule (sVCAM-1), were evaluated at baseline and 4 hours post methionine loading (4hPML).

Results: Chronic homocysteinemia was associated with increased oxLDL (p < 0.01), higher ET-1 (p < 0.05) and impaired endothelial function (p < 0.01). However, oxLDL (but not ET-1) was increased 4hPML in the placebo group, an effect prevented by antioxidant vitamins. The development of severe endothelial dysfunction 4hPML was not however prevented by antioxidants. In linear regression analysis, fasting tHcy was an independent predictor of baseline oxLDL (p = 0.0001), but not of ET-1 levels. On the contrary, oxLDL was the main predictor of ET-1 (p = 0.008), suggesting that tHcy may increase ET-1 by enhancing the production of oxLDL.

Conclusions: Both chronic and acute methionine-induced homocysteinemia are associated with elevated oxidative stress status. Although ET-1 is increased in chronic homocysteinemia, it does not participate in the rapid development of endothelial dysfunction after methionine loading. These findings suggest that despite its potential role in chronic homocysteinemia, ET-1 has a limited contribution to the development of endothelial dysfunction in acute, methionine-induced homocysteinemia in humans.     

血浆同型半胱氨酸水平与妊娠相关性疾病关系的研究进展

血浆高同型半胱氨酸血症可引起妊娠期相关性疾病,如妊娠高血压、胎盘血管疾病、先天性心脏病、增加血小板黏附性和致妊娠丢失,严重者危及母子生命。补充叶酸、维生素B6和维生素B12有望降低妊娠相关疾病的发生,对于降低孕产妇及围产儿发病率及死亡率有重大意义。     

Fatty Acid Status and Its Relationship to Cognitive Decline and Homocysteine Levels in the Elderly

Polyunsaturated fatty acids (PUFAs), especially the n-3 series, are known for their protective effects. Considering that cardiovascular diseases are risk factors for dementia, which is common at aging, the aim of this study was to evaluate whether fatty acid status in the elderly was associated with cognitive function and cardiovascular risk. Forty-five elderly persons (age ≥60 years) were included and divided into two groups based on their Mini-Mental Status Examination score adjusted for educational level: the case group (n = 12) and the control group (n = 33). Serum fatty acid composition, homocysteine (Hcy), hs-CRP, lipid profile and different cognitive domains were evaluated. The case group, characterized by reduced cognitive performance, showed higher levels of 14:0, 16:0, 16:1n-7 fatty acids and lower levels of 22:0, 24:1n-9, 22:6n-3 (DHA) and total PUFAs compared to the control group (p < 0.05). The n-6/n-3 ratio was elevated in both study groups, whereas alterations in Hcy, hs-CRP and lipid profile were observed in the case group. Cognitive function was positively associated with the 24:1n-9, DHA and total n-3 PUFAs, while 14:0, 16:0 and 16:1n-7 fatty acids, the n-6/n-3 ratio and Hcy were inversely associated. In addition, n-3 PUFAs, particularly DHA, were inversely associated with cardiovascular risk, assessed by Hcy levels in the elderly.     

Heritability of blood pressure in 7- to 12-year-old Chinese twins, with special reference to body size effects

Systolic and diastolic blood pressures and body-size indices such as body height, body weight, sitting height, chest circumference, skinfold thickness, and body mass index (BMI) were assessed in 110 pairs of like-sex Chinese twins (75 monozygotic and 35 dizygotic) aged 7-12 years. Significant correlations of blood pressure with body-size indices were found. Prior to adjusting for body-size effects, three twin methods yielded low heritability estimates for both systolic (0.32-0.41) and diastolic (0.32-0.51) pressures. Adjusting systolic pressure for body height and BMI via multiple regression nearly halved heritability estimates, but adjusting diastolic pressure for body height and skinfold thickness only changed the estimates slightly.     

我国慢性非传染性疾病卫生费用与筹资分析

目的探讨高血压患者血同型半胱氨酸水平与急性心脑血管事件发生的关系。方法采用巢式病例对照的研究方法从随访4年的13 209例新发高血压患者中观察到197例发生过急性心脑血管事件,采用病例对照1 ︰ 1进行匹配,利用卡方检验、配对t检验、条件logistics回归对数据进行分析。结果研究对象的血同型半胱氨酸几何均数为14.63 μmol/L,男性(16.07 μmol/L)高于女性(13.02 μmol/L),F=20.67,P < 0.01。病例组血同型半胱氨酸几何均数为15.07 μmol/L,与对照组(14.20 μmol/L)间差异无统计学意义(t=0.53,P=0.60)。进一步控制多种混杂因素后,血同型半胱氨酸与心脑血管急性事件间无关联。结论血同型半胱氨酸与急性心脑血管事件间的关系并不是很明确,需对此进行进一步的研究。     

Homocysteine, folate, vitamin B12, and cardiovascular risk in Indians, Malays, and Chinese in Singapore

OBJECTIVE: To examine the hypothesis that the higher rates of coronary heart disease (CHD) in Indians (South Asians) compared with Malays and Chinese is partly attributable to differences in blood concentrations of homocysteine, and related blood concentrations of folate and vitamin B12. DESIGN: Cross sectional study of the general population. SETTING: Singapore. PARTICIPANTS: Random sample of 726 fasting subjects aged 30 to 69 years. MAIN RESULTS: Mean plasma total homocysteine concentrations did not show significant ethnic differences; values were Indians (men 16.2 and women 11.5 mumol/l), Malays (men 15.0 and women 12.5 mumol/l), and Chinese (men 15.3 and women 12.2 mumol/l). Similarly, the proportions with high plasma homocysteine (> 14.0 mumol/l) showed no important ethnic differences being, Indians (men 60.0 and women 21.9%), Malays (men 53.9 and women 37.8%), and Chinese (men 56.6 and women 30.6%). Mean plasma folate concentrations were lower in Indians (men 8.7 and women 10.9 nmol/l) and Malays (men 8.5 and women 10.8 nmol/l), than Chinese (men 9.7 and women 13.8 nmol/l). Similarly, the proportions with low plasma folate (< 6.8 nmol/l) were higher in Indians (men 44.9 and women 36.6%) and Malays (men 45.3 and women 24.5%) than Chinese (men 31.4 and women 12.6%). Mean plasma vitamin B12 concentrations were lowest in Indians (men 352.5 and women 350.7 pmol/l), then Chinese (men 371.1 and women 373.7 pmol/l), and then Malays (men 430.5 and women 486.0 pmol/l). CONCLUSION: While there were ethnic differences for plasma folate and vitamin B12 (in particular lower levels in Indians), there was no evidence that homocysteine plays any part in the differential ethnic risk from CHD in Singapore and in particular the increased susceptibility of Indians to the disease.     

Exploring the Determinants of Food Choice in Chinese Mainlanders and Chinese Immigrants: A Systematic Review

Determinants of food choice in Chinese populations have not been systematically synthesised using a cultural lens. This study reviewed qualitative studies exploring food choice determinants of both Chinese mainlanders and Chinese immigrants living in Western countries. Ovid Medline, CINAHL Plus, Web of Science, ProQuest, and China National Knowledge Infrastructure database (CNKI) were searched from database inception to 1 April 2021. Studies were included if they involved qualitative research methods, were written in English or Chinese, investigated the factors influencing food choices, and targeted Chinese mainlanders or Chinese immigrants living in Western countries. Twenty-five studies (24 in English, 1 in Chinese) were included, involving 2048 participants. Four themes were identified; (1) the principles of traditional Chinese medicine (TCM), (2) perceptions of a healthy diet in Chinese culture (e.g., regular eating, eating in moderation, and emphasis on food freshness), (3) the desire to maintain harmony in families/communities, and (4) physical/social environmental factors all significantly influenced Chinese people’s food choices. It is important to acknowledge these factors when developing culturally appropriate nutrition programs for promoting health in Chinese mainlanders and Chinese immigrants.     

Effect of Folic Acid,Betaine, Vitamin B6, and Vitamin B12 on Homocysteine and Dimethylglycine Levels in Middle-Aged Men Drinking White Wine

Moderate regular consumption of alcoholic beverages is believed to protect against atherosclerosis but can also increase homocysteine or dimethylglycine, which are putative risk factors for atherosclerosis. We aimed (1) to investigate the effect of alcohol consumption on vitamins and several metabolites involved in one-carbon metabolism; and (2) to find the most effective way of decreasing homocysteine during moderate alcohol consumption. Methods: Male volunteers (n = 117) were randomly divided into five groups: the wine-only group (control, 375 mL of white wine daily for one month) and four groups combining wine consumption with one of the supplemented substances (folic acid, betaine, and vitamins B₁₂ or B₆). Significant lowering of homocysteine concentration after the drinking period was found in subjects with concurrent folate and betaine supplementation. Vitamin B₁₂ and vitamin B₆ supplementation did not lead to a statistically significant change in homocysteine. According to a multiple linear regression model, the homocysteine change in the wine-only group was mainly determined by the interaction between the higher baseline homocysteine concentration and the change in dimethylglycine levels. Folate and betaine can attenuate possible adverse effects of moderate alcohol consumption. Dimethylglycine should be interpreted together with data on alcohol consumption and homocysteine concentration.     

Effects of Periconceptional Multivitamin Supplementation on Folate and Homocysteine Levels Depending on Genetic Variants of Methyltetrahydrofolate Reductase in Infertile Japanese Women

Methylenetetrahydrofolate reductase (MTHFR) has various polymorphisms, and the effects of periconceptional folic acid supplementation for decreasing neural tube defects (NTDs) risk differ depending on the genotypes. This study analyzed the effectiveness of multivitamin supplementation on folate insufficiency and hyperhomocysteinemia, depending on MTHFR polymorphisms. Of 205 women, 72 (35.1%), 100 (48.8%) and 33 (16.1%) had MTHFR CC, CT and TT, respectively. Serum folate and homocysteine levels in women with homozygous mutant TT were significantly lower and higher, respectively, than those in women with CC and CT. In 54 women (26.3% of all women) with a risk of NTDs, multivitamin supplementation containing folic acid and vitamin D for one month increased folate level (5.8 ± 0.9 to 19.2 ± 4.0 ng/mL, p < 0.0001) and decreased the homocysteine level (8.2 ± 3.1 to 5.8 ± 0.8 nmol/mL, p < 0.0001) to minimize the risk of NTDs in all women, regardless of MTHFR genotype. Regardless of MTHFR genotype, multivitamin supplements could control folate and homocysteine levels. Tests for folate and homocysteine levels and optimal multivitamin supplementation in women with risk of NTDs one month or more before pregnancy should be recommended to women who are planning a pregnancy.     

Smoking and alcohol consumption in a UK Chinese population

Little research has been conducted on health in Chinese communities in the UK and there are few representative data on smoking, alcohol consumption or other aspects of lifestyle. We undertook a cross sectional population-based study of 380 Chinese and 625 European men and women aged 25 to 64 y, using self-completion and interview questionnaires in Newcastle upon Tyne, UK between 1991 and 1995. We measured self-reported prevalence of cigarette smoking, number of cigarettes smoked per week and age at starting smoking; self-reported prevalence of alcohol consumption and units of alcohol consumed per week. In age-adjusted comparisons smoking was less common in Chinese (24%) than European men (35%) (P=0.00002) and among Chinese (1%) compared with European women (33%) (P<0.00001). Number of cigarettes smoked was similar among Chinese and European male smokers. Median age at starting smoking was higher among Chinese (18.5 y) compared with European men (15 y) (P=0.00001). Smoking was commonest in older Chinese and in younger Europeans.The prevalence of alcohol consumption was lower among Chinese (63%) than European men (93%) (P<0.00001) and among Chinese (29%) compared to European women (89%) (P<0.00001). Median alcohol consumption was significantly lower among Chinese (2 units/week) than European men (16 units/week) (P<0.00001), and among Chinese (1 unit/week) compared to European women (6 units/week) (P<0.00001). Among those who drank alcohol, Chinese men were less likely to drink above recommended limits than European men (1% vs 39%; P<0.00001). Chinese men and women currently have relatively favourable patterns of smoking compared to European adults in Newcastle. Average alcohol consumption among Chinese who drink is lower than among Europeans, and a substantial proportion of the Chinese population in Newcastle drink no alcohol. Patterns of health related behaviour should be tracked over time in ethnic minority populations to identify changes that pose risk to health and which deserve appropriate intervention.     

The role of genotype in determining the effects of cigarette smoking on pulmonary function

The effect of cigarette smoking on pulmonary function is highly variable. Some heavy smokers retain normal pulmonary function and others experience profound pulmonary function loss. The role of genotype in this process is unknown. We tested for gene by environment interaction (GxE) in smoking-associated loss of forced expiratory volume in one second (FEV1) using repeated pulmonary function and smoke-exposure measures from 352 twin pairs enrolled in the NHLBI Male Veteran Twin Study. Inferences using global [Jinks and Fulker, 1970] and dichotomous [Ramakrishnan et al., 1992] procedures were supplemented with a new model for repeatedly observed twinships. The model facilitates testing of standard heritability hypotheses and families of hypotheses regarding the dependence of quantitative twin-twin phenotypic similarity on continuously varying twin-twin exposure concordance. The global and dichotomous procedures were suggestive of GxE in smoke-associated loss of FEV1 (p < 0.01, p = 0.08, respectively). With the new model, overall twin-twin correlation of FEV1 for concordant-smoking MZ and DZ twin pairs was estimated at 0.71 and 0.34, respectively. For twins with little or no difference in cigarette use, the intra-pair correlations of FEV(1) did not differ according to cigarette exposure over a wide range of exposures (0 - > or = 200 pack years). Even great twin-twin discordance in cigarette smoking (> or =10 pack years) had little effect of correlations. We conclude that a constant factor, such as genotype, appears to be interposed between the environmental toxin (cigarette smoke) and phenotype (FEV1).     

中国成年人吸烟与心血管疾病发病风险的关联及其性别差异分析

目的 分析中国成年人吸烟与不同心血管疾病发病风险的关联及其性别差异。方法 研究对象来自中国慢性病前瞻性研究,基线调查开展于2004年6月至2008年7月,剔除基线自报患有恶性肿瘤、冠心病、脑卒中的个体,最终纳入487 373名研究对象。随访人年数的计算从研究对象完成基线调查时开始,至最早出现以下任一事件的时间为止：心血管疾病（CVD）发病、死亡、失访或2015年12月31日。使用Cox比例风险模型计算吸烟行为特征和心血管疾病发病风险的关联。结果 研究对象平均随访8.9年。随访期间新发缺血性心脏病33 947人,急性冠心病事件6 048人,脑内出血7 794人,脑梗死31 722人。男性吸烟率（67.9%）远高于女性（2.7%）。与非吸烟者相比,吸烟能增加各类CVD结局的发病风险,风险效应值HR值 （95%CI）由大到小依次为急性冠心病事件1.54 （1.43～1.66）、缺血性心脏病1.28 （1.24～1.32）、脑梗死1.18 （1.14～1.22）、脑内出血1.07 （1.00～1.15）。当前吸烟者中,每天吸烟量和开始吸烟年龄与急性冠心病事件风险间的关联存在性别差异（性别交互作用P值分别为0.006、0.011）,主要表现为女性吸烟者风险高于男性。每天吸烟量和开始吸烟年龄与缺血性心脏病、脑内出血和脑梗死之间的关联均未见性别差异（性别交互作用P>0.05）。结论 吸烟能够增加各类CVD的发病风险,而女性吸烟者发生急性冠心病事件的风险远高于男性。     

小学生被动吸烟对体内抗氧化能力及维生素C的影响

小学生被动吸烟其尿中可铁宁明显升高。血浆中脂质过氧化物（LPO）随着可铁宁的升高浓度不断增加．而红细胞超氧化物歧化酶（SOD）受影响较少。维生素C随着可铁宁及LPO的升高而逐渐减少。差异有高度显著性（P＜0．01）。