深圳市南山区成年健康居民同型半胱氨酸水平及影响因素

目的揭示深圳市不同性别社区居民血浆同型半胱氨酸（Hcy）的分布特征和影响因素,为高Hcy血症的社区防治提供参考依据。方法采用多阶段随机抽样方法,对16个社区1 600名居民进行问卷调查、体格测量与实验室检测,采用Logistic回归分析高Hcy血症的影响因素,用受试者工作特征曲线（ROC曲线）分析评价模型效果。结果研究人群Hcy中位数为11.4μmol/L,其中男性13.2μmol/L,女性10.2μmol/L;高Hcy血症患病率为17.02%,其中男性为29.60%,女性为8.47%,男性约为女性的3.5倍;各个年龄组男性的Hcy水平及高Hcy血症患病率均明显高于女性（P〈0.01）,且二者均随年龄的升高而升高（P〈0.01）;不同性别高Hcy血症的影响因素有差异,全人群高Hcy血症的影响因素为年龄、性别、文化程度、用盐、体育锻炼、体质指数、舒张压和肌酐,ROC曲线下面积（AUC）为0.774。结论深圳市社区居民的Hcy水平低于国内其他一些城市,但高于西方发达国家;卫生部门应针对主要危险因素采取有针对性的干预措施,控制高Hcy血症的流行现状,降低心脑血管事件的发生率。

Study on the distribution of hyperhomocysteinemia and its influencing factors in healthy population of community in Nanshan Shenzhen

Objective To reveal the serum homocysteine（Hcy） distribution and characteristics in different sex groups in the community residents in Shenzhen,and provide reference for prevention of hyperhomocysteinemia in the community.Methods A number of 1 600 residents from 16 communities were enrolled by a multi-stage sampling method,and conducted a questionnaire survey,physical measurements and laboratory testing.Logistic regression was used to analyze association factors of hyperhomocysteinemia,and receiver operating characteristic curve（receiver operating characteristic curve,referred to as the ROC curve） was used to analyze and evaluate of the model results. Results The median of Hcy was 13.2 in male,10.2 in female and 11.4 in total.Prevalence rate of hyperhomocysteinemia was 29.60% for males,8.47% for females and 17.02% for total.The level of Hcy and the prevalence rate of hyperhomocysteinemia were both higher in males and in the older people.The association factors in whole population were age,gender,educational level,salt,physical exercise,body mass index,diastolic blood pressure and creatinine; the AUC value was 0.774. Conclusions Hcy level of residents in Shenzhen was lower than some other cities in China,but higher than that in west countries.Health sector should take the major risk factors for targeted interventions to control the epidemic situation of hyperhomocysteinemia,to reduce cardiovascular and cerebrovascular incidence.