533名中老年人高同型半胱氨酸血症的危险因素调查

摘要：目的研究中老年人高同型半胱氨酸血症（hyperhomocysteinmia，HHcy）的危险因素，为人群干预提供依据。方法以天津市5个社区及2所老年公寓55岁及以上的中老年志愿者698人为研究对象，进行问卷调查、膳食调查和血清同型半胱氨酸检测；分析HHcy组和非高同型半胱氨酸血症（N—HHcv）组中老年人生活方式、膳食叶酸和VitB。摄入量的差异。结果533人完成了全程研究。总人群HHcy患病率随年龄增长而升高（P〈0．001），男性（57．0％）高于女性（35．7％），P〈0．001。与男性不吸烟者比较，男性吸烟者HHcy患病率（x2=0．047，P=0．828）、血清tHcy水平（t=-1．020，P=0．310）的差异无统计学意义。服用叶酸、VitB6、VitB12者的血清tHcy平均浓度（15．2μmol／L）明显低于不服用者（16．9μmol／L），HHcy患病率（39．7％）低于不服用者（46．2％），P〈0．05。HHcy组中老年人平均每日膳食叶酸、VitB。摄入量（207．9μg／d，0．37ms／d）均低于N—HHcy组（295．4μg／d，0．53ms／d），P〈0．05。膳食叶酸、VitB6的摄入量均与血清tHcy水平呈负相关，相关系数分别为-0．439（P=-0．000）和-0．390（P=-0．000）。结论吸烟与HHcy患病率和tHcy水平无关。日常服用叶酸、VitB6和VitB12或富含上述维生素的膳食有助于保持较低的tHcy水平。

Analysis on Risk Factors for Hyperhomocysteinmia among 533 middle-aged and the Elderly Subjects

Objective To study the risk factors of hyperhomocysteinmia （HHcy） in the middle-aged and the elderly. Methods Total 698 subjects aged I〉55 years were recruited from 5 communities and 2 apartments for the elderly in Tianjin. Health and dietary questionnaire were used. The serum tHcy concentrations were determined. Then the differences of life styles, and dietary intakes of folate, VitB6 between HHcy and N-HHcy groups were analyzed. Results 533 samples completed the whole test. The HHcy prevalence increased with age （P〈0.001） and was higher in male （57.0%） than in female（ 35.7% ）（P〈0.001 ）. Compared with non-smokers in male, the changes of HHcy prevalence （X2=0.047, P=0.828 ）and serum they concentrations （t=-1.020, P =0.310） in male were not significant. Both of the daily dietary intakes of folate and VitB6 were negative correlated with serum tHcy concentration （P〈O.05）. Serum tHey concentrations （15.2 μmol/L） and HHcy prevalence （39.7%） of subjects supplemented with folate,VitB6 and VitB12 were significantly lower than those without supplements （16.9 μmol/L, 46.2%, P〈0.05）. Both of the average daily dietary intake of folate and VitB6 of subjects in HHcy group（207.9 μg/d, 0.37 mg/d） were lower than that of those in N-HHcy group （295.4 μg/d, 0.53 mg/d, P〈0.05）. Dietary intake of folate and VitB6 were negatively correlated with serum tHcy levels （P〈0.01）, correlate coefficient was -0.439 （P=0.000） and -0.390 （P=0.000）, respectively. Conclusion Smoking was no correlation with HHcy prevalence and serum tHey levels in this study. Taking folate, VitB6 and VitB12 supplements or dietary rich in these three vitamins would be benefit for keeping lower serum tHey level.