血浆同型半胱氨酸水平对糖尿病视网膜病变的预测意义

目的探讨血浆同型半胱氨酸与糖尿病视网膜病变（DR）的关系。方法比较40例DR（DR组）和63例非DR（非DR组）2型糖尿病患者血浆同型半胱氨酸水平、病程、年龄、血压、空腹血糖、糖化血红蛋白（GHbA1c）、血脂、叶酸及维生素B12等与DR可能相关的指标。结果DR组血浆同型半胱氨酸水平中位数为12．9μmol／L,与非DR组的7．8μmol／L比较,差异有统计学意义（P〈0．01）,两组在校正了病程、GHbA1c、年龄、叶酸及维生素B12后仍显著相关（OR值1．23,P〈0．05）。结论高同型半胱氨酸血症为DR的危险因素,并为独立的预测因子。     

同型半胱氨酸和胆红素与糖尿病视网膜病变的关系

目的分析血浆同型半胱氨酸、血清胆红素水平与糖尿病视网膜病变发生之间的关系。方法选取2011年10月至2012年10月在我院内分泌科住院的2型糖尿病患者95例作为研究对象,分为糖尿病视网膜病变组（DR组）50例,糖尿病非视网膜病变组（NDR组）45例。测定两组血浆同型半胱氨酸和血清叶酸、维生素B12、总胆红素水平。采用SPSS 17.0软件进行统计学分析。结果 DR组血浆同型半胱氨酸水平（16.67μmol/L）高于NDR组（13.91μmol/L）,差异有统计学意义（P〈0.05）,叶酸水平（7.5μmol/L）低于NDR组（11.8μmol/L）,差异有统计学意义（P〈0.05）,两组间血清维生素B12水平差异无统计学意义（P=0.858）。DR组血清总胆红素水平（10.45μmol/L）低于NDR组（11.40μmol/L）,差异有统计学意义（P〈0.05）。结论高同型半胱氨酸血症可能是糖尿病视网膜病变发生的危险因素。血清胆红素对糖尿病视网膜病变的发生有一定的保护作用。     

同型半胱氨酸、叶酸和维生素B12水平与不良妊娠结局的相关性分析

目的:探讨同型半胱氨酸、叶酸和维生素B12与不良妊娠结局的相关性。方法:选取2016年10月-2017年3月发生不良妊娠结局的孕妇70例为观察组,未发生不良妊娠事件的孕妇627例为对照组,健康未孕育龄期妇女60例为未孕组。对比3组血清同型半胱氨酸、叶酸和维生素B12血清水平;通过Pearson相关性分析检验同型半胱氨酸和叶酸、维生素B12的相关性;通过非条件logistic多元逐步回归分析统计发生不良妊娠事件的相关危险因素。结果:观察组的同型半胱氨酸水平(11.2±2.8μmol/L)高于另外两组,而叶酸水平(645.9±281.4nmol/L)、维生素B12水平(247.2±102.3pmol/L)均低于另外两组(均P0.05);Pearson相关性分析结果显示,血清同型半胱氨酸水平与叶酸、维生素B12水平呈负相关关系(r=-0.089,-0.108,均P0.05);非条件logistic多元逐步回归分析结果显示,同型半胱氨酸升高、维生素B12降低以及年龄增大是不良妊娠发生的相关危险因素(均P0.05)。结论:同型半胱氨酸升高、维生素B12降低以及年龄增大是不良妊娠发生的相关危险因素,临床应加强孕期保健,对年龄较大的孕妇应加强同型半胱氨酸及维生素B12的监测,预防不良妊娠的发生。     

同型半胱氨酸与脑梗死关系的实验研究

目的探讨血浆同型半胱氨酸和脑梗死之间的关系。方法测定120例脑梗死患者及41例健康对照者的血浆同型半胱氨酸、维生素B12和叶酸水平。结果脑梗死组的血浆同型半胱氨酸水平(17.15±4.63)μmol/L显著高于对照组(10.12±2.62)μmol/L,P<0.01;血浆同型半胱氨酸水平与叶酸和维生素B12均呈负相关;男女患者之间同型半胱氨酸的差异有显著性(P<0.01);高血压脑梗死患者的同型半胱氨酸水平高于单纯脑梗死患者(P<0.01)。结论同型半胱氨酸是脑梗死的一个重要发病因素,血浆同型光胱氨酸水平与叶酸和维生素B12均呈负相关,雌激素水平对血浆同型半胱氨酸也有影响,高同型半胱氨酸血症与高血压性脑梗死有关。     

同型半胱氨酸水平与脑梗死及动脉狭窄支数的相关性研究

目的 探讨同型半胱氨酸(Hcy)水平与脑梗死以及动脉狭窄支数的关系.方法 选择80例脑梗死患者(脑梗死组)与50例对照者(对照组).脑梗死组患者中,磁共振成像血管造影(MRA)检查有≥2支动脉狭窄者32例,设为A组,无或有1支动脉狭窄者48例,设为B组.采用高效液相色谱分析法测定各组血浆Hcy水平,同时测定血清叶酸、维生素B12(VitB12)、血脂、血糖等指标.结果 脑梗死组Hcy水平[(21.10士8.98)μmol/L]显著高于对照组[(12.49±7.43)μmol/L,P＜0.05],叶酸、VitB12水平低于对照组,差异均有统计学意义.A组Hcy水平[(24.65±11.20)μmol/L]显著高于B组[(18.79±9.97)μmol/L,P＜0.05],A组叶酸水平[(3.63±2.32)μg/L]明显低于B组[(4.82±2.26)μg/L,P＜0.05].VitB12水平A组低于B组,但差异无统计学意义.结论 高同型半胱氨酸血症是脑梗死的重要独立危险因素,Hcy水平升高与脑梗死及动脉狭窄支数有关.     

阿尔茨海默病与维生素B12及同型半胱氨酸的相关性

目的研究阿尔茨海默病(AD)与血清维生素B12、叶酸及血浆同型半胱氨酸水平之间的关系。方法采用简易精神状态量表(MMSE)对30例AD患者和30例同龄健康人进行评分,并用放射免疫分析法测定血清维生素B12及叶酸水平;用荧光偏振免疫法测定血浆同型半胱氨酸。结果AD组维生素B12水平为(217.3±134.2)pmol/L明显低于对照组(313.6±184.7)pmol/L,两者差异有极显著性(P<0.001)。AD组血浆同型半胱氨酸为(18.9±6.8)μmol/L高于对照组(9.4±4.1)μmol/L,差异有极显著性(P<0.001)。AD组叶酸水平为(29.2±12.7)nmol/L低于对照组(37.2±21.2)nmol/L,但差异无显著性(P>0.05)。AD患者血清维生素B12水平与MMSE得分呈正相关(r=0.87,P<0.01)。结论AD患者血浆维生素B12水平与智能障碍及其程度有关。     

血浆同型半胱氨酸与急性脑梗死关系的临床研究

目的 探讨血浆同型半胱氨酸(Hcy)与急性脑梗死的关系及其临床意义.方法 86例急性脑梗死患者(急性脑梗死组)和同期66例体检正常的健康者(对照组)采用荧光偏振免疫分析法测定血浆Hcy,采用化学发光法测定叶酸和维生素B12,并将结果进行比较.结果 急性脑梗死组血浆Hcy为(20.08±8.72)μmol/L,对照组为(12.50±2.20)μmol/L,两组比较差异有统计学意义(P＜0.01);急性脑梗死组血浆叶酸为(4.98±5.01)μg/L,对照组为(7.68±2.02)μg/L,两组比较差异有统计学意义(P＜0.01);急性脑梗死组血浆维生素B12为(227.39±127.89)pmol/L,对照组为(311.64±152.15)pmol/L,两组比较差异有统计学意义(P＜0.01).结论 急性脑梗死患者血浆Hcy是升高的,而血浆叶酸和维生素B12呈下降趋势,Hcy是急性脑梗死的独立危险因素.     

早产儿孕母血浆同型半胱氨酸水平及影响因素

[目的]探讨早产儿孕母血浆同型半胱氨酸水平(hcy)及相关影响因素。[方法]采用病例对照研究,用高效液相色谱荧光检测法(HPLC-FD)检测60例胎龄为28～34周早产儿孕母和30例于孕31～34周采血的非早产儿孕母的血浆同型半胱氨酸水平。用直线相关等统计方法分析早产儿孕母hcy水平与相关因素的关系。[结果]早产儿孕母血浆同型半胱氨酸水平(7.56±2.97μmol/L)显著高于非早产儿孕母(5.96±2.54μmol/L),P=0.013;孕母的血浆同型半胱氨酸水平受孕周、叶酸水平直接影响,尤其与叶酸水平存在密切负相关(早产儿孕母组γ=-0.844,P=0.000;非早产儿孕母组γ=-0.658,P=0.000),而与年龄无直接关系。[结论]早产儿孕母血浆同型半胱氨酸水平受生理、饮食等因素影响,随孕周大小、叶酸水平高低变化。     

同型半胱氨酸与脑梗死的相关性研究

目的 探讨同型半胱氨酸与脑梗死的相关性,为脑梗死的防治提供依据.方法 选择脑梗死患者200例(观察组)、健康体检者100例(对照组),采用速率法检测研究对象血浆同型半胱氨酸水平,并分析其与性别、年龄、梗死体积、脑功能缺损程度的关系.结果 观察组血浆同型半胱氨酸为(16.89±2.31) μmol/L、对照组为(11.23±3.12)μmol/L,两组比较P＜0.05.脑梗死患者中,年龄＞60者血浆同型半胱氨酸为(19.76±1.98) μmol/L,显著高于≤60岁者的(14.32±2.65) μmol/L,P＜0.05;梗死体积为小、中、大梗死者血浆同型半胱氨酸分别为(13.11±1.02)、(15.77±2.23)、(19.56±3.42)μmol/L,不同体积梗死灶间比较,P均＜0.05;脑功能缺损程度轻、中、重度者血浆同型半胱氨酸分别为(14.22±3.21)、(18.21±3.12)、(23.98±4.32) μmol/L,不同脑功能缺损程度间比较,P均＜0.05;复发者血浆同型半胱氨酸为(19.12±3.45)μmol/L,显著高于初发者的(14.21±3.41) μmol/L,P＜0.05.结论 血浆同型半胱氨酸水平升高与脑梗死的发生、发展有关,血浆同型半胱氨酸检测有助于脑梗死患者病情严重程度及预后的判断.     

急性脑梗死患者血浆同型半胱氨酸水平及其干预治疗探讨

目的:分析急性脑梗死患者的同型半胱氨酸、叶酸、维生素B12水平,并对患者接受维生素B12制剂和叶酸治疗之后的各项指标变化情况做出准确判断。方法:随机抽取我院收治的90例急性脑梗死患者作为研究对象,检测患者的血浆同型半胱氨酸、叶酸、维生素B12水平,另外选择我院50例健康体检者作为健康对照组,同样检测患者的血浆同型半胱氨酸、叶酸、维生素B12水平。比较两组之间存在的差异;初步检测完成后将90例急性脑梗死患者随机分为两组:观察组45例接受在常规治疗的基础上接受维生素B12制剂与叶酸联合治疗,对照组45例患者接受常规治疗。治疗1个月后比较两组患者的血浆同型半胱氨酸、叶酸、维生素B12水平,比较患者的神经功能缺损情况。结果:急性脑梗死患者的血浆同型半胱氨酸、叶酸、维生素B12水平与健康者比较存在明显差异(P0.05);治疗后,观察组患者的各项指标以及神经功能状况均发生了显著的好转,与对照组相比存在着显著的优越性(P0.05)。结论:急性脑梗死患者的血浆同型半胱氨酸水平升高情况异常,使用维生素B12制剂和叶酸为其进行治疗可有效改善指标异常情况,保护患者的生命安全。     

血清同型半胱氨酸、叶酸、维生素B12浓度与多发性硬化的关系研究

目的：探讨血清同型半胱氨酸水平（Hcy）与多发性硬化（MS）的关系。方法：检测41例MS患者（MS组）和42例正常对照者（NC组）血清中Hcy浓度、叶酸及维生素B12浓度,并将结果进行比较分析。结果：MS组和NC组血清中Hcy浓度分别为（25.82±1.724）μmol/L、（13.60±1.517）μmol/L。MS组的Hcy浓度明显高于NC组,差异有统计学意义（P〈0.01）,而两组的叶酸、维生素B12浓度比较差异均无统计学意义（P〉0.05）。结论：MS患者血清Hcy水平升高,同型半胱氨酸可能在多发性硬化病理过程中起作用。     

Association of dietary factors with plasma homocysteine and coronary heart disease outcome

ObjectiveThe aim of the present study was to investigate the association between serum levels of vitamins B12, B6, folic acid and hyperhomocysteinemia with the risk of coronary heart disease (CHD).Material and methodsA case control study was carried out involving 105 newly diagnosed coronary heart disease patient of both gender (age range 25–60 years) and 105 age and sex matched normal healthy individuals at Punjab Institute of Cardiology, Lahore. Fasting blood samples were collected from both cases and controls. Sera were analyzed for folic acid, vitamin B6 and B12 using high performance liquid chromatography (HPLC). Plasma homocysteine was analyzed by fluorescence polarization immunoassay (FPIA) and traditional risk factors were also assessed.ResultsMean plasma homocysteine level in cases (22.33 ± 9.22 μmol/L) was significantly higher (P = 0.0001) than controls (12.5 ± 3.73 μmol/L). Mean serum folic acid concentration, serum vitamin B6 and vitamin B12 were significantly lower in cases than the mean levels in controls (P < 0.05). When compared to controls the data revealed significantly greater deficiency of folic acid, vitamin B6 and B12 in coronary heart disease patients. Statistically significant inverse correlation was observed between folic acid, vitamin B6, B12 and plasma homocysteine concentration (r = ?0.463, r = ?0.431 and r = ?0.294, respectively).ConclusionNutritional deficiency of folic acid, vitamin B12 and B6 were common in coronary heart disease patients with an inverse correlation of plasma homocysteine concentration with these vitamins. Substantial deficiency of these vitamins along with hyperhomocysteinemia could be further aggravating the risk of CHD in Pakistani population.     

2型糖尿病患者血清维生素D水平及相关研究

目的 了解2型糖尿病患者血清维生素D水平的变化,并探讨其在2型糖尿病患者代谢紊乱中的作用及与其他代谢指标的关系.方法 按WHO 1999年关于糖尿病诊断标准筛选初发2型糖尿病患者70例,并按2002年国际肥胖特别工作组亚洲成年人标准,根据体质指数(BMI)分为2型糖尿病A组(BMI≥25.00 kg/m2) 32例和2型糖尿病B组(BMI＜ 25.00 kg/m2)38例,另筛选健康人33例作为对照组,检测人体参数和测量生化指标,用酶联免疫吸附试验法测定血清25羟基维生素D3 [25 (OH)D3]水平,对三组进行比较.结果 2型糖尿病A组血清25 (OH)D3水平为(20.59±4.82)μg/L,2型糖尿病B组为(27.07±5.73) μg/L,对照组为(32.27±8.49)μg/L,三组之间比较差异有统计学意义(P＜0.05).2型糖尿病患者血压正常者43例,血清25(OH)D3水平(25.51±6.12)μg/L,高血压者27例,血清25 (OH)D3水平(21.87±5.78)μg/L,两者比较差异有统计学意义(P＜0.05);2型糖尿病患者血脂正常者8例,血清25(OH)D3水平(28.42±5.20)μg/I,血脂异常者62例,血清25 (OH)D3水平(23.55±6.15)μg/L,两者比较差异有统计学意义(P＜0.05).25(OH)D3与体重、腰围、BMI、收缩压、舒张压、空腹血糖、空腹胰岛素、胰岛素抵抗指数、总胆固醇、三酰甘油、低密度脂蛋白胆固醇呈负相关(P＜0.01或＜0.05),与甲状旁腺素、钙、磷、高密度脂蛋白胆固醇、年龄无明显相关性(P＞0.05).结论 2型糖尿病患者血清维生素D水平降低,尤其是伴有肥胖、高血压、血脂异常者血清维生素D水平降低更明显.     

Serum folate is a reliable indicator of hyperhomocysteinemia and borderline hyperhomocysteinemia in young adults

Serum folate has been shown to correlate well with fasting plasma homocysteine; however, erythrocyte folate concentration is a better index of tissue folate stores and probably could be a more reliable indicator for reflecting long-term supply of the vitamin and homocysteine status. The present study was undertaken to test the hypothesis that serum folate and erythrocyte folate levels had a different degree of correlation to fasting plasma homocysteine in young Taiwanese adults. This study had a cross-sectional design. Healthy young adults were divided into either a hyperhomocysteinemia (HHcy; ≥14.9 μmol/L; n = 13), borderline HHcy (BHcy; fasting homocysteine, 14.9-10.2 μmol/L; n = 52), or normohomocysteinemia (fasting homocysteine, <10.2 μmol/L; n = 65) groups based on fasting homocysteine levels. The concentrations of plasma fasting homocysteine, serum folate, erythrocyte folate, vitamin B₁₂, and plasma pyridoxal 5′-phosphate were measured. Fasting homocysteine was only significantly and inversely affected by serum folate (β = −0.21, P < .05) concentration after adjusting for potential confounders. Only serum folate concentration remained to decrease the risk of fasting HHcy (odds ratio, 0.73; confidence interval, 0.56-0.95) after the other B vitamins were additionally adjusted. Serum folate also had the highest area under the receiver operating characteristic (AUC) curve to predict the risk of HHcy (AUC, 0.81) and BHcy (AUC, 0.77). Serum folate is a reliable indicator of fasting hyperhyperhomocysteinemia and BHcy in young adults.     

原发性高血压患者补充适量的叶酸、维生素B12对其治疗效果影响的临床研究

目的探讨原发性高血压患者给予叶酸及维生素B12治疗前后血浆同型半胱氨酸（Hcy）、不对称二甲基精氨酸（ADMA）,血清一氧化氮（NO）及内皮性一氧化氮合酶（eNOS）水平的变化。方法选取156例原发性高血压患者为研究对象,按随机数字表法分成两组,每组78例。对照组给予常规降压治疗,试验组在对照组治疗的基础上给予口服叶酸及维生素B12,比较两组治疗前后Hcy、ADMA、NO及eNOS水平的变化。结果对照组治疗后2、12周Hcy及ADMA水平与治疗前比较差异无统计学意义（P〉0．05）;试验组治疗后2、12周Hcy、ADMA水平较治疗前显著降低,差异有统计学意义（P〈0．05）。治疗后12周,试验组NO、eNOS水平高于对照组[（77．35±9．55）拉mol／L比（64．26±11．49）μmol／L、（30．05±6．88）μmol／L比（19．92±10．24）μmol/L],差异有统计学意义（P〈0．05）。原发性高血压患者ADMA水平与Hcy水平呈正相关（r=0．612,P〈0.05）,与NO和eNOS水平呈负相关（r=-0．557、-O．529,P〈0．05）。结论原发性高血压患者适当补充叶酸及维生素B12可降低血液中Hcv和ADMA的水平,升高NO、eNOS水平,改善患者血管内皮细胞功能,并可辅助降低血压,有利于预防心脑血管意外的发生。     

Homocysteine and risk of coronary artery disease: Folate is the important determinant of plasma homocysteine concentration

OBJECTIVES: The purposes of this study were to study the effects of folate and vitamins B6 and B12 on plasma homocysteine concentration and to estimate the risks for coronary artery disease (CAD) according to quartiles of plasma homocysteine concentration. METHODS: The study was designed as a case-reference observational study. Case subjects (CAD group, n = 60) were identified by cardiac catheterization to have at least 70% stenosis of one major coronary artery; otherwise, patients were considered for a reference group (n = 60). Risk factors of cardiovascular disease were recorded, including age, sex, blood lipid profile, hypertension, smoking habits, and drinking habits. Plasma homocysteine, folate, pyridoxal 5'-phosphate, and vitamin B12 were measured. RESULTS: CAD subjects had significantly higher mean plasma homocysteine concentrations than did the reference subjects (13.9 +/- 4.9 versus 9.1 +/- 3.3 micromol/L). There were no significant differences between groups with regard to the three B vitamins; however, mean serum folate concentrations for subjects in the highest two quartiles of plasma homocysteine concentration (10.8-13.8 and >/=13.9 micromol/L) were significantly lower than those for subjects in the lowest two quartiles (相似文献   

Folic acid and vitamin B12 are more effective than vitamin B6 in lowering fasting plasma homocysteine concentration in patients with coronary artery disease

OBJECTIVE: To investigate whether vitamin B(6) supplementation had a beneficial effect on lowering fasting plasma homocysteine concentrations in coronary artery disease (CAD) patients. DESIGN: A single-blind intervention study. SETTING: The study was performed at the Taichung Veterans General Hospital, the central part of Taiwan. SUBJECTS: A total of 50 subjects were identified by cardiac catheterization to have at least 70% stenosis of one major coronary artery. In all, 42 patients successfully completed this study. INTERVENTIONS: Patients were randomly assigned to one of five groups and treated with a daily dose of placebo (n=8), 5 mg vitamin B(6) (n=8), 10 mg vitamin B(6) (n=8), 50 mg vitamin B(6) (n=9), or 5 mg folic acid combined with 0.25 mg vitamin B(12) (n=9) for 12 weeks. MAIN OUTCOME MEASURES: Nutrient intakes were recorded by using 24-h diet recalls when patients returned to the cardiology clinic before the intervention (week 0) and at week 12. Vitamin B(6) status was assessed by direct measures (plasma pyridoxal 5'-phosphate) and indirect measures (erythrocyte alanine and aspartate aminotransaminase activity coefficient). Fasting plasma homocysteine, serum folic acid, and vitamin B(12) were measured. RESULTS: Fasting plasma homocysteine concentration did not respond to high or low doses of vitamin B(6) when compared with a placebo treatment after 12 weeks of supplementation. The mean fasting plasma homocysteine concentration, however, decreased significantly after 12 weeks of folic acid combined with vitamin B(12) supplementation (P=0.047). Further, within group, mean fasting plasma homocysteine concentration was nonsignificantly increased by 25.5, 16.2, and 18.3% in placebo, 10 mg/day and 50 mg/day vitamin B(6) supplemented groups, respectively; whereas folic acid combined with vitamin B(12) supplementation significantly reduced fasting plasma homocysteine concentration by 32% (P<0.001). CONCLUSIONS: Our results indicate that vitamin B(6) supplementation alone is less effective than folic acid combined with vitamin B(12) in lowering plasma homocysteine concentrations in CAD patients. SPONSORSHIP: This study was supported by the National Science Council, Taiwan, Republic of China (NSC-91-2320-B-040-023).