高同型半胱氨酸血症与健康体检人群的低高密度脂蛋白血症有关  

Hyperhomocysteinemia Is Related to the Low Level of High Density Lipoprotein in Healthy People

作　　者：刘佳[1] 胡延晋[1] 潘永华[1] 苗莉[1] 陈哲[1] 张恒[1] 徐援[1] 王广[1] 

机构地区：[1]首都医科大学附属北京朝阳医院内分泌科,北京市100020

出　　处：《中国动脉硬化杂志》2016年第8期803-806,共4页Chinese Journal of Arteriosclerosis

基　　金：国家自然科学基金(81270369;81070244;30770873);北京市自然科学基金(7142060);中国糖尿病英才基金(YC2014-CYLJ);北京市重点实验室基金(1300-1150170642)

摘　　要：目的观察高同型半胱氨酸血症(Hhcy)对健康体检人群血高密度脂蛋白(HDL)及载脂蛋白AⅠ(Apo AⅠ)水平的影响。方法选取无高血压、糖尿病等疾病的健康体检人群,共1980名。根据是否合并HHcy分成两组:HHcy组及对照组。测定空腹血糖、空腹胰岛素、血脂等生物化学指标,并测定Apo AⅠ水平及计算稳态模型胰岛素抵抗指数。结果 HHcy组血高密度脂蛋白胆固醇(HDLC)、Apo AⅠ水平显著低于对照组(1.16±0.25mmol/L比1.27±0.31 mmol/L,1.37±0.19 g/L比1.46±0.26 g/L,均P<0.01)。相关分析显示,在校正了年龄、体质指数及甘油三酯水平后,血同型半胱氨酸(Hcy)水平与HDLC、Apo AⅠ呈明显负相关(r=-0.10,r=-0.11,P<0.05)。多元回归分析显示,血Hcy水平是血Apo AⅠ的独立影响因子(β=-0.067,P<0.05)。结论 HHcy与低HDL血症有关。HHcy可能通过降低HDL、Apo AⅠ水平导致健康人群发生动脉粥样硬化。临床上应积极治疗HHcy。Aim To investigate the effect of hyperhomocysteinemia（ Hhcy） on serum high density lipoprotein（ HDL） and apolipoprotein AⅠ（ Apo AⅠ） in healthy people. Methods A total of 1980 normal healthy people was recruited without hypertension,diabetes and other diseases. According to whether the HHcy,the subjects were divided into two groups： HHcy group and control group. Biochemical parameters such as fasting blood glucose,fasting insulin and blood lipid were measured. Apo AⅠ was measured and the homeostasis model assessment index of insulin resistance was calculated. Results The level of serum high density lipoprotein cholesterol（ HDLC） and Apo AⅠ in HHcy group was significantly lower than that in control group（ 1. 16 ± 0. 25 mmol / L vs 1. 27 ± 0. 31 mmol / L,1. 37 ± 0. 19 g / L vs 1. 46 ± 0. 26 g / L,all P0.01）. Correlation analysis showed that after adjusting for age,body mass index and triglyceride levels,blood homocysteine（ Hcy） level was significantly negatively correlated with HDLC and Apo AⅠ（ r =-0.10,r =-0.11,P0.05）.Multiple regression analysis showed that the blood Hcy level was the independent influencing factor of blood Apo AⅠ（ β =-0.067,P0.05）. Conclusions HHcy is associated with low HDL. HHcy may lead to atherosclerosis in healthy people by decreasing the levels of HDL and Apo AⅠ. Clinically,HHcy should be actively treated.

关 键 词：高同型半胱氨酸血症 高密度脂蛋白 载脂蛋白AⅠ 动脉粥样硬化 

分 类 号：R589[医药卫生—内分泌]