北方社区中老年人群血浆中同型半胱氨酸水平与视网膜血管直径的相关性研究  

Correlation between homocysteine and retinal vessel diameter in the middle-aged and elderly in a northern community

作　　者：刘欣欣[1] 卢爱东[1] 王亚星 魏文斌 陈朔华 吴寿岭[4] LIU Xin-Xin;LU Ai-Dong;WANG Ya-Xing;WEI Wen-Bin;CHEN Shuo-Hua;WU Shou-Ling(Department of Ophthalmology,Kailuan General Hospital,Tangshan 063000,Hebei Province,China;Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;The Kailuan Employees Health Care Center,Tangshan 063000,Hebei Province,China;Department of Cardiology,Kailuan General Hospital,Tangshan 063000,Hebei Province,China)

机构地区：[1]开滦总医院眼科,河北省唐山市063000 [2]首都医科大学附属北京同仁医院北京同仁眼科中心,北京市100730 [3]开滦员工健康保健中心,河北省唐山市063000 [4]开滦总医院心内科,河北省唐山市063000

出　　处：《眼科新进展》2019年第8期785-789,共5页Recent Advances in Ophthalmology

摘　　要：目的探讨中老年人血浆中同型半胱氨酸(homocysteine,Hcy)水平与视网膜血管直径之间的关系。方法本研究为横断面研究,研究人群为开滦研究中参加2012-2013年健康体检人群(年龄≥40岁),其中行眼底彩照者3447人,应用软件分析视网膜血管直径。最终纳入统计分析共3401人,分析血浆中Hcy水平对视网膜中央动脉直径(central retinal artery equivalent,CRAE)、视网膜中央静脉直径(central retinal vein equivalent,CRVE)和动静脉比(arteriovenous ratio,AVR)的影响。将基线Hcy水平四分位分组,用Logistic回归分析不同Hcy水平分组对AVR的影响。结果本研究共入选3401人,其中男1910人、女1491人,年龄(56.81±10.17)岁,Hcy为0.09~70.60(15.27±9.11)mmol·L^-1,其中CRAE为(174.29±24.59)μm,CRVE为(281.74±28.66)μm,AVR为0.62±0.11。Hcy四分位数分别为9.50 mmol·L^-1、13.30 mmol·L^-1和18.20 mmol·L^-1。Spearman相关分析显示,血浆中Hcy水平与CRAE呈负相关(r=-0.125,P<0.001),与CRVE呈负相关(r=-0.093,P<0.001),Hcy与AVR呈负相关(r=-0.050,P=0.004)。将Hcy分别和CRAE、CRVE和AVR进行多因素线性回归分析显示,Hcy是CRAE(β=-0.147)、CRVE(β=-0.120)的影响因素(均为P<0.05)。Logistic回归分析不同Hcy分位值对AVR的影响发现,其不是AVR的危险因素。性别分层后进一步行多因素线性回归分析发现,男性血浆中Hcy水平与CRAE(β=-0.132)、CRVE(β=-0.136)均有相关性(均为P<0.05)。结论 CRAE和CRVE均随着血浆中Hcy水平的增加而变窄,而这种现象似乎只发生在男性人群中。Objective To investigate the relationship between the level of plasma homocysteine(Hcy) and retinal vessel diameter in middle-aged and elderly people.Methods This study was a cross-sectional study,and the subjects were from the Kailuan study in 2012-2013(age≥40 years).Totally 3447 individuals had an analytical results of fundus color check.The retinal vascular diameter was analyzed by software and 3401 individuals were finally included in the statistical analysis.The effects of plasma Hcy on central retinal artery equivalent(CRAE),central retinal vein equivalent(CRVE) and arteriovenous ratio(AVR) were analyzed.The baseline Hcy level was divided into four sub-groups by quartiles,and Logistic regression was used to analyze the effects of different Hcy groups on AVR.Results Totally 3401 individuals were selected in this study,including 1910 males and 1491 females.The mean age was(56.81±10.17)years.The value of Hcy was(0.09-70.6)(15.27±9.11)mmol·L^-1,CRAE was(174.29±24.59)μm,CRVE was(281.74±28.66)μm and AVR was(0.62±0.11),respectively.The quartiles of Hcy were 9.50 mmol·L^-1,13.30 mmol·L^-1 and 18.20 mmol·L^-1,respectively.Spearman correlation analysis showed that Hcy was negatively correlated with CRAE(r=-0.125,P<0.001),CRVE(r=-0.093,P<0.001),and AVR(r=-0.050,P=0.004).Multivariate linear regression analysis showed that Hcy was a risk factor of CRAE(β=-0.147) and CRVE(β=-0.120)(both P<0.05).Logistic regression analysis of the effects of different Hcy level on AVR showed that it was not a risk factor for AVR.After gender stratification,further multivariate linear regression analysis showed that plasma Hcy was a risk factor for CRAE(β=-0.132)and CRVE(β=-0.136)in male person(both P<0.05).Conclusion CRVE and CRVE get narrow with the increase of plasma Hcy levels and this phenomenon seems to occur only in the male population.

关 键 词：同型半胱氨酸 视网膜中央动脉直径 视网膜中央静脉直径 动静脉比 

分 类 号：R774[医药卫生—眼科]