上海农村社区老年人高同型半胱氨酸血症患病率及其相关因素

目的 研究上海市农村社区老年人群高同型半胱氨酸血症(hyperhomocysteinemia,HHcy)的患病率和分布特征,并分析其主要相关因素。方法 以上海市浦东新区大团社区≥60岁老年人群为研究对象,通过横断面调查检测其血浆同型半胱氨酸(homocysteine,Hcy)水平及分布特征,并采用多因素非条件Logistic回归分析影响Hcy水平的高危因素。结果 在1 621例≥60岁的老年人群中,男性血浆Hcy平均水平高于女性［(15.72±9.22) μmol/L vs.(14.08±7.55) μmol/L,P<0.001］,男性HHcy患病率高于女性(43.6% vs.29.5%,P<0.001)。<70岁、70~80岁、>80岁的老年人血浆Hcy值分别为(13.75±5.43)、(15.26±9.72)和(15.55±9.12) μmol/L(P=0.001)；HHcy患病率分别为23.9%、40.5%和46.3%(P<0.001)。吸烟组和不吸烟组Hcy水平分别为(16.14±8.05)和(14.60±8.31) μmol/L(P=0.037),HHcy患病率分别为44.9%和34.2%(P=0.011)。高血压组和无高血压组Hcy水平分别为(15.24±9.72)和(14.20±6.42) μmol/L(P=0.012),HHcy患病率分别为39.7%和30.3%(P<0.001)。多因素Logistic回归分析表明,性别、年龄和高血压是HHcy的危险因素,优势比(odds ratio,OR)分别为1.92(95%CI为1.46～2.54,P<0.001)、1.89(95%CI为1.55～2.29,P<0.001)和1.57(95%CI为1.20～2.05,P=0.001)。结论 上海大团社区老年人群中Hcy血浆水平存在性别、年龄差异,HHcy的危险因素包括性别、年龄和高血压。
Objective To explore the prevalence and distribution characteristics of hyperhomocysteinemia (HHcy) of the elderly population in a rural community of Shanghai, and to analyze its related risk factors. Methods A cross-sectional survey on the level and distribution characteristics of plasma homocysteine (Hcy) was conducted in the elderly (≥60 years) in Datuan community of Shanghai. Multi-factor non-conditional logistic regression was used to analyze the risk factors of Hcy level. Results A total of 1 621 elderly people were enrolled in this study. The plasma Hcy level in the male was higher than that in the female, and the difference was statistically significant ［(15.72± 9.22) μmol/L vs.(14.08 ± 7.55) μmol/L, P<0.001］, while the prevalence of HHcy in the male was higher than that in the female (43.6% vs.29.5%,P<0.001). The plasma Hcy levels in the different age groups of ＜70 years, 70-80 years and ＞80 years were (13.75± 5.43), (15.26 ± 9.72) and (15.55± 9.12) μmol/L(P=0.001), while the prevalences of HHcy were 23.9%, 40.5% and 46.3%, respectively (P<0.001). The plasma Hcy levels in the groups with and without smoke were (16.14±8.05) and (14.60±8.31) μmol/L (P=0.037), while the prevalences of HHcy were 44.9% and 34.2%, respectively (P=0.011). The plasma Hcy levels in the groups with and without hypertension were (15.24 ± 9.72) and (14.20 ± 6.42) μmol/L (P=0.012), while the prevalences of HHcy were 39.7% and 30.3%, respectively (P<0.001). The Logistic regression showed that gender, age and hypertension were risk factors for HHcy with the odds ratio (OR) of 1.92 (95%CI: 1.46-2.54, P<0.001), 1.89 (95%CI: 1.55-2.29, P<0.001) and 1.57 (95%CI: 1.20-2.05, P=0.001), respectively. Conclusions Plasma Hcy level had