同型半胱氨酸代谢异常与原发性高血压的病例对照研究  

A case-control study on the relationship between abnormal homocysteine metabolism and essential hypertension

作　　者：詹思延[1] 高原原[1] 尹香君 黄玉婵[2] 胡永华[1] 李立明[1] 

机构地区：[1]北京医科大学公共卫生学院流行病学教研室,100083 [2]上海市第二人民医院检验科

出　　处：《中华流行病学杂志》2000年第3期194-197,共4页Chinese Journal of Epidemiology

基　　金：教育部博士点基金!资助 (编号 :972 3)

摘　　要：目的　探讨同型半胱氨酸代谢异常与原发性高血压的关系。方法　从上海市一个社区中随机选取 12 7例 35～ 75岁的原发性高血压病人和 170例正常血压者。使用高效液相色谱结合电化学方法检测血清中同型半胱氨酸总浓度 ,使用放射免疫法同时测定血清中叶酸和B12 浓度。采用聚合酶链反应 限制性片段长度多态性分析亚甲基四氢叶酸还原酶 (MTHFR)基因多态性。结果　调整年龄和性别后 ,病例和对照组同型半胱氨酸水平分别为 10 .5 6 μmol/L和10 .34 μmol/L ,差异无显著性 (F =0 .2 34 ,P =0 .6 3)。在未服降压药的对象中同型半胱氨酸浓度与收缩压和舒张压亦无关联。该人群MTHFR不耐热性基因突变频率为 13.1% ,突变等位基因频率为 38.7%。病例组与对照组基因型分布和突变等位基因频率差异无显著性。然而 ,病例组叶酸和B12 浓度高于对照组。结论　本研究未发现升高的同型半胱氨酸水平、MTHFR基因突变是原发性高血压的独立危险因素。高血压病人较高的叶酸和B12 水平可能降低了同型半胱氨酸的危险性。Objective To examine the relationship between abnormal homocysteine metabolism and essential hypertension in a Chinese population, a community based case control study was conducted. Methods 127 essential hypertensive patients aged 35 to 75 were randomly selected from a community. Another 170 control subjects with blood pressure <140/90 mmHg were selected from the same community. Serum homocysteine was determined using HPLC. Folate and vitamin B 12 were measured by radioimmunoassay. MTHFR genotypes were identified by PCR and restriction fragment length polymorphism analysis with Hinf Ⅰ digestion. Results After adjusting for age and sex, the mean homocysteine level was 10.56 μmol/L for hypertensive patients and 10.34 μmol/L for controls ( F = 0.234 , P = 0.63 ). No association between either SBP or DBP and Hcy concentration was found in subjects without anti hypertensive medications. The prevalence of homozygousity for thermolabile MTHFR variant for this population was 13.1 %, and the mutant allele frequency was 38.7 %. There was no significant difference on genotype distributions and the mutant allele frequency for the two studied groups. However, the concentrations of folate and B 12 for the hypertensive subjects were generally higher than the controls. Conclusions The present study did not discover that the elevation of Hcy levels or MTHFR mutation were independent risk factors for essential hypertension. The higher folate and B 12 in the hypertensive subjects might contribute to a lower risk.

关 键 词：同型半胱氨酸代谢异常 原发性高血压 病例对照 

分 类 号：R544.1[医药卫生—心血管疾病]