中老年人血清同型半胱氨酸水平与血压的关系  

The association between serum homocysteine and blood pressure among middle-aged and elderly people

作　　者：张仲迎[1,2] 方向华[1] 吉训明[3] 汤哲 关绍晨[1] 刘宏军[1] 吴晓光[1] 王淳秀[1] 侯城北[1] 顾乡[5] 

机构地区：[1]首都医科大学宣武医院循证医学科,北京100053 [2]首都医科大学宣武医院老年医学综合科,北京100053 [3]首都医科大学宣武医院神经外科,北京100053 [4]北京市老年病防治中心 [5]首都医科大学附属友谊医院综合科

出　　处：《中华高血压杂志》2015年第9期846-850,共5页Chinese Journal of Hypertension

基　　金：北京市科委重大专项(D121100004912002);2014年度首都医科大学宣武医院院级课题资助项目

摘　　要：目的研究中老年人群同型半胱氨酸（Hcy）与血压水平的关系。方法对＂北京老龄化多维纵向研究＂2009年的数据进行横断面分析,研究对象为北京部分地区≥55岁人群共1458人,被调查对象均完成问卷调查、体格检查及实验室检查。按照被调查对象是否存在高同型半胱氨酸血症（Hcy〉15μmol/L）将其分为两组,采用一般线性模型及Logistic回归分析控制混杂因素后血清Hcy浓度与收缩压、舒张压、脉压水平及脉压过宽（≥60mm Hg）的关系。结果血清Hcy浓度中位数为16.6μmol/L,其中Hcy浓度正常者556人,高同型半胱氨酸血症902人。在调整了潜在混杂因素之后,一般线性模型显示,Hcy升高人群的脉压均值较Hcy浓度正常人群高[63.5比61.2mm Hg,P〈0.05],两组收缩压差异无统计学意义;Logistic回归分析发现,高同型半胱氨酸血症可升高33%脉压过宽的风险（OR=1.33,95%CI1.04~1.68）。结论中老年人群血清Hcy与脉压水平独立相关,并可增加脉压过宽的风险。Objective To investigate the association between serum homocysteine（Hcy）and blood pressure levels among middle-aged and elderly people. Methods A cross-sectional study by recruiting 1458 participants aged 55 years and older from a cohort of the Beijing Longitudinal Study of Aging in 2009 was conducted. All participants were asked to complete a standardized questionnaire and underwent a physical examination,including laboratory examinations. The participants were divided into two groups according to serum level of Hcy with a cutpoint of 15μmol/L. General linear model and Logistic regression were used to analyze the association between serum Hcy and parameters of blood pressure after adjusting confounding factors,including systolic blood pressure,diastolic blood pressure,pulse pressure and wide pulse pressure（≥60 mm Hg）. Results The median level of serum Hcy was16.6μmol/L,and the numbers of participants with normal level of serum Hcy and hyperhomocysteinemia were 556 and 902,respectively. After adjusting potential confounding factors,general linear model showed that the participants with hyperhomocysteinemia had higher levels of mean pulse pressure than those with normal level of serum Hcy[63.5vs 61.2mm Hg,P〈0.05],while there were no significant differences in systolic blood pressure between two groups. Logistic regression analysis indicated that hyperhomocysteinemia increased the risk for wide pulse pressure by 33%（OR1.33,95% CI 1.04-1.68）. Conclusion Serum Hcy was independently associated with pulse pressure,and increased the risk for wide pulse pressure among middle-aged and elderly people.

关 键 词：同型半胱氨酸 高血压 脉压 中老年人 

分 类 号：R544.1[医药卫生—心血管疾病]