绝经前后女性血浆同型半胱氨酸水平及相关因素研究  

Plasma homocysteine level and related factors in premenopausal and postmenopausal women

作　　者：王园园 黄艺舟 宁玉梅 许凌 WANG Yuanyuan;HUANG Yizhou;NING Yumei;XU Ling(Zhejiang Maternal Child and Reproductive Health Center,Zhejiang Hangzhou 310012,China;Women’s Hospital School of Medicine Zhejiang University,Zhejiang Hangzhou 310006,China)

机构地区：[1]浙江省妇幼和生殖保健中心,浙江杭州310012 [2]浙江大学医学院附属妇产科医院,浙江杭州310006

出　　处：《中国妇幼健康研究》2022年第4期6-12,共7页Chinese Journal of Woman and Child Health Research

基　　金：国家卫生健康委科学研究基金(WKJ-ZJ-1921)。

摘　　要：目的了解女性绝经前后血浆同型半胱氨酸(Hcy)水平的分布特点及其与性激素、代谢指标等的相关性,探究影响女性高同型半胱氨酸血症(HHcy)发生的相关因素。方法选取2018年1月至2019年12月于杭州师范大学附属医院妇科就诊的622例40~69岁女性为研究对象,收集其Hcy、性激素、空腹血糖及脂质代谢等指标,比较绝经前后Hcy水平及HHcy发生率间的差异,分析Hcy水平及HHcy发生与各代谢指标间的关系,并采用Logistic回归分析影响HHcy发生的相关因素。结果绝经妇女Hcy水平(Z=-4.796,P<0.05)和HHcy发生率(χ^(2)=18.913,P<0.05)均显著高于未绝经妇女。HHcy组妇女的E2、T水平低于Hcy正常组(Z值分别是-2.62、-2.02,P<0.05),FSH、LH、HDL-C水平高于Hcy正常组(Z值分别是-4.82、-4.95、-2.01,P<0.05),差异有统计学意义。相关分析显示,Hcy水平及HHcy的发生与年龄、FSH、LH呈正相关(r_(Hcy)值分别是0.198、0.188、0.193;r_(HHcy)值分别是0.149、0.158、0.162,P<0.05),与T、E_(2)呈负相关(r_(Hcy)值分别是-0.110、-0.040;r_(Hcy)值分别是-0.067、-0.087,P<0.05)。多因素Logistic回归分析显示,FSH≥40 IU/L的女性发生HHcy的风险是FSH<40IU/L者的2.01倍(OR=2.01,95%CI:1.14~3.54)。结论与绝经前相比,绝经后女性的Hcy水平升高,HHcy发生率亦升高,绝经后女性FSH水平升高可能是导致HHcy发生的危险因素之一,建议增加对围绝经期及绝经后女性Hcy指标的检查和HHcy的筛查,及早对其进行健康指导和临床干预,控制心血管疾病的风险。Objective To understand the distribution characteristics of plasma homocysteine (Hcy) level in premenopausal and postmenopausal women and the correlations with sex hormones, metabolic indexes and other indicators, and to explore the related factors of hyperhomocysteinemia (HHcy) in women. Methods A total of 622 women aged 40-69 years old, who were hospitalized in the Affiliated Hospital of Hangzhou Normal University from January 2018 to December 2019, were the subjects. Their Hcy, sex hormones, fasting blood glucose and lipid metabolism and other indicators levels were collected. The differences in Hcy levels and HHcy incidences were compared between the premenopausal and the postmenopausal women. The correlations of Hcy level, HHcy incidence and various metabolic indicators were analyzed. Logistic regression analysis was performed to analyze the related factors of HHcy. Results For postmenopausal women, the Hcy level (Z=-4.796, P<0.05) and HHcy incidence (χ^(2)=18.913, P<0.05) were both significantly higher than those of premenopausal women. The E2 and T levels of the HHcy group were lower than those of the normal Hcy group (Z=-2.62 and -2.02, respectively, P<0.05), while the FSH, LH, HDL-C levels were higher than those of the normal Hcy group, and the differences were statistically significant (Z=-4.82,-4.95 and -2.01, respectively, P<0.05). Correlation analysis showed that Hcy level and HHcy incidence were positively correlated with age, FSH and LH (r_(Hcy)=0.198, 0.188, and 0.193, respectively, r_(HHcy)=0.149, 0.158, and 0.162, respectively, P<0.05), negatively correlated with T and E2 (r_(Hcy)=-0.110 and -0.040, respectively, r_(HHcy)=-0.067 and -0.087, respectively, P<0.05). The multivariate logistic regression analysis showed that women with FSH≥40 IU/L had 2.01 times higher risk of HHcy than women with FSH<40 IU/L (OR=2.01, 95%CI:1.14-3.54). Conclusion The Hcy level and HHcy incidence of postmenopausal women are increased compared to those of premenopausal women. The increased FSH level in postmenopaus

关 键 词：同型半胱氨酸 绝经 围绝经期 性激素 心血管疾病 影响因素 

分 类 号：R173[医药卫生—妇幼卫生保健]