北京地区1458名中老年人血清同型半胱氨酸分布的横断面调查  

The distribution of serum homocysteine among middle-aged and elderly people in Beijing:a cross-sectional study

作　　者：张仲迎[1] 方向华[2] 吉训明[3] 汤哲[4] 关绍晨[2] 刘宏军[2] 吴晓光[2] 王淳秀[2] 侯城北[2] 顾乡[5] 

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

出　　处：《北京医学》2016年第8期811-816,共6页Beijing Medical Journal

基　　金：北京市自然科学基金(7152068)

摘　　要：目的描述北京地区中老年社区人群血清同型半胱氨酸（Hcy）的分布特征。方法对于2009年“北京老龄化多维纵向研究”的数据进行横断面分析，研究对象为北京地区55岁及以上人群共1458人，Hcy采用循环酶法检测，Hey〉15μmol／L定义为高Hcy血症。采用我国2000年北京市人口普查的年龄和性别结构对数据进行权重，报告高Hcy血症患病率。对该人群血清Hey以不同年龄、性别、居住地、生活习惯及心血管病患病情况的分布特点进行统计分析。结果该人群平均年龄（69．48±8．09）岁，Hcy呈正偏态分布，中位值16．56μmol／L（四分位间距：13．11—21．78μmol／L）。高Hey血症患病率为57．2％。男性Hey中位值及高Hey血症患病率分别为18．24μmol／L（14．65～25．65μmol／L）及69．0％，女性分别为15．47μmol／L（12．09～19．62μmol／L）及45．6％，男性均高于女性（P均〈0．001）。女性Hey水平及高Hcy血症患病率均随年龄增长而升高（P均〈0．001），男性则无此趋势（P=0．23，0．374）。城市居民Hey中位数为15．33μmol／L（12．03～19．28μmol／L），农村为17．42μmol／L（13．86～23．88μmol／L），农村高于城市（P〈0．001）。Hcy浓度及高Hcy血症患病率在有吸烟及饮酒习惯的人群中更高（P均〈0．001），且随肾功能的下降而上升（P均〈0．001）。在有高血压、心肌梗死及脑卒中病史的人群中高Hey血症患病率比无以上病史的人群高（P均〈0．05）。结论北京地区中老年人群血清Hey存在性别、年龄、城乡、是否患心血管病的分布差异。Objective To understand the distribution of serum homocysteine among middle-aged and elderly com- munity-dwelling people in Beijing. Methods A cross-sectional study was conducted by recruiting 1 458 participants aged 55 years and older from a cohort of Beijing Longitudinal Study of Aging in 2009. Hyperhomocysteinemia was defined as 〉 15 μmol/L. The distribution of homocysteine was analyzed according to age, gender, habitat, life styles and cardiovascular diseases. Results Among 1 458 participants, the average age was 69.48±8.09 years and the distribution of homocysteine was skewed with the median of 16.56 μmol/L （interquartile range： 13.11-21.78 μ mol/L）. The prevalence of hyperhomo- cysteinemia was 57.2%0 The median homocysteine level and the prevalence of hyperhomocysteinemia were 18.24 μmol/ L （14.65-25.65 μmol/L） and 69.0% in male, 15.47 p, mol/L （12.09-19.62 μmol/L） and 45.6% in female, respectively. Male subjects had higher homocyteine level and the higher prevalence of hyperhomocysteinemia （all P 〈 0.001）. The level of homocysteine and prevalence of hyperhomocysteinemia increased with age in female subjects （all P 〈 0.001）, but not in male subjects （P = 0.230 and P = 0.374, respectively）. The median homocysteine level in rural subjects and urban subjects was 15.33 μmol/L（ 12.03-19.28 μmol/L） and 17.42 μmol/L（ 13.86-23.88 μmol/L）, respectively. The subjects from rural area had higher level of homocysteine level （P 〈 0.001）. Homocysteine level and prevalence of hyperhomocysteinemia were higher in smoking or drinking subjects （all P 〈 0.001）, and increased with kidney impairment （all P 〈 0.001）. The subjects with hypertension, myocardial infarction or stroke had higher prevalence of hyperhomocysteinemia （all P 〈 0.05）. Conclusion There is a significant difference in serum homocysteine levels among gender, age, habitat and history of cardiovascular disease in Beijing residents.

关 键 词：同型半胱氨酸 中老年人 患病率 横断面研究 

分 类 号：R54[医药卫生—心血管疾病]