高原藏族居民血浆同型半胱氨酸水平与血脂不同组分及血脂异常的关系  

Association Between Plasma Homocysteine Level and Different Components of Blood Lipid and Dyslipidemia in Tibetan Residents at high Altitude

作　　者：索朗德吉 次仁仲嘎 尼玛 Suolang-Deji;Ciren-Zhongga;Nima(Department of Internal Medicine-Cardiovascular,Lhasa People’s Hospital,Lhasa 850000,China)

机构地区：[1]拉萨市人民医院心内科,西藏拉萨850000

出　　处：《高原科学研究》2021年第3期38-45,共8页Plateau Science Research

基　　金：西藏地区H型高血压流行病学调查研究(XZ2017ZY02).

摘　　要：目的:探讨高原地区藏族居民血浆同型半胱氨酸(tHcy)与血脂不同组分以及血脂异常的关系。方法:2017年10月至2019年6月通过问卷调查方法采集来自西藏六个不同海拔地区1743名藏族人群的人口学特征,病史信息及个人生活方式资料;采用日立7600型全自动生化分析仪检测空腹血糖、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)等指标;使用电化学发光法测量tHcy水平;多因素回归分析tHcy对TC、TG、LDL-C、HDL-C的影响;利用方差分析进行相关因素的交互作用检验。结果:研究对象平均年龄为(47.0±14.7)岁,其中女性1027名(58.9%),男性716名(41.1%);tHcy以及TG中位数(P25∼P75)为14.7(11.6∼18.6)μmol/L和1.0(0.8∼1.4)mmol/L。tHcy浓度<10μmol/L者占12.9%(225人),10∼15μmol/L者占39.0%(680人),≥15μmol/L者占48.1%(838人)。多因素回归结果显示,不同性别人群的lnHcy与TC、TG逆正态变换以及血脂异常的关系存在交互作用;在女性中,lnHcy每增加1,TC和LDL-C分别增加0.41 mmol/L和0.29 mmol/L,TGtrans增加0.28,血脂异常风险增加174%;不同海拔人群的lnHcy与TC、LDL-C以及血脂异常的关系存在交互作用;在海拔3000∼4000 m人群中,lnHcy每增加1,TC和LDL-C分别增加0.30 mmol/L和0.23 mmol/L,TGtrans增加0.18,血脂异常风险增加157%(P<0.05)。结论:高原藏族居民中,tHcy水平与TC、TG以及LDL-C呈正相关,随着tHcy水平的升高,TC、TG以及LDL-C水平也升高,合并血脂异常的风险增加,性别以及海拔对tHcy与血脂异常的关系存在修饰作用,提示女性及高海拔地区的藏族居民,更应该关注tHcy对血脂异常的影响。Objective:To investigate the relationship between plasma total homocysteine(tHcy)and different components of blood lipids and dyslipidemia in Tibetan residents in high altitude area.Methods:From October 2017 to June 2019,the demographic characteristics,medical history information and personal lifestyle data of 1743 people from six different altitudes in Tibet were collected by questionnaire,Hitachi 7600 automatic bio⁃chemical analyzer was used to detect fasting blood glucose,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C),The level of tHcy was mea⁃sured by electrochemistry-Luminescence method;The effects of tHcy on TC,TG,LDL-C and HDL-C were ana⁃lyzed by multivariate regression;Analysis of variance was used to test the interaction of related factors.Results:The average age of the subjects was(47.0±14.7)years,including 1027 women(58.9%)and 716 men(41.1%);The median of tHcy and TG(P25∼P75)was 14.7(11.6∼18.6)μmol/L and 1.0(0.8∼1.4)mmol/L.THcy con⁃centration<10μmol/L accounted for 12.9%(225 people),10~15μmol/L accounted for 39.0%(680 people),≥15μmol/L accounted for 48.1%(838).The results of multivariate regression showed that there was interaction between lnhcy and TC,TG inverse normal transformation and dyslipidemia in different gender groups,In women,for each increase of lnhcy,TC and LDL-C increased by 0.41 mmol/L and 0.29 mmol/L respectively,TGtrans in creased by 0.28 respectively,and the risk of dyslipidemia increased by 174%;There was interaction between ln⁃hcy and TC,LDL-C and dyslipidemia in people at different altitudes(P values of interaction were 0.021,0.038 and 0.030,respectively),In the population at an altitude of 3000∼4000 m,TC and LDL-C increased by 0.30 mmol/L and 0.23 mol/L,TGtrans increased by 0.18,the risk of dyslipidemia increased by 157%for each in⁃crease of lnHcy(P<0.05).Conclusion:Among Tibetan residents in high altitude,the level of tHcy is positively correlated with TC,TG and LDL-C.With

关 键 词：同型半胱氨酸 血脂异常 藏族 低密度脂蛋白胆固醇 高密度脂蛋白胆固醇 

分 类 号：R749.16[医药卫生—神经病学与精神病学]