摘要目的 分析血清同型半胱氨酸(Hcy)与代谢综合征(MS)间的关系.方法 1680名北京市社区居民纳入调查.MS依据NCEP-ATP Ⅲ标准定义.以多因素logistic回归分析计算MS发病危险比值比(OR),多元线性回归分析Hcy与各指标间的相关关系.结果 校正性别、年龄后MS组Hcy水平高于非MS组(17.99 μmol/Lvs.17.18 μmol/L,P=0.007),随着MS组分由0个增加至4或5个,Hcy水平逐渐升高为16.71、16.94、17.62、18.20和17.82 μmol/L(线性趋势P=0.044).MS的5个组分中,表现为腹型肥胖、高血压和高甘油三酯血症者,其Hcy水平相应较高.多元logistic回归分析显示,Hcy最高四分位水平(Hcy Ⅳ)与MS发生相关.校正年龄、性别、肌酐、肾小球滤过率(eGFR)、低密度脂蛋白胆固醇(LDL-C)、尿酸、吸烟、饮酒、运动等因素后,与Hcy最低四分位水平(Hcy Ⅰ)相比,HcyⅣ的MS发生风险OR=1.379(1.005～1.892).排除性别及年龄因素,偏相关分析显示Hcy与体重指数(BMI)、腰围、血压、LDL-C、甘油三酯、尿酸、肌酐、eGFR呈正相关,与高密度脂蛋白胆固醇呈负相关.多元线性回归分析显示,年龄、男性、BMI、LDL-C、肌酐、尿酸与Hcy水平呈独立正相关.结论 高Hcy水平是MS发生的相关因素,Hcy与年龄、男性、BMI、LDL-C、肌酐、尿酸独立相关.

abstractsObjective To explore the relationship between serum homocysteine and metabolic syndrome (MS).Methods A cohort with 1680 people involved in a community-based population in Beijing was investigated.Metabolic syndrome was defined by NCEP-ATP Ⅲ criteria.Multivariate logistic regression analysis was used to estimate the odds ratios (OR) of MS.Multiple linear regression analysis was performed to analyze the association between Hcy and characteristic variables.Results Homocysteine was higher in MS population compared to those without MS ( 17.99 μmol/L vs.17.18 μmol/L,P=0.007) after adjusted for age and sex.Levels of homocysteine increased with the presence of MS components (from 0 to 4 or 5) (16.71,16.94,17.62,18.20,17.82 μmol/L respectively,P=0.044 for linear trend).Among the components,groups with larger waist circumference,higher blood pressure and triglycerides showed significantly higher Hcy level than their counterparts.Results from multiple logistic regression analysis revealed that the highest Hcy quartile (Hcy Ⅳ ) was significantly associated with MS.Compared with the lowest Hcy quartile (Hcy Ⅰ ),the adjusted odds ratio of having MS in HcyⅣ was 1.379(1.005-1.892) after adjusting for age,sex,levels on creatinine/estimated glomerular filtration rate (eGFR)/low-density lipoprotein cholesterol (LDL-C) and uric acid,smoking,alcohol intake and exercise.In the partial correlation analyses,Hcy was positively associated with body mass index (BMI),waist circumsternece,blood pressure,LDL-C,triglycerides (TG),uric acid,serum creatinine,eGFR,but inversely associated with high-density lipoprotein cholesterol (HDL-C) and independently with age and sex.In multiple linear regression analysis,age,male sex,BMI,LDL-C,creatinine and uric acid were found to be independently associated with Hcy level.Conclusion There was an association noticed between the MS using NCEP-ATP Ⅲ criteria and the highest quartile level of Hcy in this study.Factors as age and being male,the levels of BMI,LDL-C,creatinine and uric acid were independently associated with the Hcy level.